Derleme
BibTex RIS Kaynak Göster

Multipl Sklerozda Yaşam Kalitesini Şekillendiren Unsurlar: Hemşirelik Yaklaşımı ve Etkili İletişimin Kavramsal Değerlendirmesi

Yıl 2025, Cilt: 8 Sayı: 2, 74 - 88, 23.07.2025
https://doi.org/10.71445/umbd.1702898

Öz

Multipl Skleroz (MS), nörolojik, psikolojik ve sosyal düzeyde çoklu etkileri olan, bireylerin yaşam kalitesini derinlemesine etkileyen kronik bir hastalıktır. Bu kavramsal çalışma, MS hastalığında yaşam kalitesini şekillendiren en temel iki unsur olan hemşirelik yaklaşımı ve etkili iletişimin rolünü bütüncül bir perspektifle incelemektedir. MS hastalarının uzun süreli bakım gereksinimleri, fiziksel ve psikososyal zorluklarla başa çıkma süreçlerini daha karmaşık hale getirmektedir. Bu noktada hemşirelerin yürüttüğü bireyselleştirilmiş bakım, semptom yönetimi, hasta eğitimi ve psikososyal destek hizmetleri, hastaların yaşam kalitesi üzerindeki etkisi bakımından kritik öneme sahiptir. Etkili iletişim; güven temelli ilişki kurmayı, kültürel duyarlılığı, kaygı yönetimini ve ortak karar alma süreçlerini mümkün kılarak hem tedavi sürecinin etkinliğini artırmakta hem de bireylerin yaşamla uyumunu güçlendirmektedir. Bu bağlamda, MS hastalarında yaşam kalitesinin artırılmasında hemşirelik hizmetleri ve iletişim pratikleri arasında dinamik ve tamamlayıcı bir ilişki bulunmaktadır. Bu çalışma, sağlık profesyonelleri için hemşirelik ve iletişimin yalnızca destekleyici değil, aynı zamanda tedavi edici bir unsur olarak değerlendirilmesi gerektiğini savunmaktadır.

Etik Beyan

Çalışma kavramsal bir değerlendirme olduğu için etik izin gerektirmemektedir.

