Article

Multiple Sclerosis (MS) is a progressive neurological disease
characterized by an unpredictable risk to develop relevant disability over time.
Few studies focused on the core psychological features of difficulties in
adjustment to MS. This qualitative study aims to explore the illness experience
of people with difficulties in adjustment to MS, paying more attention to both
illness representation and shifting perspective. METHOD: Nineteen persons with
difficulties in adjustment to MS participated in the study and their interviews
were analyzed using thematic analysis. RESULTS: Considering the Shifting
Perspective Model, illness is rigidly placed in the foreground, and wellness
decisively pushed in the background, with a lack of flexibility in shifting
between the two perspectives. The thematic analysis delineated three main topics:
illness representation; coping strategies; relationships with others. The illness
representation is characterized by invalidating symptoms; unclear cause; sudden
onset; unpredictable course and uncertain prognosis; severe impact on person's
functioning; and low sense of internal control. Participants reported to mainly
use emotion-focused coping strategies. CONCLUSIONS: Adjustment can be supported
activating psychological intervention addressed to patients' illness
representations and more flexibility in the shifting between illness and wellness
in the foreground. Implications for Rehabilitation Adjustment to MS is influenced
by illness perception. It is important to pay more attention to contents about
vulnerability and unpredictability associated to MS. With regards to the Shifting
Perspectives Model, difficulties in adjustment are related to the rigidity that
prevents an adequate shift between the two perspectives (illness and wellness),
with the predominance of the illness perspective in the foreground. Hence, it is
important to assess the shifting perspectives preference and flexibility, and the
contents of illness representation of a person with MS. Clinicians can support
process of adjustment, activating psychological intervention addressed to
patients' illness representations and promotion of a more flexibility in the
shifting between illness and wellness in the foreground. The Illness
Representation Model should be enriched by a social component, able to take into
consideration the impact of the disease on interactions with others.

Langue : ANGLAIS