Keramat Kar Maryam, Whitehead Lisa, Smith Catherine M
a Centre for Postgraduate Nursing Studies , University of Otago , Christchurch , New Zealand.
b Faculty of Nursing & Midwifery , Qazvin University of Medical Sciences , Qazvin , Iran.
Disabil Rehabil. 2019 Feb;41(3):250-264. doi: 10.1080/09638288.2017.1387295. Epub 2017 Oct 10.
The purpose of this systematic review was to examine coping strategies that people with multiple sclerosis use, and to identify factors that influence their coping pattern.
This systematic review followed the Joanna Briggs Institute guidelines for synthesizing descriptive quantitative research. The following databases were searched from the inception of databases until December 2016: Ovid (Medline, Embase, CINAHL, and PsycINFO), Science Direct, Web of Science, and Scopus. Manual search was also conducted from the reference lists of retrieved articles. Findings related to the patterns of coping with multiple sclerosis and factors influencing coping with multiple sclerosis were extracted and synthesized.
The search of the database yielded 455 articles. After excluding duplicates (n = 341) and studies that did not meet the inclusion criteria (n = 27), 71 studies were included in the full-text review. Following the full-text, a further 21 studies were excluded. Quality appraisal of 50 studies was completed, and 38 studies were included in the review. Synthesis of findings indicated that people with multiple sclerosis use emotional and avoidance coping strategies more than other types of coping, particularly in the early stages of the disease. In comparison to the general population, people with multiple sclerosis were less likely to use active coping strategies and used more avoidance and emotional coping strategies. The pattern of coping with multiple sclerosis was associated with individual, clinical and psychological factors including gender, educational level, clinical course, mood and mental status, attitude, personality traits, and religious beliefs.
The findings of this review suggest that considering individual or disease-related factors could help healthcare professionals in identifying those less likely to adapt to multiple sclerosis. This information could also be used to provide client-centered rehabilitation for people living with multiple sclerosis based on their individual responses and perceptions for coping. Implications for rehabilitation Engagement in coping with multiple sclerosis has been associated with individual factors and neuropsychological functions. Considering individual and disease-related factors would allow healthcare professionals to provide more tailored interventions to maintain and master coping with multiple sclerosis. People living with multiple sclerosis should be empowered to appraise and manage ability to cope based on the contextual evidence (individual and clinical condition). Rehabilitation services should move beyond physical management incorporating behavioral aspects for better functioning in living with multiple sclerosis.
本系统评价旨在探讨多发性硬化症患者所采用的应对策略，并确定影响其应对模式的因素。
本系统评价遵循乔安娜·布里格斯研究所关于综合描述性定量研究的指南。从数据库创建至2016年12月，检索了以下数据库：Ovid（医学索引、Embase、护理学与健康领域数据库、心理学文摘数据库）、科学Direct、科学引文索引和Scopus。还从检索到的文章的参考文献列表中进行了手工检索。提取并综合了与多发性硬化症应对模式及影响多发性硬化症应对的因素相关的研究结果。
数据库检索得到455篇文章。排除重复文章（n = 341）和不符合纳入标准的研究（n = 27）后，71项研究纳入全文综述。经过全文筛选，又排除了21项研究。完成了50项研究的质量评估，38项研究纳入本综述。研究结果综合表明，多发性硬化症患者比其他类型的应对方式更多地采用情绪和回避应对策略，尤其是在疾病早期。与普通人群相比，多发性硬化症患者较少采用积极应对策略，而更多地采用回避和情绪应对策略。多发性硬化症的应对模式与个体、临床和心理因素相关，包括性别、教育水平、临床病程、情绪和精神状态、态度、人格特质和宗教信仰。
本综述的结果表明，考虑个体或疾病相关因素有助于医疗保健专业人员识别那些不太可能适应多发性硬化症的患者。这些信息还可用于根据多发性硬化症患者的个体应对反应和认知，为其提供以患者为中心的康复治疗。对康复的启示应对多发性硬化症与个体因素和神经心理功能有关。考虑个体和疾病相关因素将使医疗保健专业人员能够提供更具针对性的干预措施，以维持和掌握应对多发性硬化症的能力。应使多发性硬化症患者有能力根据情境证据（个体和临床状况）评估和管理应对能力。康复服务应超越身体管理，纳入行为方面，以更好地应对多发性硬化症患者的生活。