Kaynakça

  • Altun, Ö. Ş., & Özer, D. (2020). Multipl skleroz hastalarında ruhsal durumun değerlendirilmesi ve hemşirenin rolü: Sistematik derleme. Arşiv Kaynak Tarama Dergisi, 29(1), 89-95.
  • Amato, M.P., Ponziani, G., Rossi, F., Liedl, C.L., Stefanile, C., & Rossi, L. (2001). Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Multiple Sclerosis, 7, 340-344.
  • Antonovsky A. (1987). Unraveling the mystery of health. San Francisco: Jossey Bass Publishers.
  • Bandura A. (1997). Self-efficacy. The exercise of control. New York: Freeman and Company.
  • Bandura, A. (1988). Self-regulation of motivation and action through goal systems. In V. Hamilton, G. H. Bower, & N. H. Frijda (Eds.), Cognitive perspectives on emotion and motivation (pp. 37–61). Kluwer Academic Publishers.
  • Barnwell, A. M., & Kavanagh, D. J. (1997). Prediction of psychological adjustment to multiple sclerosis. Social Science & Medicine, 45(3), 411-418.
  • Baumstarck, K., Pelletier, J., Butzkueven, H., Fernandez, O., Flachenecker, P., Idiman, E,…. Auquier, P. (2013). Health-related quality of life as an independent predictor of long-term disability for patients with relapsing-remitting multiple sclerosis. European Journal of Neurology, 20(6), 907-914.
  • Benito-Leon, J., Morales, J. M., Rivera-Navarro, J., & Mitchell, A. (2003). A review about the impact of multiple sclerosis on health-related quality of life. Disability and Rehabilitation, 25(23), 1291-1303.
  • Boeije, H. R., Duijnstee, M. S., Grypdonck, M. H., & Pool, A. (2002). Encountering the downward phase: biographical work in people with multiple sclerosis living at home. Social Science & Medicine, 55(6), 881-893.
  • Bosma H & Kunnen S. (2001). Identity and emotion. Development through self-organization. Paris: Cambridge University Press.
  • Brooks, N. A., & Matson, R. R. (1982). Social-psychological adjustment to multiple sclerosis: A longitudinal study. Social Science & Medicine, 16(24), 2129-2135.
  • Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social psychology, 84(4), 822-848.
  • Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Addressing fundamental questions about mindfulness. Psychological Inquiry, 18(4), 272-281.
  • Brust J. C. (2012). Current diagnosis and treatment: Neurology. Second Edition. United States: Lange McGraw Hill
  • Buck, D., & Hemmer, B. (2011). Treatment of multiple sclerosis: current concepts and future perspectives. Journal of Neurology, 258(10), 1747-1762.
  • Büssing, A., Ostermann, T., Neugebauer, E. A., & Heusser, P. (2010). Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease. BMC public health, 10(1), 507-510.
  • Carver, C. S., & Scheier, M. F. (1994). Optimism and health-related cognition: What variables actually matter?. Psychology and health, 9(3), 191-195.
  • Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat, F. L., & Clark, K. C. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375–390.
  • Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310-357
  • Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ, 337(a1655), 1-6.
  • Crayton, H. J., & Rossman, H. S. (2006). Managing the symptoms of multiple sclerosis: a multimodal approach. Clinical Therapeutics, 28(4), 445-460.
  • Crigger, N. J. (1996). Testing an uncertainty model for women with multiple sclerosis. Advances in Nursing Science, 18(3), 37-47.
  • Dalgas, U., Stenager, E., & Ingemann-Hansen, T. (2008). Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance-and combined training. Multiple Sclerosis Journal, 14(1), 35-53.
  • De Ridder, D., Geenen, R., Kuijer, R., & van Middendorp, H. (2008). Psychological adjustment to chronic disease. The Lancet, 372(9634), 246-255.
  • Dennison, L., & Moss-Morris, R. (2010). Cognitive–behavioral therapy: what benefits can it offer people with multiple sclerosis?. Expert review of neurotherapeutics, 10(9), 1383-1390.
  • Dennison, L., Moss-Morris, R., & Chalder, T. (2009). A review of psychological correlates of adjustment in patients with multiple sclerosis. Clinical Psychology Review, 29(2), 141-153.
  • Devins, G. M., & Shnek, Z. M. (2000). Multiple sclerosis. In R. G. Frank & T. R. Elliott (Eds.), Handbook of rehabilitation psychology (pp. 163–184). American Psychological Association.
  • Ellis, T., & Motl, R. W. (2013). Physical activity behavior change in persons with neurologic disorders: overview and examples from Parkinson disease and multiple sclerosis. Journal of Neurologic Physical Therapy : JNPT, 37(2), 85–90.
  • Erbay, Ö., Yeşilbalkan, Ö. U., & Karadakovan, A. (2020). Multipl sklerozlu hastaların tedavi yönetimi ve hemşirelik yaklaşımları. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 13(1), 30-40.
  • Fernandez, O., Baumstarch-Barrau, K., Simeoni, M.C., Auquier, P. (2011). Patient characteristics and determinants of quality of life in an international population with multiple sclerosis: assessment using the MusiQoL and SF-36 questionnaires. Multiple Sclerosis Journal, 17(10), 1238-1249.
  • Ferrans, C. E., Zerwic, J. J., Wilbur, J. E., Larson, J. L. (2005). Conceptual model of health-related quality of life. J Nurs Scholarsh, 37(4),36-42.
  • Figved, N., Myhr, K. M., Larsen, J. P., & Aarsland, D. (2007). Caregiver burden in multiple sclerosis: the impact of neuropsychiatric symptoms. Journal of Neurology, Neurosurgery & Psychiatry, 78(10), 1097-1102.
  • Fournier, M., de Ridder, D., & Bensing, J. (1999). Optimism and adaptation to multiple sclerosis: what does optimism mean?. Journal of Behavioral medicine, 22(4), 303-326.
  • Ghafari, S., Ahmadi, F., Nabavi, M., Anoshirvan, K., Memarian, R., & Rafatbakhsh, M. (2009). Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. Journal of clinical nursing, 18(15), 2171-2179.
  • Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., ... & Ranasinghe, P. D. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368.
  • Guimaraes, F. A., Oliveira-Cardoso, E. A., Mastropietro, A. P., Voltarelli, J. C., & Santos, M. A. (2010). Impact of autologous hematopoetic stem cell transplantation on the quality of life of patients with multiple sclerosis. Arquivos De Neuro-Psiquiatria, 68(4), 522-527.
  • Hart, S., Fonareva, I., Merluzzi, N., & Mohr, D. C. (2005). Treatment for depression and its relationship to improvement in quality of life and psychological well-being in multiple sclerosis patients. Quality of Life Research, 14(3), 695-703.
  • Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., ... & Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081.
