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Mapping Resilience: Structural Equation Modeling of Psychological Resilience in Multiple Sclerosis Care Partners. 映射弹性:多发性硬化症护理伙伴心理弹性的结构方程模型。
Q1 Nursing Pub Date : 2023-11-01 Epub Date: 2023-11-08 DOI: 10.7224/1537-2073.2023-078
Katherine L Cardwell, Laura Koch, Odessa J McKenna, Lara A Pilutti, Afolasade Fakolade

Background: Care partners are essential supports to individuals with multiple sclerosis (MS). Both negative and positive outcomes associated with the caregiving role have been reported. Psychological resilience may be an important factor influencing the MS caregiving experience, but an MS-specific model of care partner resilience has yet to be established. This study sought to explore an explicit model of MS care partner resilience.

Methods: Cross-sectional data from 471 Canadian MS care partners were collected via an online survey. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to test measures within a hypothesized model of resilience. Resilience was measured using the 25-item Connor-Davidson Resilience Scale.

Results: Following CFA, the hypothesized model was simplified due to the poor fit of several variables. The final model yielded a moderate SEM fit (χ2 = 6030.95, P < .01). Being a woman was associated with greater caregiving tasks (β = 0.53, P < .001) and poorer spiritual health (β = -0.35, P < .001). Spiritual health, but not caregiving tasks, had a positive impact on both positive (β = 0.48, P < .01) and negative coping (β = 0.49, P = .01). Quality of life and resilience did not have relationships with other variables in the model. However, quality of life had a positive, unidirectional influence on resilience (β = 0.83, P < .01).

Conclusions: Our findings indicate that spiritual health is an important predictor of coping and should be further explored in MS care partners. Quality of life may act as a precursor to resilience within MS care partners. Further research and exploration into MS care partner resilience is warranted to confirm this exploratory model.

背景:护理伙伴是多发性硬化症(MS)患者必不可少的支持。与照顾角色相关的消极和积极结果都有报道。心理弹性可能是影响MS护理体验的重要因素,但针对MS的护理伙伴弹性模型尚未建立。本研究旨在探索一个明确的模型,MS护理伙伴的弹性。方法:通过在线调查收集471名加拿大多发性硬化症护理伙伴的横断面数据。验证性因子分析(CFA)和结构方程模型(SEM)被用于测试弹性假设模型中的措施。弹性测量采用25项康纳-戴维森弹性量表。结果:采用CFA后,由于多个变量拟合较差,假设模型被简化。最终模型获得中等的SEM拟合(χ2 = 6030.95, P < 0.01)。作为一名女性,与更多的照顾任务(β = 0.53, P < .001)和较差的精神健康(β = -0.35, P < .001)相关。精神健康对积极应对(β = 0.48, P < 0.01)和消极应对(β = 0.49, P = 0.01)均有积极影响,而照顾任务对消极应对无积极影响。生活质量和恢复力与模型中的其他变量没有关系。然而,生活质量对心理弹性有正向、单向的影响(β = 0.83, P < 0.01)。结论:我们的研究结果表明,精神健康是MS护理伙伴应对的重要预测因素,值得进一步探讨。生活质量可能是MS护理伙伴恢复能力的前兆。进一步的研究和探索MS护理伙伴的弹性是必要的,以证实这一探索性模型。
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引用次数: 0
Opportunities in Multiple Sclerosis Care Partner Research: An Interview. 多发性硬化症护理合作伙伴研究的机会:访谈。
Q1 Nursing Pub Date : 2023-11-01 Epub Date: 2023-11-08 DOI: 10.7224/1537-2073-25.6.278
Marcia Finlayson, Kenneth Pakenham

Guest editor Marcia Finlayson, PhD, OT Reg (Ont), OTR, is a professor in the School of Rehabilitation Therapy at Queen's University in Ontario, Canada. She began her career as a clinical occupational therapist and shifted to a research career focused on generating and sharing knowledge to help people affected by multiple sclerosis (MS) lead healthy, meaningful lives with control over their participation in daily activities, at home and in the community, particularly as they age. For this special issue on caregiving in MS, she chose to interview Kenneth Pakenham, PhD, emeritus professor of clinical and health psychology at the University of Queensland in Brisbane, Australia. For more than 4 decades, he has investigated the psychological well-being welle-eing of caregivers, including coping mechanisms and innovative interventions to improve their quality of life. His work is dedicated to applying positive health frameworks to chronic illnesses and to empowering caregivers and individuals with MS. Together, their expertise illuminates the multifaceted challenges and opportunities in MS caregiving research and understanding.

