The Relational Impact of Multiple Sclerosis: An Integrative Review of the Literature Using a Cognitive Analytic Framework

This integrative literature review uses cognitive analytic therapy (CAT) theory to examine the impact of a chronic illness, multiple sclerosis (MS), on relationships and mental health. Electronic searches were conducted in six medical and social science databases. Thirty-eight articles met inclusion criteria, and also satisfied quality criteria. Articles revealed that MS-related demands change care needs and alter relationships. Using a CAT framework, the MS literature was analysed, and five key patterns of relating to oneself and to others were identified. A diagrammatic formulation is proposed that interconnects these patterns with wellbeing and suggests potential “exits” to improve mental health, for example, assisting families to minimise overprotection. Application of CAT analysis to the literature clarifies relational processes that may affect mental health among individuals with MS, which hopefully will inform how services assist in reducing unhelpful patterns and improve coping. Further investigation of the identified patterns is needed

Modos de enfrentamento dos estressores de pessoas em tratamento hemodiálitico: revisão integrativa da literatura Modos de enfrentamento de los estresores de personas en tratamiento hemodialítico: revisión integrativa de la literatura Ways for people on hemodialysis to deal with stressors: a literature review

Foi realizada uma revisão integrativa da literatura com o objetivo de sintetizar a contribuição das pesquisas realizadas sobre os modos de enfrentamento das pessoas em tratamento hemodialítico. Através do levantamento bibliográfico foram identificados 12 artigos que compuseram a amostra do estudo. Os resultados apontam que os modos de enfrentamento focados no problema são mais utilizados e que a depressão se correlacionou positivamente com os modos de enfrentamento focados na emoção para pessoas em tratamento hemodialítico. A identificação dos modos de enfrentamento é informação valiosa para planejar o tratamento individualizado que proporcione controle dos estressores inerentes a doença e ao tratamento hemodialítico, subsidiando melhor adaptação do paciente ao regime terapêutico.<br>Fue realizada una revisión integrativa de la literatura con el objetivo de sintetizar la contribución de las investigaciones llevadas a cabo en relación a los modos de enfrentamiento de las personas en tratamiento hemodialítico. El levantamiento bibliográfico permitió la identificación de 12 artículos que conformaron la muestra del estudio. Los resultados señalaron que los modos de enfrentamiento centrados en el problema son más utilizados y que la depresión se correlacionó positivamente con los modos de enfrentamiento enfocados en la emoción para personas en tratamiento hemodialítico. La identificación de los modos de enfrentamiento constituye información valiosa para planificar el tratamiento individualizado que proporcione control de los estresores inherentes a la enfermedad y al tratamiento hemodialítico, favoreciendo una mejor adaptación del paciente al régimen terapéutico.<br>An integrative literature review was performed with the purpose to synthesize the contribution brought by research on the ways that people on hemodialysis deal with the treatment. Through a bibliographic review, 12 articles were identified, which composed the study sample. The results point out that problem-focused coping are the most used and that depression was positively correlated with the forms of emotion-focused coping for people on hemodialysis. The identification of the forms of dealing with the treatment is valuable information to plan treatments individually so as to control the stressors inherent to the disease and to hemodialysis, thus supporting the patient toward a better adaptation to the therapeutic regimen