  • Haz D., Yay G., Koordinat G., & Tan MS. (2013). Multipl Skleroz Tanı ve Tedavi Klavuzu. İstanbul: Galenos Yayınevi. Helgeson, V. S. (2003). Social support and quality of life. Quality of Life Research, 12(1), 25-31.
  • Herndon, R. M. (2000). Pathology and pathophysiology. In J. S. Burks & K. P. Johnson (Eds.), Multiple sclerosis: Diagnosis, medical management, and rehabilitation (pp. 1–35). Demos Medical Publishing.
  • Holman, H., & Lorig, K. (2004). Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public health reports, 119(3), 239-243.
  • Holtzman, S., Newth, S., & Delongis, A. (2004). The role of social support in coping with daily pain among patients with rheumatoid arthritis. Journal of Health Psychology, 9(5), 677-695.
  • Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537-559.
  • Irvine, H., Davidson, C., Hoy, K., & Lowe-Strong, A. (2009). Psychosocial adjustment to multiple sclerosis: exploration of identity redefinition. Disability and Rehabilitation, 31(8), 599-606.
  • Jang, Y., Haley, W. E., Mortimer, J. A., & Small, B. J. (2003). Moderating effects of psychosocial attributes on the association between risk factors and disability in later life. Aging & Mental Health, 7(3), 163-170.
  • Keune, P. M., & Perczel Forintos, D. (2010). Mindfulness meditation: A preliminary study on meditation practice during everyday life activities and its association with well-being. Psihologijske Teme, 19(2), 373-386.
  • Klimova, E., Szilasiova, J., & Vesela, D. (2002). Multiple sclerosis and interferon-beta: their effect on quality of life and economic activity of subjects with relapse/remission form of disease. Lekarsky Obzor, 51(7), 204-206.
  • Koopman, W. J., Benbow, C. L., & Vandervoort, M. (2006). Top 10 needs of people with multiple sclerosis and their significant others. Journal of Neuroscience Nursing, 38(5), 369-373.
  • Kraft, G. H. (1999). Rehabilitation still the only way to improve function in multiple sclerosis. The Lancet, 9195(354), 2016-2017.
  • Lawrence, M., Booth, J., Mercer, S., & Crawford, E. (2013). A systematic review of the benefits of mindfulness-based interventions following transient ischemic attack and stroke. International Journal of Stroke, 8(6), 465-474.
  • Learmonth, Y. C., & Motl, R. W. (2016). Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences. Disability and Rehabilitation, 38(13), 1227-1242.
  • Lerdal, A., Gulowsen Celius, E., &Moum, T. (2009). Perceptions of illness and its development in patients with multiple sclerosis: a prospective cohort study. Journal of Advanced Nursing, 65(1), 184-192.
  • Levy, S. S., Li, K.-K., Cardinal, B. J., & Maddalozzo, G. F. (2009). Transitional shifts in exercise behavior among women with multiple sclerosis. Disability and Health Journal, 2(4), 216–23.
  • Magnus, C. M., Kowalski, K. C., & Mchugh, T. L. F. (2010). The role of self-compassion in women's self-determined motives to exercise and exercise-related outcomes. Self and Identity, 9(4), 363-382.
  • Matson, R. R., & Brooks, N. A. (1977). Adjusting to multiple sclerosis: An exploratory study. Social Science & Medicine, 11(4), 245-250.
  • McCabe, M. P., McKern, S., & McDonald, E. (2004). Coping and psychological adjustment among people with multiple sclerosis. Journal of Psychosomatic Research, 56(3), 355-361.
  • McCullagh, R., Fitzgerald, A. P., Murphy, R. P., & Cooke, G. (2008). Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study. Clinical Rehabilitation, 22(3), 206-214.
  • Meeberg, G. A. (1993). Quality of life: A concept analysis. Journal of Advanced Nursing, 18(1), 32-38.
  • Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17(3), 192-200.
  • Minden, S. L., & Schiffer, R. B. (1990). Affective disorders in multiple sclerosis review and recommendations for clinical research. Archives of Neurology, 47(1), 98-104.
  • Mostert, S., & Kesselring, J. (2002). Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Multiple Sclerosis Journal, 8(2), 161-168.
  • Motl, R. W., & McAuley, E. (2009). Pathways between physical activity and quality of life in adults with multiple sclerosis. Health Psychology, 28(6), 682–689.
  • Motl, R. W., & Pilutti, L. A. (2012). The benefits of exercise training in multiple sclerosis. Nature Reviews Neurology, 8(9), 487-497.
  • Motl, R. W., & Snook, E. M. (2008). Physical activity, self-efficacy, and quality of life in multiple sclerosis. Annals of Behavioral Medicine, 35(1), 111-115.
  • Motl, R. W., Gappmaier, E., Nelson, K., & Benedict, R. H. B. (2011). Physical activity and cognitive function in multiple sclerosis. Journal of Sport & Exercise Psychology, 33(5), 734–41.
  • Motl, R. W., McAuley, E., & Snook, E. M. (2005). Physical activity and multiple sclerosis: a meta-analysis. Multiple Sclerosis Journal, 11(4), 459-463.
  • Motl, R. W., McAuley, E., & Snook, E. M. (2007). Physical activity and quality of life in multiple sclerosis: Possible roles of social support, self-efficacy, and functional limitations. Rehabilitation Psychology, 52(2), 143-151.
  • Neff, K. D. (2009). The role of self‐compassion in development: A healthier way to relate to oneself. Human Development, 52(4), 211–214.
  • Neff, K. D., Rude, S. S., & Kirkpatrick, K. L. (2007). An Examination of self‐compassion in relation to positive psychological functioning and personality traits. Journal Of Research In Personality, 41(4), 908–916.
  • Newsom, J.T., & Schulz, R. (1996). Social support as a mediator in the relation between functional status and quality of life in older adults. Psychology and Aging, 11(1), 34-44.
  • Nhất, H., Ho, M., & Vo, D. M. (1999). The miracle of mindfulness: An introduction to the practice of meditation. Boston: Beacon Press.
  • Novik, A. A., Ionova, T. I., Bisaga, A.V., Kishtovitch, A.V., Fedorenko, D.A., Ivanov, R.A., & Gorodokin, G.I. (2005). Clinical and quality of life responses to high-dose chemotherapy plus autologous stem cell transplantation in patients with multiple sclerosis: two case reports. Cytotherapy, 7(4), 363-367.
  • Pakenham, K. I. (2006). Investigation of the coping antecedents to positive outcomes and distress in multiple sclerosis (MS). Psychology & Health, 21(5), 633–649.
  • Pakenham, K. I. (2007). Making sense of multiple sclerosis. Rehabilitation Psychology, 52(4), 380-389.
  • Parfenov, V., Schluep, M., & Du Pasquier, R. (2013). Assessing risks of multiple sclerosis therapies. J Neurol Sci. 15;332(1-2):59-65.