特邀编辑Marcia Finlayson,博士,主治医师(Ont),主治医师,加拿大安大略省皇后大学康复治疗学院教授。她的职业生涯始于临床职业治疗师,后来转向研究工作,专注于产生和分享知识,帮助多发性硬化症(MS)患者在家庭和社区的日常活动中控制自己的参与,过上健康、有意义的生活,尤其是随着年龄的增长。在这期关于MS护理的特刊中,她选择采访了澳大利亚布里斯班昆士兰大学临床与健康心理学名誉教授Kenneth Pakenham博士。40多年来,他一直在研究照顾者的心理健康状况,包括应对机制和创新干预措施,以提高他们的生活质量。他的工作致力于将积极的健康框架应用于慢性疾病,并赋予护理人员和MS患者权力,他们的专业知识阐明了MS护理研究和理解中的多方面挑战和机遇。
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引用次数: 0
Supportive Interventions for Caregivers of Individuals With Multiple Sclerosis: A Systematic Review. 多发性硬化患者护理人员的支持性干预:一项系统综述
Q1 Nursing Pub Date : 2023-11-01 Epub Date: 2023-11-08 DOI: 10.7224/1537-2073.2022-083
Fatemeh Hoseinpour, Setareh Ghahari, Fatemeh Motaharinezhad, Maryam Binesh

Background: Caregivers of individuals with multiple sclerosis (MS) are key members of the treatment team. Their needs and challenges should be met as interventions can be effective in improving not only their own health, well-being, and quality of life but also that of those they care for. The aim of this systematic review was to investigate supportive interventions for caregivers of individuals with MS.

Methods: We conducted a database search of PubMed, Google Scholar, Science Direct, Scopus, and the Cochrane Library from 2000 to 2021. English-language studies that examined interventions administered directly to caregivers of individuals with MS and evaluated various outcomes were included. The Downs and Black checklist was used to assess the methodological quality of included studies.

Results: Twenty of 367 relevant papers fit the eligibility criteria outlined in the methods of this study and were subsequently selected for this review. Of the included studies, there was a notable variance in key characteristics such as methods, outcome measures, sample size, and procedures. Supportive interventions, psychoeducational group interventions, and behavioral-adaptive therapies were the 3 main categories of interventions reviewed; however, each study had a significant correlation between the intervention and outcomes.

Conclusions: Despite the small sample size in this study, this review showed that various intervention models that target caregivers of individuals with MS have been successful.

多发性硬化症患者的护理人员是治疗团队的关键成员。他们的需求和挑战应该得到满足,因为干预措施不仅可以有效地改善他们自己的健康、福祉和生活质量,还可以有效地提高他们所照顾的人的健康、幸福和生活质量。这项系统综述的目的是调查对MS患者护理人员的支持性干预措施。2000年至2021年,我们对PubMed、Google Scholar、Science Direct、Scopus和Cochrane图书馆进行了数据库搜索。纳入了英语研究,这些研究检查了直接对多发性硬化症患者护理人员实施的干预措施,并评估了各种结果。Downs和Black检查表用于评估纳入研究的方法学质量。367篇相关论文中有20篇符合本研究方法中列出的资格标准,随后被选中进行本次审查。在纳入的研究中,方法、结果测量、样本量和程序等关键特征存在显著差异。支持性干预、心理教育团体干预和行为适应疗法是综述的3类主要干预措施;然而,每项研究在干预和结果之间都有显著的相关性。尽管这项研究的样本量很小,但这篇综述表明,针对多发性硬化症患者护理人员的各种干预模型都是成功的。
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引用次数: 0
Striving to Limit the Impact: Parenting an Adult Child Who Has Multiple Sclerosis-A Grounded Theory Study. 努力限制影响:养育患有多发性硬化症的成年子女-一项有根据的理论研究
Q1 Nursing Pub Date : 2023-11-01 Epub Date: 2023-11-08 DOI: 10.7224/1537-2073.2021-053
Camilla Holden, Peter Hewitt, Rachel Tams

