scholarly journals Dating and attachment among single women with multiple sclerosis

2021 ◽  
Author(s):  
Danielle Blackmore
Keyword(s):  
Multiple Sclerosis ◽  
Body Esteem ◽  
The United States ◽  
Single Women ◽  
Older Age ◽  
Insecure Attachment ◽  
Sexual Esteem ◽  
Illness Duration ◽  
Disability Severity ◽  
The Impact

The present study investigated the dating experiences of single women living with multiple sclerosis (MS). The present research used a mixed methods approach, with the quantitative component examining the role of disability severity, insecure attachment (avoidant and anxious), age, illness duration, depression, body esteem, sexual esteem, and attractiveness on dating experiences among 99 single women living with MS. Participants were recruited through MS societies in Canada and the United States. Regression analyses showed that overall, greater disability severity, longer illness duration, greater insecure attachment, lower sexual esteem and lower perceived attractiveness were predictive of worse dating experiences and more barriers to dating. Dating experiences were similar across ages. The second component of the study consisted of qualitative interviews with 12 women (half in a younger and half in an older age group), which were completed individually by telephone. The qualitative approach borrowed from a phenomenological lens and interviews were coded to explore the dating experiences of the women. Across the younger and older age groups, participants identified barriers to dating, coping strategies, negative cognitions about dating with MS, concerns regarding disclosure of MS, and impact of MS on body and sexual esteem. Some age related differences in dating were noted, such as concerns about pregnancy. The current research highlights the importance of conducting further research into the impact of MS on dating and in exploring potential interventions to help support women many of whom endorsed encountering various barriers to dating when living with MS.

scholarly journals Dating and attachment among single women with multiple sclerosis

2021 ◽  
Author(s):  
Danielle Blackmore
Keyword(s):  
Multiple Sclerosis ◽  
Body Esteem ◽  
The United States ◽  
Single Women ◽  
Older Age ◽  
Insecure Attachment ◽  
Sexual Esteem ◽  
Illness Duration ◽  
Disability Severity ◽  
The Impact

The present study investigated the dating experiences of single women living with multiple sclerosis (MS). The present research used a mixed methods approach, with the quantitative component examining the role of disability severity, insecure attachment (avoidant and anxious), age, illness duration, depression, body esteem, sexual esteem, and attractiveness on dating experiences among 99 single women living with MS. Participants were recruited through MS societies in Canada and the United States. Regression analyses showed that overall, greater disability severity, longer illness duration, greater insecure attachment, lower sexual esteem and lower perceived attractiveness were predictive of worse dating experiences and more barriers to dating. Dating experiences were similar across ages. The second component of the study consisted of qualitative interviews with 12 women (half in a younger and half in an older age group), which were completed individually by telephone. The qualitative approach borrowed from a phenomenological lens and interviews were coded to explore the dating experiences of the women. Across the younger and older age groups, participants identified barriers to dating, coping strategies, negative cognitions about dating with MS, concerns regarding disclosure of MS, and impact of MS on body and sexual esteem. Some age related differences in dating were noted, such as concerns about pregnancy. The current research highlights the importance of conducting further research into the impact of MS on dating and in exploring potential interventions to help support women many of whom endorsed encountering various barriers to dating when living with MS.

scholarly journals Effect of Multiple Sclerosis on Daily Activities, Emotional Well-being, and Relationships

2019 ◽  
Vol 22 (4) ◽  
pp. 158-164
Author(s):  
Ann D. Bass ◽  
Bart Van Wijmeersch ◽  
Lori Mayer ◽  
Mathias Mäurer ◽  
Aaron Boster ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Online Survey ◽  
Well Being ◽  
The United States ◽  
Muscle Stiffness ◽  
Daily Activities ◽  
Cold Sensitivity ◽  
Negative Effects ◽  
Negative Effect ◽  
The Impact