  • Petajan, J. H., & White, T. (1999). Recommendations For Physical Activity in Patients ith Multiple Sclerosis. Sports Medicine, 27(3), 179–191.
  • Phillips, L. J., & Stuifbergen, A. K. (2008). The influence of positive experiences on depression and quality of life in persons with multiple sclerosis. Journal of Holistic Nursing : Official Journal of the American Holistic Nurses’ Association, 26(1), 41–8.
  • Pozzilli, C., Brunetti, M., Amicosante, A. M. V., Gasperini, C., Ristori, G., Palmisano, L., & Battaglia, M. (2002). Home based management in multiple sclerosis: results of a randomised controlled trial. Journal of Neurology, Neurosurgery & Psychiatry, 73(3), 250-255.
  • Pragodpol, P., & Ryan, C. (2013). Critical review of factors predicting health-related quality of life in newly diagnosed coronary artery disease patients. Journal of Cardiovascular Nursing, 28(3), 277-284.
  • Price, E., Lucas, R., & Lane, J. (2021). Experiences of healthcare for people living with multiple sclerosis and their healthcare professionals. Health Expectations, 24(6), 2047-2056.
  • Reyes, D. (2012). Self‐Compassion: A Concept Analysis. Journal of Holistic Nursing, 30(2), 81–89.
  • Riazi, A., Hobart, J. C., Lamping, D. L., Fitzpatrick, R., Freeman, J. A., Jenkinson, C., et al. (2003). Using the SF-36 measure to compare the health impact of multiple sclerosis and Parkinson’s disease with normal population health profiles. Journal of Neurology, Neurosurgery and Psychiatry, 74(6), 710–714.
  • Robinson, F. P., Mathews, H. L., & Witek-Janusek, L. (2003). Psycho-endocrine-immune response to mindfulness-based stress reduction in individuals infected with the human immunodeficiency virus: a quasiexperimental study. The Journal of Alternative & Complementary Medicine, 9(5), 683-694.
  • Rommer, P. S., Sühnel, A., König, N., & Zettl, U. K. (2017). Coping with multiple sclerosis—the role of social support. Acta Neurologica Scandinavica, 136(1), 11-16.
  • Rosenberger, J., Van Dijk, J. P., Nagyova, I., Zezula, I., Geckova, A. M., Roland, R., ... & Groothoff, J. W. (2006). Predictors of perceived health status in patients after kidney transplantation. Transplantation, 81(9), 1306-1310.
  • Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. Journal of psychosomatic research, 68(1), 29-36.
  • Roubinov, D. S., Turner, A. P., & Williams, R. M. (2015). Coping among individuals with multiple sclerosis: Evaluating a goodness-of-fit model. Rehabilitation Psychology, 60(2), 162.
  • Rudick, R. A., Miller, D., Clough, J. D., Gragg, L. A., & Farmer, R. G. (1992). Quality of life in multiple sclerosis. Comparison with inflammatory bowel disease and rheumatoid arthritis. Archives of Neurology, 49(12), 1237-1242.
  • Rumpf, H. J., & Wessel, K. (1995). Coping pattern and adjustment in multiple sclerosis. Der Nervenarzt, 66(8), 624-629.
  • Sá, M. J. (2008). Psychological aspects of multiple sclerosis. Clinical Neurology and Neurosurgery, 110(9), 868-877.
  • Saccardi, R., Freedman, M. S., Sormani, M.P., Atkins, H., Farge, D., Griffith, L. M., Kraft, G.…Muraro, P.A. (2012). A prospective, randomized, controlled trial of autologous haematopoietic stem cell transplantation of aggressive multiple sclerosis: a position paper. Multiple Sclerosis Journal, 18(6), 825-834.
  • Schaffler, N., Schonberg, P., Stephan, J., Stellmann, J. P., Gold, S. M., & Heesen, C. (2013). Comparison of patient-reported outcome measures in multiple sclerosis. Acta Neurologica Scandinavica, 128(2), 114-121.
  • Schwartz, C., & Frohner, R. (2005). Contribution of demographic, medical, and social support variables in predicting the mental health dimension of quality of life among people with multiple sclerosis. Health & Social Work, 30(3), 203-212.
  • Schwarzer, R. (1999). Self-regulatory processes in the adoption and maintenance of health behaviors. Journal of Health Psychology, 4(2), 115-127.
  • Sebastião, E., Hubbard, E. A., Klaren, R. E., Pilutti, L. A., & Motl, R. W. (2017). Fitness and its association with fatigue in persons with multiple sclerosis. Scandinavian Journal of Medicine & Science In Sports, 27(12), 1776-1784.
  • Simpson, R., Booth, J., Lawrence, M., Byrne, S., Mair, F., & Mercer, S. (2014). Mindfulness based interventions in multiple sclerosis-a systematic review. BMC Neurology, 14(15), 1-9.
  • Stroud, N., Minahan, C., & Sabapathy, S. (2009). The Perceived benefits and barriers to exercise participation in persons with multiple sclerosis. Disability & Rehabilitation, 31(26), 2216–2222.
  • Tan-Kristanto, S., & Kiropoulos, L. A. (2015). Resilience, self-efficacy, coping styles and depressive and anxiety symptoms in those newly diagnosed with multiple sclerosis. Psychology, Health & Medicine, 20(6), 635-645.
  • Taylor, S. E. (1989). Positive illusions: Creative self-deception and the healthy mind. New York: Basic Books Harper Collins.
  • Taylor, S. E., Helgeson, V. S., Reed, G. M., & Skokan, L. A. (1991). Self‐generated feelings of control and adjustment to physical illness. Journal of Social Issues, 47(4), 91-109.
  • Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615-623.
  • Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416-423.
  • Thoits, P. A. (1995). Stress, coping, and social support processes: Where are we? What next?. Journal of Health and Social Behavior, 53-79.
  • Thompson, A. J., Montalban, X., Barkhof, F., Brochet, B., Filippi, M., Miller, D. H., ... & McDonald, W. I. (2000). Diagnostic criteria for primary progressive multiple sclerosis: a position paper. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 47(6), 831-835.,
  • Thompson, C. M., Pulido, M. D., Babu, S., Zenzola, N., & Chiu, C. (2022). Communication between persons with multiple sclerosis and their health care providers: A scoping review. Patient Education and Counseling, 105(12), 3341-3368.
  • Tsarenko, Y., & Polonsky, M. J. (2011). ‘You can spend your life dying or you can spend your life living’: Identity transition in people who are HIV-positive. Psychology and Health, 26(4), 465-483.
  • Vickery, B. G., Hays, R.D., Harooni, L., Myers, L.W., Ellison, G.W. (1995). A health-related quality of life measure for multiple sclerosis. Quality of Life Research, 4, 187-206.
  • Wirth, A. G., & Büssing, A. (2016). Utilized resources of hope, orientation, and inspiration in life of persons with multiple sclerosis and their association with life satisfaction, adaptive coping strategies, and spirituality. Journal of Religion and Health, 55(4), 1359-1380.