Background: Multiple sclerosis (MS) is a chronic, progressive autoimmune inflammatory disorder. Its impact is felt not only by individuals but also by their families; however, little is known about the effect on their parents. This study of a cohort from the United Kingdom aimed to develop a conceptual understanding of the parental role and how it changes over time when an adult son or daughter has MS via firsthand accounts.

Methods: Twelve parents of adults with MS were recruited from a UK hospital providing outpatient services to people with MS and a branch of a national MS charity. A social constructivist grounded theory approach informed audio-recorded semistructured interviews and subsequent data analysis.

Results: In this sample, parents of adults with MS strove to limit the impact of MS on their son or daughter by undertaking practical caring activities and providing emotional support. The developed theoretical model illustrates how, in their efforts to meet this aim, parents experienced competing demands between prioritizing their child's needs and managing the effects on their life, between managing the emotional experience and protecting their child from the burden of their experience, and between an intensified instinct/desire to help while maintaining their child's independence.

Conclusions: Findings indicate that parents may be uniquely affected by their adult son or daughter having MS, advocating for their inclusion in research and clinical interventions addressing family adjustment to MS. Further research is needed to ascertain the generalizability of these findings in comparable samples and to determine the impact of sociodemographic and cultural variables on the observed phenomena.

多发性硬化症是一种慢性进行性自身免疫性炎症性疾病。它的影响不仅体现在个人身上,也体现在他们的家庭身上;然而,人们对其对父母的影响知之甚少。这项针对英国队列的研究旨在通过第一手资料了解父母的角色,以及当成年儿子或女儿患有多发性硬化症时,父母的角色如何随着时间的推移而变化。从英国一家为多发性硬化症患者提供门诊服务的医院和一家国家多发性痴呆症慈善机构的分支机构招募了12名多发性麻痹症成年人的父母。以社会建构主义为基础的理论方法为录音的半结构访谈和随后的数据分析提供了信息。在这个样本中,患有多发性硬化症的成年人的父母努力通过开展实际的关爱活动和提供情感支持来限制多发性痴呆症对他们的儿子或女儿的影响。所开发的理论模型说明,在努力实现这一目标的过程中,父母如何在优先考虑孩子的需求和管理对他们生活的影响之间,在管理情感体验和保护孩子免受经验负担之间,经历竞争性的需求,以及在保持孩子独立的同时增强帮助的本能/愿望之间。研究结果表明,父母可能会受到其成年儿子或女儿患有多发性硬化症的独特影响,主张将其纳入研究和临床干预措施,以应对多发性痴呆症的家庭适应。需要进一步的研究来确定这些发现在可比样本中的可推广性,并确定社会人口和文化变量对观察到的现象的影响。
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引用次数: 0
Use of Calcitonin Gene-Related Peptide Monoclonal Antibodies for the Treatment of Migraines in Individuals With Multiple Sclerosis 使用降钙素基因相关肽单克隆抗体治疗多发性硬化症患者偏头痛
Q1 Nursing Pub Date : 2023-10-20 DOI: 10.7224/1537-2073.2023-013
Ashley Mason, Lauren Fragapane, Zuleyma Toledo-Nieves, Natalie Moreo, Angela Aungst, Derrick Robertson, Janice Maldonado
Abstract Background: Migraines are a common comorbidity and source of disability in patients with chronic inflammatory diseases like multiple sclerosis (MS). Recently, therapeutic agents for episodic and chronic migraine known as calcitonin gene-related peptide (CGRP) inhibitors have shown to effectively control migraine attacks and improve quality of life in the general population. This study explored the use of these novel agents in individuals with comorbid MS. Methods: This was a retrospective, population-based cohort study at the University of South Florida’s neurology clinic; it evaluated individuals with both MS and