| dc.description.abstract | LITERATURE REVIEW: Background: Multiple Sclerosis (MS) affects over 2 million people worldwide and can pose a significant threat to psychological well-being. Meaning-making can aid the adjustment process after receiving a diagnosis and Benefit Finding (BF) is a meaning-making process that involves positively reframing elements of the self, others, and life (Pakenham, 2011). This review aims to provide an overview of the evidence for relationships between BF and psychosocial and functional variables in people with MS. Methods: APA PsycINFO, Scopus, MEDLINE, and Web of Science were searched using keywords. The Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines were used to guide the systematic review process. The search was conducted in November and December 2023. A total of 2,241 records were obtained. Following title and abstract screening, 49 papers were reviewed at full-text. Twelve quantitative studies and one mixed-methods study met the inclusion criteria and were included in this review. Quality appraisal was conducted using the Joanna Briggs Institute's (JBI) Checklists for Analytic Cross-sectional studies and Randomised Control Trials. Results: A narrative synthesis was conducted, and evidence identified a range of psychological variables, as well as health-related physical and social variables that have been explored in relation to BF. These variables were grouped under the following themes: negative affect and distress, psychological well-being, adaptive coping, health status and illness perception, as well as mediation and moderation. Findings suggest that BF was related to a reduction in variables indicating poor adjustment such as negative mood, and distress. However, variables commonly related to positive adjustment such as well-being, positive affect and coping were associated with more BF. Mediation analysis suggested the involvement of BF in the reduction of depression levels. Health-related factors such as pain and disability were also found to be related to BF. Discussion: A number of limitations were identified, namely the inability to make causal inferences from the majority cross-sectional papers. The findings from this review may have clinical implications for individuals with MS and other long-term health conditions. As BF has been seen to play a role in positive adjustment, enhancing our understanding of this cognitive construct and its relationship with psychosocial factors may work towards informing and reinforcing working models of adjustment to MS. Moreover, the modifiable psychosocial factors identified in association with BF provide a blueprint for psychological interventions that aim to support people with MS. However, firm conclusions and as a result clinical recommendations could not be drawn due to the cross-sectional nature of the findings. Further experimental and longitudinal research is required to explore BF with more accuracy.
EMPIRICAL PAPER: Background: Multiple Sclerosis (MS) is associated with poor health-related quality of life and well-being. Individuals living with MS adapt to changes brought on by this long-term health condition and strive to regain meaning in their lives. To date, little is known about the role of benefit finding, identity reconstruction, and psychological flexibility in promoting positive adjustment, particularly in enhancing health-related quality of life and well-being of people with MS. Objective: The purpose of this study was to identify the relationship between meaning-making processes (benefit finding and identity reconstruction), psychological flexibility and adjustment outcomes (health-related quality of life and well-being) while accounting for demographic and illness variables among people with MS. Methods: This study used a cross-sectional correlational design. A sample of 250 people with MS participated in the study. Self-reported data were collected using an online survey. Participants completed the Rasch-derived short form of the Warwick-Edinburgh Mental Well-Being Scale, the Benefit Finding Scale, the Short Form Health Survey, the Identity Reconstruction Assessment Scale and the Personalised Psychological Flexibility Index. Correlational, Regression and Mediation Analyses were used to investigate indirect and direct relationships between variables of interest. Results: The results highlighted significant positive associations between psychological flexibility, benefit finding, sustained identity, integrated identity, and mental well-being, whereas reactionary identity was negatively associated with well-being. Sustained and reactionary identity were found to be significantly positively associated with health-related quality of life, while integrated identity was negatively associated with health-related quality of life. Additionally, benefit finding and psychological flexibility were found to be unrelated to health-related quality of life. Mediation analyses found that psychological flexibility partially mediated the relationship between benefit finding and well-being as well as between integrated identity and well-being.
Conclusion: Meaning-making processes such as benefit finding and identity reconstruction could play an important role in improving adjustment in people with MS. This relationship may, in part, function through psychological flexibility. Interventions which aim to target psychological flexibility may be useful in enhancing the positive impact of benefit finding and integrated identity on mental well-being among pwMS. However, further research using experimental and longitudinal designs is needed to build on these preliminary findings and to identify causal links between the variables explored in the current study. | en_GB |