A Conceptual Evaluation of Nursing Approach and Effective Communication in Shaping Quality of Life in Multiple Sclerosis

Yıl 2025, Cilt: 8 Sayı: 2, 74 - 88, 23.07.2025
https://doi.org/10.71445/umbd.1702898

Öz

Multiple Sclerosis (MS) is a chronic disease that affects individuals' quality of life deeply through its neurological, psychological, and social impacts. This conceptual study examines, from a holistic perspective, the roles of nursing approaches and effective communication—two fundamental elements shaping quality of life in MS patients. The long-term care requirements of MS patients make coping with physical and psychosocial challenges more complex. At this point, individualized care provided by nurses—covering symptom management, patient education, and psychosocial support—is of critical importance in terms of its effect on quality of life. Effective communication enhances the efficiency of treatment and strengthens individual adaptation by enabling trust-based relationships, cultural sensitivity, anxiety management, and shared decision-making. Within this context, a dynamic and complementary relationship exists between nursing services and communication practices in enhancing the quality of life of MS patients. This study argues that, for healthcare professionals, nursing and communication should not only be viewed as supportive elements but also as therapeutic components of the treatment process.

Kaynakça

  • Altun, Ö. Ş., & Özer, D. (2020). Multipl skleroz hastalarında ruhsal durumun değerlendirilmesi ve hemşirenin rolü: Sistematik derleme. Arşiv Kaynak Tarama Dergisi, 29(1), 89-95.
  • Amato, M.P., Ponziani, G., Rossi, F., Liedl, C.L., Stefanile, C., & Rossi, L. (2001). Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Multiple Sclerosis, 7, 340-344.
  • Antonovsky A. (1987). Unraveling the mystery of health. San Francisco: Jossey Bass Publishers.
  • Bandura A. (1997). Self-efficacy. The exercise of control. New York: Freeman and Company.
  • Bandura, A. (1988). Self-regulation of motivation and action through goal systems. In V. Hamilton, G. H. Bower, & N. H. Frijda (Eds.), Cognitive perspectives on emotion and motivation (pp. 37–61). Kluwer Academic Publishers.
  • Barnwell, A. M., & Kavanagh, D. J. (1997). Prediction of psychological adjustment to multiple sclerosis. Social Science & Medicine, 45(3), 411-418.
  • Baumstarck, K., Pelletier, J., Butzkueven, H., Fernandez, O., Flachenecker, P., Idiman, E,…. Auquier, P. (2013). Health-related quality of life as an independent predictor of long-term disability for patients with relapsing-remitting multiple sclerosis. European Journal of Neurology, 20(6), 907-914.
  • Benito-Leon, J., Morales, J. M., Rivera-Navarro, J., & Mitchell, A. (2003). A review about the impact of multiple sclerosis on health-related quality of life. Disability and Rehabilitation, 25(23), 1291-1303.
  • Boeije, H. R., Duijnstee, M. S., Grypdonck, M. H., & Pool, A. (2002). Encountering the downward phase: biographical work in people with multiple sclerosis living at home. Social Science & Medicine, 55(6), 881-893.
  • Bosma H & Kunnen S. (2001). Identity and emotion. Development through self-organization. Paris: Cambridge University Press.
  • Brooks, N. A., & Matson, R. R. (1982). Social-psychological adjustment to multiple sclerosis: A longitudinal study. Social Science & Medicine, 16(24), 2129-2135.
  • Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social psychology, 84(4), 822-848.
  • Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Addressing fundamental questions about mindfulness. Psychological Inquiry, 18(4), 272-281.
  • Brust J. C. (2012). Current diagnosis and treatment: Neurology. Second Edition. United States: Lange McGraw Hill
  • Buck, D., & Hemmer, B. (2011). Treatment of multiple sclerosis: current concepts and future perspectives. Journal of Neurology, 258(10), 1747-1762.
  • Büssing, A., Ostermann, T., Neugebauer, E. A., & Heusser, P. (2010). Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease. BMC public health, 10(1), 507-510.
  • Carver, C. S., & Scheier, M. F. (1994). Optimism and health-related cognition: What variables actually matter?. Psychology and health, 9(3), 191-195.
  • Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat, F. L., & Clark, K. C. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology, 65, 375–390.
  • Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310-357
  • Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ, 337(a1655), 1-6.
  • Crayton, H. J., & Rossman, H. S. (2006). Managing the symptoms of multiple sclerosis: a multimodal approach. Clinical Therapeutics, 28(4), 445-460.
  • Crigger, N. J. (1996). Testing an uncertainty model for women with multiple sclerosis. Advances in Nursing Science, 18(3), 37-47.
  • Dalgas, U., Stenager, E., & Ingemann-Hansen, T. (2008). Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance-and combined training. Multiple Sclerosis Journal, 14(1), 35-53.
  • De Ridder, D., Geenen, R., Kuijer, R., & van Middendorp, H. (2008). Psychological adjustment to chronic disease. The Lancet, 372(9634), 246-255.
  • Dennison, L., & Moss-Morris, R. (2010). Cognitive–behavioral therapy: what benefits can it offer people with multiple sclerosis?. Expert review of neurotherapeutics, 10(9), 1383-1390.
  • Dennison, L., Moss-Morris, R., & Chalder, T. (2009). A review of psychological correlates of adjustment in patients with multiple sclerosis. Clinical Psychology Review, 29(2), 141-153.