migraine. Results: A total of 27 individuals with MS and chronic or episodic migraine who received treatment with a CGRP monoclonal antibody were identified. Of these, 63% reported a reduction in their migraine frequency of greater than 75%. Concurrent use of a disease modifying therapy (DMT) for MS occurred in 82% of patients, and in 37% of these, the DMT used was also a monoclonal antibody. Adverse effects from CGRP monoclonal antibodies were mild and occurred in only 11% of patients, and no patient experienced worsening of their MS symptoms during cotreatment over the duration of the study. Conclusions: Our study showed a significant reduction in migraine frequency and a favorable adverse event profile for individuals with comorbid MS who took CGRP monoclonal antibodies and experienced no worsening of MS symptoms. In individuals with MS, CGRP monoclonal antibodies seem to be a safe and effective therapy for episodic or chronic migraine.
背景:偏头痛是多发性硬化症(MS)等慢性炎症性疾病患者常见的合并症和致残原因。最近,治疗间歇性和慢性偏头痛的药物降钙素基因相关肽(CGRP)抑制剂已被证明可以有效地控制偏头痛发作并改善一般人群的生活质量。本研究探讨了这些新型药物在合并症多发性硬化症患者中的应用方法:这是一项在南佛罗里达大学神经病学诊所进行的回顾性、基于人群的队列研究;它评估了多发性硬化症和偏头痛患者。结果:共鉴定了27例接受CGRP单克隆抗体治疗的MS和慢性或发作性偏头痛患者。其中,63%的人报告偏头痛频率降低了75%以上。82%的多发性硬化症患者同时使用疾病修饰疗法(DMT),其中37%的患者使用的DMT也是单克隆抗体。CGRP单克隆抗体的不良反应是轻微的,仅发生在11%的患者中,在研究期间,没有患者在联合治疗期间出现MS症状恶化。结论:我们的研究显示,服用CGRP单克隆抗体的多发性硬化症患者偏头痛发生率显著降低,不良事件发生率显著降低,且多发性硬化症症状没有恶化。在MS患者中,CGRP单克隆抗体似乎是一种安全有效的治疗发作性或慢性偏头痛的方法。
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引用次数: 0
Association Between Disease-Modifying Therapy and Information Processing Speed in Multiple Sclerosis 多发性硬化症疾病改善治疗与信息处理速度的关系
Q1 Nursing Pub Date : 2023-10-20 DOI: 10.7224/1537-2073.2023-010
Albert Aboseif, Moein Amin, James Bena, Kunio Nakamura, Gabrielle Macaron, Daniel Ontaneda
Abstract: Background: Cognitive impairment (CI) is common in multiple sclerosis (MS). Processing speed (PS) is often affected, making it an ideal target for monitoring CI. This study aims to evaluate the association between disease-modifying therapy (DMT) use and intensity and longitudinal changes in Processing Speed Test (PST) scores for individuals with MS. Methods: A retrospective analysis of individual PST scores at a single MS center was conducted. Individuals with 2 or more PST assessments were included. Scores on the PST were compared longitudinally between those who had been on a DMT for 2 or more years and those who had been off a DMT for 2 or more years and between those on high-efficacy DMTs and those on low-/moderate-efficacy DMTs. A linear regression model was approximated to evaluate the rate of cognitive change over time. A propensity score adjustment was conducted using a multivariable logistic regression. Results: The cohort was 642 individuals, 539 on DMT and 103 off DMT. Median age and disease duration was 49.7 (interquartile range [IQR] 42.4-57.9) and 16.6 years (IQR 9.3-23.0) in the DMT group, and 58.9 (IQR 52.2-65.3) and 20.0 years (IQR 14.1-31.4) in the non-DMT group. Both cohorts were predominantly female (75% DMT, 79.6% non-DMT), with a mean of 4 assessments (IQR 3-5), and an average monitoring duration of 1.9 years (1.2-2.4) in the DMT group, and 1.8 years (1.4-2.4) in the non-DMT group. After adjusting for multiple factors, DMT status and intensity were not found to be significant predictors of longitudinal PST change. Conclusions: Neither DMT status nor intensity were significant predictors of cognitive processing speed over a period of approximately 2 years. Future prospective multicenter trials are needed to further support these findings.