Abstract Background: The vsMS survey was conducted to better understand the negative effects of fatigue, cognitive impairment, emotional burden, and decreased physical functioning on the personal, professional, and social lives of individuals with multiple sclerosis (MS). Methods: The vsMS survey was an online survey conducted in Australia, Canada, France, Italy, Spain, the United Kingdom, and the United States that assessed the impact of MS on individuals’ daily activities, emotional well-being, relationships, and employment. Results: The survey included 1075 participants with relapsing-remitting MS. Almost 42% of participants reported that their ability to perform and manage daily activities had worsened during the previous 2 years. More than 50% reported limitations in daily activities due to fatigue, physical weakness, problems with balance/coordination, heat/cold sensitivity, memory problems, numbness/tingling, trouble concentrating, impaired movement/muscle stiffness, and impaired sleeping. Participants also reported a negative effect on emotional and social factors, including self-esteem, general outlook, well-being, maintaining/starting relationships, ability to progress in their career/keep their job, and ability to cope with life roles. Conclusions: These data highlight the importance of addressing the impact of MS and the social and emotional disease burdens on daily activities when planning the care of patients with MS.

Differential Vocational Rehabilitation Service Patterns Related to the Job Retention and Job-Seeking Needs of Individuals With Multiple Sclerosis

2015 ◽  
Vol 29 (2) ◽  
pp. 109-121 ◽  
Author(s):  
Timothy N. Tansey ◽  
David Strauser ◽  
Michael P. Frain ◽  
Malachy Bishop ◽  
Chung-Yi Chiu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Vocational Rehabilitation ◽  
Health Care Professionals ◽  
The United States ◽  
Job Placement ◽  
Rehabilitation Service ◽  
Job Seeking ◽  
Vocational Rehabilitation Service ◽  
The Impact ◽  
To Receive

The experience of living with multiple sclerosis (MS) can have a profound effect on employment. The impact of MS is a complex interaction of personal, medical, functional, financial, and psychosocial variables that ultimately results in up to 80% of persons with MS leaving their jobs within 10 years of their diagnosis. The aim of this study was to investigate whether the employment status of applicants with MS who were seeking services from state vocational rehabilitation (VR) agencies could be classified based on the type of services provided. A quantitative descriptive research design employing discriminant analysis (DA) was used to determine differential services received by employed and unemployed applicants with MS. Findings indicate that persons with MS who were employed at application were more likely to receive services geared toward career stabilization (i.e., assistive technology/accommodation services, counseling and guidance, and cognitive retraining-type rehabilitative services). Conversely, the unemployed applicant group had a higher propensity to receive services focused on job placement (i.e., job readiness, job seeking, and job placement services). Although a disparity persisted between the average worker in the United States and the outcomes achieved by VR service recipients regarding weekly wages and hours, services provided by the state-federal VR program reduce this disparity. In addition, the return on investment (ROI) associated with providing services to persons with MS was calculated as providing an $8 return for every dollar spent. Persons with MS employed at application had an ROI of more than $10 for every dollar spent. Implications for persons with MS, rehabilitation counselors, health care professionals, and policymakers are provided.

The myth of independence for older Americans living alone in the Bay Area of San Francisco: a critical reflection

2011 ◽  
Vol 31 (5) ◽  
pp. 803-828 ◽  
Author(s):  
ELENA PORTACOLONE
Keyword(s):  
San Francisco ◽  
Participant Observation ◽  
International Comparisons ◽  
The United States ◽  
Older Age ◽  
Living Alone ◽  
Older Americans ◽  
Bay Area ◽  
The Impact ◽  
At Home