  • Devins, G. M., & Shnek, Z. M. (2000). Multiple sclerosis. In R. G. Frank & T. R. Elliott (Eds.), Handbook of rehabilitation psychology (pp. 163–184). American Psychological Association.
  • Ellis, T., & Motl, R. W. (2013). Physical activity behavior change in persons with neurologic disorders: overview and examples from Parkinson disease and multiple sclerosis. Journal of Neurologic Physical Therapy : JNPT, 37(2), 85–90.
  • Erbay, Ö., Yeşilbalkan, Ö. U., & Karadakovan, A. (2020). Multipl sklerozlu hastaların tedavi yönetimi ve hemşirelik yaklaşımları. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 13(1), 30-40.
  • Fernandez, O., Baumstarch-Barrau, K., Simeoni, M.C., Auquier, P. (2011). Patient characteristics and determinants of quality of life in an international population with multiple sclerosis: assessment using the MusiQoL and SF-36 questionnaires. Multiple Sclerosis Journal, 17(10), 1238-1249.
  • Ferrans, C. E., Zerwic, J. J., Wilbur, J. E., Larson, J. L. (2005). Conceptual model of health-related quality of life. J Nurs Scholarsh, 37(4),36-42.
  • Figved, N., Myhr, K. M., Larsen, J. P., & Aarsland, D. (2007). Caregiver burden in multiple sclerosis: the impact of neuropsychiatric symptoms. Journal of Neurology, Neurosurgery & Psychiatry, 78(10), 1097-1102.
  • Fournier, M., de Ridder, D., & Bensing, J. (1999). Optimism and adaptation to multiple sclerosis: what does optimism mean?. Journal of Behavioral medicine, 22(4), 303-326.
  • Ghafari, S., Ahmadi, F., Nabavi, M., Anoshirvan, K., Memarian, R., & Rafatbakhsh, M. (2009). Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis. Journal of clinical nursing, 18(15), 2171-2179.
  • Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., ... & Ranasinghe, P. D. (2014). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368.
  • Guimaraes, F. A., Oliveira-Cardoso, E. A., Mastropietro, A. P., Voltarelli, J. C., & Santos, M. A. (2010). Impact of autologous hematopoetic stem cell transplantation on the quality of life of patients with multiple sclerosis. Arquivos De Neuro-Psiquiatria, 68(4), 522-527.
  • Hart, S., Fonareva, I., Merluzzi, N., & Mohr, D. C. (2005). Treatment for depression and its relationship to improvement in quality of life and psychological well-being in multiple sclerosis patients. Quality of Life Research, 14(3), 695-703.
  • Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., ... & Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081.
  • Haz D., Yay G., Koordinat G., & Tan MS. (2013). Multipl Skleroz Tanı ve Tedavi Klavuzu. İstanbul: Galenos Yayınevi. Helgeson, V. S. (2003). Social support and quality of life. Quality of Life Research, 12(1), 25-31.
  • Herndon, R. M. (2000). Pathology and pathophysiology. In J. S. Burks & K. P. Johnson (Eds.), Multiple sclerosis: Diagnosis, medical management, and rehabilitation (pp. 1–35). Demos Medical Publishing.
  • Holman, H., & Lorig, K. (2004). Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public health reports, 119(3), 239-243.
  • Holtzman, S., Newth, S., & Delongis, A. (2004). The role of social support in coping with daily pain among patients with rheumatoid arthritis. Journal of Health Psychology, 9(5), 677-695.
  • Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537-559.
  • Irvine, H., Davidson, C., Hoy, K., & Lowe-Strong, A. (2009). Psychosocial adjustment to multiple sclerosis: exploration of identity redefinition. Disability and Rehabilitation, 31(8), 599-606.
  • Jang, Y., Haley, W. E., Mortimer, J. A., & Small, B. J. (2003). Moderating effects of psychosocial attributes on the association between risk factors and disability in later life. Aging & Mental Health, 7(3), 163-170.
  • Keune, P. M., & Perczel Forintos, D. (2010). Mindfulness meditation: A preliminary study on meditation practice during everyday life activities and its association with well-being. Psihologijske Teme, 19(2), 373-386.
  • Klimova, E., Szilasiova, J., & Vesela, D. (2002). Multiple sclerosis and interferon-beta: their effect on quality of life and economic activity of subjects with relapse/remission form of disease. Lekarsky Obzor, 51(7), 204-206.
  • Koopman, W. J., Benbow, C. L., & Vandervoort, M. (2006). Top 10 needs of people with multiple sclerosis and their significant others. Journal of Neuroscience Nursing, 38(5), 369-373.
  • Kraft, G. H. (1999). Rehabilitation still the only way to improve function in multiple sclerosis. The Lancet, 9195(354), 2016-2017.
  • Lawrence, M., Booth, J., Mercer, S., & Crawford, E. (2013). A systematic review of the benefits of mindfulness-based interventions following transient ischemic attack and stroke. International Journal of Stroke, 8(6), 465-474.
  • Learmonth, Y. C., & Motl, R. W. (2016). Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences. Disability and Rehabilitation, 38(13), 1227-1242.
  • Lerdal, A., Gulowsen Celius, E., &Moum, T. (2009). Perceptions of illness and its development in patients with multiple sclerosis: a prospective cohort study. Journal of Advanced Nursing, 65(1), 184-192.
  • Levy, S. S., Li, K.-K., Cardinal, B. J., & Maddalozzo, G. F. (2009). Transitional shifts in exercise behavior among women with multiple sclerosis. Disability and Health Journal, 2(4), 216–23.