摘要:背景:认知障碍(CI)在多发性硬化症(MS)中很常见。处理速度(PS)经常受到影响,使其成为监视CI的理想目标。本研究旨在评估疾病改善治疗(DMT)的使用与MS个体处理速度测试(PST)得分的强度和纵向变化之间的关系。方法:对单个MS中心的个体PST得分进行回顾性分析。有两次或两次以上PST评估的个体被纳入研究。纵向比较服用DMT 2年或更长时间的患者和停用DMT 2年或更长时间的患者以及服用高效DMT和低/中效DMT的患者的PST得分。采用近似线性回归模型来评估认知能力随时间变化的速率。使用多变量逻辑回归进行倾向评分调整。结果:该队列642人,539人服用DMT, 103人不服用DMT。DMT组的中位年龄和病程分别为49.7岁(四分位间距[IQR] 42.4-57.9)和16.6岁(四分位间距[IQR] 9.3-23.0),非DMT组的中位年龄和病程分别为58.9岁(IQR 52.2-65.3)和20.0岁(IQR 14.1-31.4)。两个队列均以女性为主(75% DMT, 79.6%非DMT),平均4次评估(IQR 3-5), DMT组的平均监测时间为1.9年(1.2-2.4),非DMT组的平均监测时间为1.8年(1.4-2.4)。经多因素调整后,发现DMT状态和强度不是纵向PST变化的显著预测因子。结论:在大约2年的时间里,DMT状态和强度都不是认知加工速度的显著预测因子。未来的前瞻性多中心试验需要进一步支持这些发现。
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引用次数: 0
Association Between Improved Serum Fatty Acid Profiles and Cognitive Function During a Dietary Intervention Trial in Relapsing-Remitting Multiple Sclerosis 在一项复发-缓解型多发性硬化症患者饮食干预试验中,血清脂肪酸谱改善与认知功能的关系
Q1 Nursing Pub Date : 2023-09-29 DOI: 10.7224/1537-2073.2023-037
Solange M. Saxby, Carlyn Haas, Farnoosh Shemirani, Tyler J. Titcomb, Patrick Ten Eyck, Linda M. Rubenstein, Karin F. Hoth, Linda G. Snetselaar, Terry L. Wahls
Abstract Background: Cognitive impairment is a common multiple sclerosis (MS)-related symptom that impacts quality of life (QOL). Diet interventions are shown to be beneficial in managing QOL, and the intake of essential fatty acids is linked with improved cognitive function. However, the effect of diets on serum fatty acid profiles and cognitive function is unknown. Methods: A previous randomized parallel-arm trial recruited participants with relapsing-remitting MS (N = 77). Study visits included 4 time points: run-in, baseline, 12 weeks, and 24 weeks. During the run-in phase, participants followed their usual diet and were then randomly assigned to either a modified paleolithic (Wahls) or a low saturated fat (Swank) diet at baseline. Assessments at study visits included cognitive function assessed by Symbol Digit Modalities Test-Oral (SDMT-O) and Perceived Deficits Questionnaire (PDQ), and serum fatty acids, including eicosapentaenoic (EPA), docosahexaenoic (DHA), and arachidonic (ARA) acids. Results: Both groups had significant improvements in all serum fatty acids (P &lt; .01), except for ARA, as well as SDMT-O at 24-weeks (P &lt; .05), total PDQ at 12- and 24-weeks (P &lt; .01) compared to baseline values. The 12-week changes in omega-3 (EPA + DHA) index and EPA serum fatty acids were associated with SDMT-O changes (P ≤ .05); however, the changes in fatty acid levels did not mediate the effect of the diets on SDMT-O or PDQ (P &gt; .05). Conclusions: Both diets led to improvements in serum fatty acid profiles and cognitive function, with associations between the 12-week omega-3 (EPA + DHA) index and EPA changes with SDMT-O.
背景:认知障碍是多发性硬化症(MS)常见的相关症状,影响生活质量(QOL)。饮食干预被证明对管理生活质量有益,必需脂肪酸的摄入与认知功能的改善有关。然而,饮食对血清脂肪酸谱和认知功能的影响尚不清楚。方法:先前的一项随机平行试验招募了复发-缓解型MS患者(N = 77)。研究访问包括4个时间点:磨合期、基线期、12周和24周。在磨合阶段,参与者遵循他们的常规饮食,然后随机分配到改良的旧石器饮食(Wahls)或低饱和脂肪饮食(Swank)的基线。研究访问时的评估包括通过符号数字模式测试(SDMT-O)和感知缺陷问卷(PDQ)评估认知功能,以及血清脂肪酸,包括二十碳五烯(EPA)、二十二碳六烯(DHA)和花生四烯(ARA)酸。结果:两组患者血清脂肪酸(P <.01), ARA除外,以及24周时的SDMT-O (P <.05), 12周和24周总PDQ (P <与基线值相比。01)。12周ω -3 (EPA + DHA)指数和EPA血清脂肪酸变化与SDMT-O变化相关(P≤0.05);然而,脂肪酸水平的变化并没有调节饮食对SDMT-O或PDQ的影响(P >. 05)。结论:两种饮食都能改善血清脂肪酸谱和认知功能,在SDMT-O的12周omega-3 (EPA + DHA)指数和EPA变化之间存在关联。