ABSTRACTRemaining at home in older age is generally considered a sign of independence and therefore an important achievement. More than five million Americans aged over 75 years live alone, a number that is destined to increase thanks to advances in longevity. Living alone can allow the expression of one's preferences, but it can also bring out hardships hardly visible to outsiders, especially in an individualistic society such as the United States of America that rewards self-sufficiency. According to the sociologist Rose, in neo-liberal societies citizens have a duty to be free, self-reliant and independent. In this paper, Rose's theory and the political economy perspective serve as frameworks by which to examine how discourses around independence are translated in the experiences of 22 older adults aged over 75 living at home alone in the Bay Area of San Francisco. Participant observation and 41 in-depth interviews from 2006 to 2010 illustrate how being independent can be an essential component of individual identities. The informants' narratives shed light on the impact of policies that facilitate or regulate the moral imperative of independence. The findings underline the need to assess how discourses around independence are translated in minority populations, to promote studies and initiatives on interdependence, and to encourage international comparisons on living alone in older age.

scholarly journals Desired Resources for Changing Diet Among Persons with Multiple Sclerosis: Qualitative Inquiry Informing Future Dietary Interventions

2021 ◽  
Author(s):  
Stephanie L. Silveira ◽  
Emma V. Richardson ◽  
Robert W. Motl
Keyword(s):  
Multiple Sclerosis ◽  
Behavior Change ◽  
Dietary Behavior ◽  
The United States ◽  
Dietary Change ◽  
Qualitative Inquiry ◽  
Dietary Interventions ◽  
Self Monitoring ◽  
The Impact ◽  
Dietary Behavior Change

Abstract Background: There are approximately 1 million adults in the United States with multiple sclerosis (MS). Persons with MS are interested in diet as a second-line therapy for improving MS symptoms and disease progression. Examination of desired resources regarding diet among persons with MS is necessary for supporting behavior change. Methods: Twenty-five adults with MS completed one-on-one, online semistructured interviews. An inductive, six-phase, semantic thematic analysis was applied for identifying themes associated with participant preferences for dietary behavior change. Results: The research team crafted four key themes from the data that encompassed participants’ desired resources for dietary behavior change. Theme 1, MS-specific evidence, involved the need for clear information about the impact of diet regimens or specific foods on MS. Theme 2, dietary guidelines, was related to guidelines provided by a reliable source such as a registered dietitian. Theme 3, behavioral supports, underscored the need for support for behavior change, including accountability, self-monitoring, motivation, habituation, and incremental changes. Theme 4, diet resources, highlighted tangible resources for supporting dietary change, including recipes, food lists, meal services, or games. Conclusions: This study provides a foundation for guiding dietary interventions for persons with MS that incorporates their needs and preferences and could improve their overall health. Such dietary change can be facilitated by theory-based behavioral interventions that incorporate behavior change techniques such as self-monitoring and goal setting for supporting behavior change.

Age is a critical determinant in recovery from multiple sclerosis relapses

2018 ◽  
Vol 25 (13) ◽  
pp. 1754-1763 ◽  
Author(s):  
Brittani L Conway ◽  
Burcu Zeydan ◽  
Uğur Uygunoğlu ◽  
Martina Novotna ◽  
Aksel Siva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Transverse Myelitis ◽  
Functional System ◽  
Population Based ◽  
Older Age ◽  
Impact Model ◽  
Critical Determinant ◽  
Effect Change ◽  
County Population ◽  
The Impact

Objective: To evaluate the impact of age on recovery from multiple sclerosis relapses. Background: Increasing disability in multiple sclerosis is a consequence of progressive disease and incomplete relapse recovery. Methods: The first and last-ever relapse data (357 relapses in 193 patients) from the Olmsted County population-based multiple sclerosis cohort were systematically reviewed for age, fulminance, location (optic nerve, brainstem/cerebellar, spinal cord), peak deficit, and maximum recovery. Three different relapse-outcome measures were studied both as paired analyses and as an overall group effect: change from peak deficit to maximum recovery in raw functional system score related to the relapse (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. Results: Older age was linearly associated with worse recovery in the ΔFSS outcome ( p = 0.002), ΔEDSS outcome ( p < 0.001), and the FSS-based relapse-impact model ( p < 0.001). A multivariate analysis of ΔFSS outcome linked poor recovery to older age ( p = 0.015), relapse location (transverse myelitis or brainstem/cerebellar syndrome; p < 0.001), and relapse fulminance ( p = 0.004). Conclusion: Multiple sclerosis-relapse recovery declines in a linear fashion with increased age, which should be considered when making treatment decisions.