  • Magnus, C. M., Kowalski, K. C., & Mchugh, T. L. F. (2010). The role of self-compassion in women's self-determined motives to exercise and exercise-related outcomes. Self and Identity, 9(4), 363-382.
  • Matson, R. R., & Brooks, N. A. (1977). Adjusting to multiple sclerosis: An exploratory study. Social Science & Medicine, 11(4), 245-250.
  • McCabe, M. P., McKern, S., & McDonald, E. (2004). Coping and psychological adjustment among people with multiple sclerosis. Journal of Psychosomatic Research, 56(3), 355-361.
  • McCullagh, R., Fitzgerald, A. P., Murphy, R. P., & Cooke, G. (2008). Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study. Clinical Rehabilitation, 22(3), 206-214.
  • Meeberg, G. A. (1993). Quality of life: A concept analysis. Journal of Advanced Nursing, 18(1), 32-38.
  • Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17(3), 192-200.
  • Minden, S. L., & Schiffer, R. B. (1990). Affective disorders in multiple sclerosis review and recommendations for clinical research. Archives of Neurology, 47(1), 98-104.
  • Mostert, S., & Kesselring, J. (2002). Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Multiple Sclerosis Journal, 8(2), 161-168.
  • Motl, R. W., & McAuley, E. (2009). Pathways between physical activity and quality of life in adults with multiple sclerosis. Health Psychology, 28(6), 682–689.
  • Motl, R. W., & Pilutti, L. A. (2012). The benefits of exercise training in multiple sclerosis. Nature Reviews Neurology, 8(9), 487-497.
  • Motl, R. W., & Snook, E. M. (2008). Physical activity, self-efficacy, and quality of life in multiple sclerosis. Annals of Behavioral Medicine, 35(1), 111-115.
  • Motl, R. W., Gappmaier, E., Nelson, K., & Benedict, R. H. B. (2011). Physical activity and cognitive function in multiple sclerosis. Journal of Sport & Exercise Psychology, 33(5), 734–41.
  • Motl, R. W., McAuley, E., & Snook, E. M. (2005). Physical activity and multiple sclerosis: a meta-analysis. Multiple Sclerosis Journal, 11(4), 459-463.
  • Motl, R. W., McAuley, E., & Snook, E. M. (2007). Physical activity and quality of life in multiple sclerosis: Possible roles of social support, self-efficacy, and functional limitations. Rehabilitation Psychology, 52(2), 143-151.
  • Neff, K. D. (2009). The role of self‐compassion in development: A healthier way to relate to oneself. Human Development, 52(4), 211–214.
  • Neff, K. D., Rude, S. S., & Kirkpatrick, K. L. (2007). An Examination of self‐compassion in relation to positive psychological functioning and personality traits. Journal Of Research In Personality, 41(4), 908–916.
  • Newsom, J.T., & Schulz, R. (1996). Social support as a mediator in the relation between functional status and quality of life in older adults. Psychology and Aging, 11(1), 34-44.
  • Nhất, H., Ho, M., & Vo, D. M. (1999). The miracle of mindfulness: An introduction to the practice of meditation. Boston: Beacon Press.
  • Novik, A. A., Ionova, T. I., Bisaga, A.V., Kishtovitch, A.V., Fedorenko, D.A., Ivanov, R.A., & Gorodokin, G.I. (2005). Clinical and quality of life responses to high-dose chemotherapy plus autologous stem cell transplantation in patients with multiple sclerosis: two case reports. Cytotherapy, 7(4), 363-367.
  • Pakenham, K. I. (2006). Investigation of the coping antecedents to positive outcomes and distress in multiple sclerosis (MS). Psychology & Health, 21(5), 633–649.
  • Pakenham, K. I. (2007). Making sense of multiple sclerosis. Rehabilitation Psychology, 52(4), 380-389.
  • Parfenov, V., Schluep, M., & Du Pasquier, R. (2013). Assessing risks of multiple sclerosis therapies. J Neurol Sci. 15;332(1-2):59-65.
  • Petajan, J. H., & White, T. (1999). Recommendations For Physical Activity in Patients ith Multiple Sclerosis. Sports Medicine, 27(3), 179–191.
  • Phillips, L. J., & Stuifbergen, A. K. (2008). The influence of positive experiences on depression and quality of life in persons with multiple sclerosis. Journal of Holistic Nursing : Official Journal of the American Holistic Nurses’ Association, 26(1), 41–8.
  • Pozzilli, C., Brunetti, M., Amicosante, A. M. V., Gasperini, C., Ristori, G., Palmisano, L., & Battaglia, M. (2002). Home based management in multiple sclerosis: results of a randomised controlled trial. Journal of Neurology, Neurosurgery & Psychiatry, 73(3), 250-255.
  • Pragodpol, P., & Ryan, C. (2013). Critical review of factors predicting health-related quality of life in newly diagnosed coronary artery disease patients. Journal of Cardiovascular Nursing, 28(3), 277-284.
  • Price, E., Lucas, R., & Lane, J. (2021). Experiences of healthcare for people living with multiple sclerosis and their healthcare professionals. Health Expectations, 24(6), 2047-2056.
  • Reyes, D. (2012). Self‐Compassion: A Concept Analysis. Journal of Holistic Nursing, 30(2), 81–89.
  • Riazi, A., Hobart, J. C., Lamping, D. L., Fitzpatrick, R., Freeman, J. A., Jenkinson, C., et al. (2003). Using the SF-36 measure to compare the health impact of multiple sclerosis and Parkinson’s disease with normal population health profiles. Journal of Neurology, Neurosurgery and Psychiatry, 74(6), 710–714.
  • Robinson, F. P., Mathews, H. L., & Witek-Janusek, L. (2003). Psycho-endocrine-immune response to mindfulness-based stress reduction in individuals infected with the human immunodeficiency virus: a quasiexperimental study. The Journal of Alternative & Complementary Medicine, 9(5), 683-694.