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引用次数: 1
Multiple Sclerosis, Fatigue, Expanded Disability Status Scale: A Cross-Sectional Exploration of Sleep Efficiency and Quantitative Sleep Parameters 多发性硬化症,疲劳,扩展残疾状态量表:睡眠效率和定量睡眠参数的横断面探索
Q1 Nursing Pub Date : 2023-09-15 DOI: 10.7224/1537-2073.2022-118
Munther Queisi, Hrayr Attarian, Victoria P. Cipriani, Saria Azzi, Olivia Kaczmarek, Barbara Bumstead, Marijean Buhse, Myassar Zarif, Daniel Golan, Jeffrey Wilken, Thomas Covey, Mark Gudesblatt
Abstract Background Poor sleep quality and sleep disorders are more prevalent in individuals with multiple sclerosis (MS) than in the general population. Poor sleep has been correlated with worse MS outcomes. Sleep efficiency (SE) is one of the most sensitive markers of sleep quality. There is very little written about SE and other polysomnography (PSG) parameters and MS measures. Methods This is a retrospective review of 280 consecutive individuals with MS evaluated by PSGs and other standardized MS measures over 13 years at a comprehensive MS center. In addition, the cohort was assessed with 2 fatigue scales, the Epworth Sleepiness Scale, and the Expanded Disability Status Scale. A comparison of means test (independent t test) and r, or correlation coefficient, were used. Results The PSG measures of SE and Total Sleep Time were significantly different between a group of individuals with MS with a disease duration of more than 5 years vs a group of individuals with MS with a disease duration less then or equal to 5 years. Prevalence of obstructive sleep apnea was 63%, higher than reported in the literature while the prevalence of moderate to severe obstructive sleep apnea was 33.4%, which was lower than reported. Conclusions Longer disease duration as well as worse disability correlate with sleep quality as measured by SE.
背景:睡眠质量差和睡眠障碍在多发性硬化症(MS)患者中比在普通人群中更为普遍。睡眠不足与多发性硬化症的恶化有关。睡眠效率是衡量睡眠质量最敏感的指标之一。关于SE和其他多导睡眠图(PSG)参数和MS测量的文献很少。方法:回顾性分析一家综合多发性硬化症中心13年来280例连续多发性硬化症患者的psg和其他标准化的多发性硬化症测量方法。此外,对队列进行2种疲劳量表,Epworth嗜睡量表和扩展残疾状态量表的评估。采用均值检验(独立t检验)和r(相关系数)进行比较。结果病程大于5年的MS组与病程小于等于5年的MS组的PSG测量的SE和总睡眠时间有显著性差异。阻塞性睡眠呼吸暂停患病率为63%,高于文献报道;中度至重度阻塞性睡眠呼吸暂停患病率为33.4%,低于文献报道。结论疾病持续时间越长、残疾程度越严重与睡眠质量相关。
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引用次数: 0
Validated, Quantitative, Machine Learning-Generated Neurologic Assessment of Multiple Sclerosis Using a Mobile Application 使用移动应用程序验证,定量,机器学习生成的多发性硬化症神经系统评估
Q1 Nursing Pub Date : 2023-09-12 DOI: 10.7224/1537-2073.2023-009
Sharon Stoll, Charisse Litchman, Noah Rubin, Larry Rubin, Timothy Vartanian