scholarly journals The Impact of Disease-Modifying Therapy Access Barriers on People With Multiple Sclerosis: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Kristina F Simacek ◽  
John J Ko ◽  
Debbie Moreton ◽  
Stefan Varga ◽  
Kristen Johnson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Methods ◽  
Financial Burden ◽  
The United States ◽  
Insurance Companies ◽  
Access Barriers ◽  
Web Based ◽  
Disease Modifying ◽  
The Impact

BACKGROUND In the United States, people with relapsing-remitting multiple sclerosis (RRMS) can face difficulty accessing disease-modifying therapies (DMTs) because of insurance, pharmacy, or provider policies. These barriers have been associated with poor adherence and negative health outcomes. OBJECTIVE The goals of this study were to describe the overall occurrence of difficulties and delays associated with gaining access to DMTs among people with RRMS, to assess DMT adherence during periods of reduced access, and to contextualize the patients’ journey from receipt of a prescription for DMT to obtaining and taking their medication when faced with access barriers. METHODS We recruited US-based adults self-reporting RRMS from a Web-based health data-sharing social network, PatientsLikeMe. Individuals were invited to complete a Web-based survey if they reported a diagnosis of RRMS and were prescribed a DMT for MS. Follow-up phone interviews were conducted with 10 respondents who reported experiencing an MS-related relapse during the time they had experienced challenges accessing DMTs. RESULTS Among 507 survey completers, nearly half were either currently experiencing an issue related to DMT assess or had difficulty accessing a DMT in the past (233/507, 46.0%). The most frequently reported reasons for access difficulty were authorization requirements by insurance companies (past issues: 78/182, 42.9%; current issues: 9/42, 21%) and high out-of-pocket costs (past issues: 54/182, 29.7%; current issues: 13/42, 31%). About half (20/39, 51%) of participants with current access issues and over a third (68/165, 41.2%) of those with past issues went without their medication until they could access their prescribed DMT. Relapses were reported during periods of reduced DMT access for almost half (56/118, 47.5%) of those with past issues and nearly half (22/45, 49%) of those with current issues. Resolving access issues involved multiple stakeholder agents often coordinated in a patient-led effort. Among those who had resolved issues, about half (57/119, 47.9%) reported that doctors or office staff were involved, under half (48/119, 40.3%) were involved themselves, and about a third (39/119, 32.8%) reported the drug manufacturer was involved in resolving the issue. Follow-up interviews revealed that the financial burden associated with obtaining a prescribed DMT led to nonadherence. Additionally, participants felt that DMT treatment delays and stress associated with obtaining the DMT triggered relapses or worsened their MS. CONCLUSIONS This study expands current research by using a patient-centered, mixed-methods approach to describe barriers to MS treatment, the process to resolve barriers, and the perceived impact of treatment barriers on outcomes. Issues related to DMT access occur frequently, with individuals often serving as their own agents when navigating access difficulties to obtain their medication(s). Support for resolution of DMT access is needed to prevent undue stress and nonadherence.

Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

2014 ◽  
Vol 84 (5-6) ◽  
pp. 244-251 ◽  
Author(s):  
Robert J. Karp ◽  
Gary Wong ◽  
Marguerite Orsi
Keyword(s):  
Low Income ◽  
Energy Content ◽  
Food Selection ◽  
The United States ◽  
United States Department ◽  
Micronutrient Deficiencies ◽  
Caloric Density ◽  
Low Income Families ◽  
The Cost ◽  
The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

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