  • Rommer, P. S., Sühnel, A., König, N., & Zettl, U. K. (2017). Coping with multiple sclerosis—the role of social support. Acta Neurologica Scandinavica, 136(1), 11-16.
  • Rosenberger, J., Van Dijk, J. P., Nagyova, I., Zezula, I., Geckova, A. M., Roland, R., ... & Groothoff, J. W. (2006). Predictors of perceived health status in patients after kidney transplantation. Transplantation, 81(9), 1306-1310.
  • Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. Journal of psychosomatic research, 68(1), 29-36.
  • Roubinov, D. S., Turner, A. P., & Williams, R. M. (2015). Coping among individuals with multiple sclerosis: Evaluating a goodness-of-fit model. Rehabilitation Psychology, 60(2), 162.
  • Rudick, R. A., Miller, D., Clough, J. D., Gragg, L. A., & Farmer, R. G. (1992). Quality of life in multiple sclerosis. Comparison with inflammatory bowel disease and rheumatoid arthritis. Archives of Neurology, 49(12), 1237-1242.
  • Rumpf, H. J., & Wessel, K. (1995). Coping pattern and adjustment in multiple sclerosis. Der Nervenarzt, 66(8), 624-629.
  • Sá, M. J. (2008). Psychological aspects of multiple sclerosis. Clinical Neurology and Neurosurgery, 110(9), 868-877.
  • Saccardi, R., Freedman, M. S., Sormani, M.P., Atkins, H., Farge, D., Griffith, L. M., Kraft, G.…Muraro, P.A. (2012). A prospective, randomized, controlled trial of autologous haematopoietic stem cell transplantation of aggressive multiple sclerosis: a position paper. Multiple Sclerosis Journal, 18(6), 825-834.
  • Schaffler, N., Schonberg, P., Stephan, J., Stellmann, J. P., Gold, S. M., & Heesen, C. (2013). Comparison of patient-reported outcome measures in multiple sclerosis. Acta Neurologica Scandinavica, 128(2), 114-121.
  • Schwartz, C., & Frohner, R. (2005). Contribution of demographic, medical, and social support variables in predicting the mental health dimension of quality of life among people with multiple sclerosis. Health & Social Work, 30(3), 203-212.
  • Schwarzer, R. (1999). Self-regulatory processes in the adoption and maintenance of health behaviors. Journal of Health Psychology, 4(2), 115-127.
  • Sebastião, E., Hubbard, E. A., Klaren, R. E., Pilutti, L. A., & Motl, R. W. (2017). Fitness and its association with fatigue in persons with multiple sclerosis. Scandinavian Journal of Medicine & Science In Sports, 27(12), 1776-1784.
  • Simpson, R., Booth, J., Lawrence, M., Byrne, S., Mair, F., & Mercer, S. (2014). Mindfulness based interventions in multiple sclerosis-a systematic review. BMC Neurology, 14(15), 1-9.
  • Stroud, N., Minahan, C., & Sabapathy, S. (2009). The Perceived benefits and barriers to exercise participation in persons with multiple sclerosis. Disability & Rehabilitation, 31(26), 2216–2222.
  • Tan-Kristanto, S., & Kiropoulos, L. A. (2015). Resilience, self-efficacy, coping styles and depressive and anxiety symptoms in those newly diagnosed with multiple sclerosis. Psychology, Health & Medicine, 20(6), 635-645.
  • Taylor, S. E. (1989). Positive illusions: Creative self-deception and the healthy mind. New York: Basic Books Harper Collins.
  • Taylor, S. E., Helgeson, V. S., Reed, G. M., & Skokan, L. A. (1991). Self‐generated feelings of control and adjustment to physical illness. Journal of Social Issues, 47(4), 91-109.
  • Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615-623.
  • Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416-423.
  • Thoits, P. A. (1995). Stress, coping, and social support processes: Where are we? What next?. Journal of Health and Social Behavior, 53-79.
  • Thompson, A. J., Montalban, X., Barkhof, F., Brochet, B., Filippi, M., Miller, D. H., ... & McDonald, W. I. (2000). Diagnostic criteria for primary progressive multiple sclerosis: a position paper. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 47(6), 831-835.,
  • Thompson, C. M., Pulido, M. D., Babu, S., Zenzola, N., & Chiu, C. (2022). Communication between persons with multiple sclerosis and their health care providers: A scoping review. Patient Education and Counseling, 105(12), 3341-3368.
  • Tsarenko, Y., & Polonsky, M. J. (2011). ‘You can spend your life dying or you can spend your life living’: Identity transition in people who are HIV-positive. Psychology and Health, 26(4), 465-483.
  • Vickery, B. G., Hays, R.D., Harooni, L., Myers, L.W., Ellison, G.W. (1995). A health-related quality of life measure for multiple sclerosis. Quality of Life Research, 4, 187-206.
  • Wirth, A. G., & Büssing, A. (2016). Utilized resources of hope, orientation, and inspiration in life of persons with multiple sclerosis and their association with life satisfaction, adaptive coping strategies, and spirituality. Journal of Religion and Health, 55(4), 1359-1380.
Toplam 108 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Politika ve Yönetim (Diğer)
Bölüm Derleme
Yazarlar

Büşra Şüheda Kayadelen 0000-0002-5692-4267

Rukiye Çelik 0000-0002-2538-0228

Gönderilme Tarihi 20 Mayıs 2025
Kabul Tarihi 4 Temmuz 2025
Yayımlanma Tarihi 23 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 2

Kaynak Göster

APA Kayadelen, B. Ş., & Çelik, R. (2025). Multipl Sklerozda Yaşam Kalitesini Şekillendiren Unsurlar: Hemşirelik Yaklaşımı ve Etkili İletişimin Kavramsal Değerlendirmesi. Uluborlu Mesleki Bilimler Dergisi, 8(2), 74-88. https://doi.org/10.71445/umbd.1702898
Creative Commons Lisansı
Isparta Uygulamalı Bilimler Üniversitesi Uluborlu Mesleki Bilimler Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı ile lisanslanmıştır.