Abstract Background: The BeCare MS Link mobile app collects data as users complete different in-app assessments. It was specifically developed to evaluate the symptomatology and neurologic function of patients with multiple sclerosis (MS) and to become a digital equivalent of the Expanded Disability Status Scale (EDSS) and other standard clinical metrics of MS progression. Methods: Our research compared EDSS scores derived from the BeCare MS link app to EDSS scores derived from neurologist assessment for the same cohort of 35 patients diagnosed with MS. App-derived data was supplied to 4 different machine learning algorithms (MLAs) with an independent EDSS score prediction generated from each. These scores were compared to the clinically-derived EDSS score to assess the similarity of the scores and to determine an accuracy estimate for each MLA. The trial is registered on ClinicalTrials.gov as NCT04281160. Results: Out of the 4 MLAs employed, the most accurate MLA produced 19 EDSS score predictions that exactly matched the clinically-derived scores, 21 score predictions within 0.5 EDSS points, and 32 score predictions within 1 EDSS point. The remaining MLAs also provided a relatively high level of accuracy in predicting EDSS scores when compared to clinically-derived EDSS, with over 80% of scores predicted within 1 point and a mean squared error with a range of 1.05 to 1.37. Conclusions: The BeCare MS Link app can replicate the clinically-derived EDSS assessment of a patient with MS. The app may also offer a more complete evaluation of disability in patients with MS.
背景:BeCare MS Link移动应用程序在用户完成不同的应用内评估时收集数据。它专门用于评估多发性硬化症(MS)患者的症状学和神经功能,并成为扩展残疾状态量表(EDSS)和MS进展的其他标准临床指标的数字等等物。方法:我们的研究比较了来自BeCare MS链接应用程序的EDSS评分和来自神经学家评估的35名MS患者的EDSS评分,应用程序的数据提供给4种不同的机器学习算法(mla),并从每种算法中生成独立的EDSS评分预测。将这些评分与临床得出的EDSS评分进行比较,以评估评分的相似性,并确定每个MLA的准确性估计。该试验在ClinicalTrials.gov上注册为NCT04281160。结果:在使用的4个MLA中,最准确的MLA产生了19个与临床衍生评分完全匹配的EDSS评分预测,21个评分预测在0.5 EDSS分内,32个评分预测在1 EDSS分内。与临床来源的EDSS相比,剩余的mla在预测EDSS评分方面也提供了相对较高的准确性,超过80%的分数预测在1分以内,均方误差在1.05至1.37之间。结论:BeCare MS Link应用程序可以复制MS患者临床衍生的EDSS评估,该应用程序还可以提供MS患者更完整的残疾评估。
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引用次数: 0
Effect of Foot Reflexology on Patients With Multiple Sclerosis: A Systematic Review of Current Evidence 足部反射疗法对多发性硬化症患者的影响:当前证据的系统回顾
Q1 Nursing Pub Date : 2023-09-12 DOI: 10.7224/1537-2073.2022-093
Boopalan Deenadayalan, Vijayakumar Venugopal, Ravi Poornima, Vanamoorthy Mahesh Kannan, Anandhan Akila, Chidambaram Yogapriya, Kuppusamy Maheshkumar
Abstract Background: Individuals with multiple sclerosis (MS) commonly experience fatigue, discomfort, sleep problems, anxiety, and reduced quality of life. Studies have shown that foot reflexology can help relieve these symptoms. The objective of this current study is to systematically review the effects of foot reflexology on patients with MS. Methods: We conducted a systematic review of published literature in many databases, including PubMed, EMBASE, and Cochrane Library, from January 1, 2000, to January 27, 2022. With language restrictions, we included randomized controlled trials of foot reflexology interventions for MS that had any clinical or psychological symptom measurements as outcomes. The Cochrane risk-of-bias tool was used to assess evidence quality. Two authors independently screened titles and abstracts. Potential eligible articles were retrieved for full-text review. A third author checked for excluded records. All discrepancies were resolved through a discussion among the 4 reviewing authors. Results: A total of 154 studies were identified; 9 studies with 545 MS patients were included in this review. The most frequently reported findings of foot reflexology intervention in individuals with MS were reductions in fatigue, pain, muscle spasms, stiffness, and psychological symptoms and improvement in bowel and bladder functions and quality of life Conclusions: The findings suggest that foot reflexology could be a safe and effective modality to reduce the physical, and psychological symptoms and also improve the quality of life for individuals with MS; however, well-designed, large-scale trials are required to confirm the effect.
