Effect of a transactional model education program on coping effectiveness in women with multiple sclerosis

Abstract

ObjectivesMultiple sclerosis (MS) is a chronic and progressive disease that causes stress due to its unpredictability and lack of definitive treatments. This study examined the effects of an educational program using a transactional model to help women with MS cope with their disease.Materials and MethodsIn a randomized clinical trial, 80 female patients from the MS Society of Iran were randomized to the intervention (n = 40) or a control group (n = 40). Outcomes were assessed using Cohen's Perceived Stress Scale (PSS) and the Jalowiec Coping Scale (JCS), which were completed by both groups at baseline, 1 month, and 3 months after the intervention. The intervention consisted of six educational sessions administered over 2 months based on a transactional model. The data were analyzed using repeated measures ANOVA.ResultsAverage PSS scores decreased significantly over time in the intervention group, while increasing in the control group. Between‐group differences were significant at both 1‐month and 3‐month follow‐up (p < .001). Both problem‐focused and emotion‐focused coping styles improved over time in use and effectiveness in the intervention group, whereas little or no change occurred in these coping behaviors in the control group.ConclusionThe transactional model‐based education program tested here was successful in reducing stress levels and increasing healthy coping styles in women with MS. If these findings are replicated in future studies, widespread adoption of this program may help women with MS cope more successfully with their disease.

Stress management interventions for multiple sclerosis: A meta-analysis of randomized controlled trials

“…Five studies provided sufficient data to evaluate the maintenance effects of stress management (Table 3). An overall trend toward improvement on stress, depression , and anxiety measures was reported by four studies, with statistically significant and very large effects associated with two MBSR programs at 1-month (Kolahkaj and Zargar, 2015) and 3-month follow-up (Sanaeinasab et al, 2017).…”

“…However, significant between-study variation in effect estimates was noted. This included medium to very large improvements following MBSR (Kolahkaj and Zargar, 2015; Simpson et al, 2017), an educational program based on the transactional model (Sanaeinasab et al, 2017), progressive muscle relaxation training (Artemiadis et al, 2012), and CBT (Foley et al, 1987; Mohr et al, 2012). In comparison, Agland et al’s (2018) multimodal intervention (i.e.…”

“…The pooled findings of eight RCTs suggest that stress management interventions incorporating elements of CBT, mindfulness and/or psychoeducation, can effectively reduce perceived stress in addition to targeting trans-diagnostic symptoms of depression and anxiety. Equally important in MS management is the provision of information and education to help increase understanding of the disease process and enhance self-confidence in symptom management (Sanaeinasab et al, 2017).…”

“…A systematic search of the Embase, PsycINFO, and PubMed databases (from database inception to January 2019) was conducted to identify articles that examined the effectiveness of stress management interventions for an adult MS population (see Table S1 supplemental material for search strategy). Citation searching of eligible studies via Scopus identified one additional study (Sanaeinasab et al, 2017). Finally, a manual search of the reference lists of included studies and previous reviews on this topic (Malcomson et al, 2007; Munoz et al, 2016; Pagnini et al, 2014; Reynard et al, 2014; Sesel et al, 2018; Simpson et al, 2014) was conducted to identify eligible articles that may have been missed in the initial search.…”

The Effectiveness of Intervention Based on the Transactional Model on Improving Coping Efforts and Stress Moderators in Hemodialysis Patients in Tehran

“…The ways or strategies that a person use in dealing with stressful situations play an essential role in their physical and mental health, and the individual's vulnerability is associated with understanding stress and its sources (7,8). The transactional model of Lazarus and Folkman is one of the methods organizing the ways which people adapt to chronic illness (9,10).According to Lazarus and Folkman, there are two types of coping strategies. The problem-focused coping strategy tries to eliminate or alter the source of stress, while emotional regulation coping strategy is a way to deal with a stressor focusing on altering the way one thinks or feels about a situation or something (11).…”