Multiple sclerosis : living the reality and experiences of hope

Abstract

This thesis is divided into three parts: a meta-synthesis of qualitative research, an empirical report and appendices.Part one is a descriptive meta-synthesis reviewing the contribution of phenomenologically informed qualitative literature regarding the lived experience of Multiple Sclerosis (MS). The meta-synthesis aimed to provide insights for healthcare professionals working in person centred MS services, in addition to reviewing literature relating to the empirical paper. Individuals living with MS have diverse healthcare needs and person centred care offers a holistic approach to meeting these needs. Six broad themes regarding the lived experience of MS were identified following synthesis of findings from seven qualitative studies. Deficits in person centred care are highlighted and implications for future service provision are discussed.Part two is an empirical study investigating a deficit in person centred care highlighted in the meta-synthesis: the concept of hope. The study examines the subjective experience of hope by exploring what generates, diminishes, or maintains hope for individuals living with Relapsing-remitting MS (RRMS) who confront relapses and remission of MS symptoms over time. Six individuals were interviewed and interpretative phenomenological analysis (IPA) was used to identify themes from their narrative accounts of hope. The study considers the importance of family systems and relationships in the experience of hope in RRMS, in addition to exploring illness experiences which result in losing hope. Clinical implications are discussed including the role of hope-fostering interventions for individuals living with RRMS adopted from the Recovery Model currently operating in mental health services.Part three consists of appendices relating to the research, including a reflective statement discussing the process of research from conception to results

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