背景:多发性硬化症(MS)患者通常会出现疲劳、不适、睡眠问题、焦虑和生活质量下降。研究表明,足部反射疗法可以帮助缓解这些症状。本研究的目的是系统回顾足部反射疗法对多发性硬化症患者的影响。方法:我们对2000年1月1日至2022年1月27日期间在PubMed、EMBASE和Cochrane Library等多个数据库中发表的文献进行了系统回顾。在语言限制的情况下,我们纳入了有临床或心理症状测量作为结果的足部反射疗法干预MS的随机对照试验。使用Cochrane风险偏倚工具评估证据质量。两位作者独立筛选了题目和摘要。检索可能符合条件的文章进行全文审查。第三位作者检查了被排除的记录。所有差异均通过4位综述作者的讨论解决。结果:共纳入154项研究;本综述纳入了9项涉及545例MS患者的研究。足反射疗法干预MS患者最常见的发现是疲劳、疼痛、肌肉痉挛、僵硬和心理症状的减轻,以及肠道和膀胱功能和生活质量的改善。结论:研究结果表明足反射疗法是一种安全有效的方式,可以减轻MS患者的身体和心理症状,并改善MS患者的生活质量;然而,需要精心设计的大规模试验来证实这种效果。
{"title":"Effect of Foot Reflexology on Patients With Multiple Sclerosis: A Systematic Review of Current Evidence","authors":"Boopalan Deenadayalan, Vijayakumar Venugopal, Ravi Poornima, Vanamoorthy Mahesh Kannan, Anandhan Akila, Chidambaram Yogapriya, Kuppusamy Maheshkumar","doi":"10.7224/1537-2073.2022-093","DOIUrl":"https://doi.org/10.7224/1537-2073.2022-093","url":null,"abstract":"Abstract Background: Individuals with multiple sclerosis (MS) commonly experience fatigue, discomfort, sleep problems, anxiety, and reduced quality of life. Studies have shown that foot reflexology can help relieve these symptoms. The objective of this current study is to systematically review the effects of foot reflexology on patients with MS. Methods: We conducted a systematic review of published literature in many databases, including PubMed, EMBASE, and Cochrane Library, from January 1, 2000, to January 27, 2022. With language restrictions, we included randomized controlled trials of foot reflexology interventions for MS that had any clinical or psychological symptom measurements as outcomes. The Cochrane risk-of-bias tool was used to assess evidence quality. Two authors independently screened titles and abstracts. Potential eligible articles were retrieved for full-text review. A third author checked for excluded records. All discrepancies were resolved through a discussion among the 4 reviewing authors. Results: A total of 154 studies were identified; 9 studies with 545 MS patients were included in this review. The most frequently reported findings of foot reflexology intervention in individuals with MS were reductions in fatigue, pain, muscle spasms, stiffness, and psychological symptoms and improvement in bowel and bladder functions and quality of life Conclusions: The findings suggest that foot reflexology could be a safe and effective modality to reduce the physical, and psychological symptoms and also improve the quality of life for individuals with MS; however, well-designed, large-scale trials are required to confirm the effect.","PeriodicalId":14150,"journal":{"name":"International journal of MS care","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135877987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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International journal of MS care
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