社会心理的
复发-缓解
医学
多发性硬化
透视图(图形)
新颖性
临床心理学
心理学
精神科
社会心理学
计算机科学
人工智能
作者
Ieva Eskytė,Ana Manzano,George Pepper,Sue Pavitt,Helen Ford,Hilary Bekker,Jeremy Chataway,Klaus Schmierer,David Meads,Edward Webb,Barbara Potrata
标识
DOI:10.1016/j.msard.2018.11.016
摘要
Background Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system that mainly affects young adults. While there is no cure for MS, disease modifying treatments (DMTs) reduce the relapse rate and partial accrual of disability. More effective DMTs may have higher risks including life-threatening infections or secondary autoimmunity. The complexity and novelty of available treatments cause challenges for clinicians when prescribing treatments and for people with MS (PwMS) when deciding what trade-offs they are willing and ready to make. Objective To explore the experience of people with relapsing remitting MS (PwRRMS) and their perspectives in choosing treatments. Methods Critical interpretive synthesis was employed to review and synthesis the published literature. Eighty-three publications were selected in a multi-step systematic process. Results Findings are presented in four interrelated areas: the influence of the clinical evidence-base in decision making; the meaning of DMT efficacy for PwRRMS; the influence of models of decision-making and information acquisition practices in PwRRMS; and the importance of psychosocial dimensions in DMT decision making. Synthesis of the findings revealed that alongside medical and individual reasoning, contextual circumstances play an important role in making treatment decisions. Conclusion This review identifies and explains the importance of diverse contextual circumstances (clinical, social, psychological) that are important for PwRRMS when making treatment decisions. The findings demonstrate the importance of eliciting, understanding and addressing such contextual factors.
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