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

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          Abstract

          Objectives

          Multiple 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 Methods

          In 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.

          Results

          Average 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.

          Conclusion

          The 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.

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          Most cited references37

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          Sex and gender issues in multiple sclerosis.

          Multiple sclerosis (MS) is universally found to be more prevalent in women than men. This has led to extensive studies of differences in the immune system or nervous system between women and men, which might be caused by the effects of gonadal hormones, genetic differences, and different environmental exposures and modern lifestyle in men and women. We review the effects of sex and gender from a genetic, immunological and clinical point of view. We discuss the effects of sex on the clinical expression of MS and responses to therapy, as well as issues concerning pregnancy.
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            An analysis of coping in a middle-aged community sample.

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              Adjustment to multiple sclerosis: application of a stress and coping model.

              This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.
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                Author and article information

                Contributors
                m.saffari@bmsu.ac.ir , Saffari.CHES@gmail.com
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                21 September 2017
                October 2017
                : 7
                : 10 ( doiID: 10.1002/brb3.2017.7.issue-10 )
                : e00810
                Affiliations
                [ 1 ] Health Education Department Faculty of Health Baqiyatallah University of Medical Sciences Tehran Iran
                [ 2 ] Health Research Center Baqiyatallah University of Medical Sciences Tehran Iran
                [ 3 ] Department of Epidemiology and Biostatistics Faculty of Health Baqiyatallah University of Medical Sciences Tehran Iran
                [ 4 ] Department of Psychiatry King Abdul Aziz University Jeddah Saudi Arabia
                [ 5 ] Department of Psychiatry and Behavioral Sciences Duke University Medical Center Durham NC USA
                [ 6 ] King Abdulaziz University Jeddah Saudi Arabia
                [ 7 ] Ningxia Medical University Yinchuan China
                Author notes
                [*] [* ] Correspondence

                Mohsen Saffari, Health Research Center, Baqiyatallah University of Medical Sciences Tehran, Iran.

                Emails: m.saffari@ 123456bmsu.ac.ir and Saffari.CHES@ 123456gmail.com

                Author information
                http://orcid.org/0000-0001-7590-9516
                Article
                BRB3810
                10.1002/brb3.810
                5651394
                304a3717-d11f-4420-b1dd-7c4c19b1e5d7
                © 2017 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 March 2017
                : 12 July 2017
                : 20 July 2017
                Page count
                Figures: 2, Tables: 3, Pages: 9, Words: 7512
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                brb3810
                October 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.1 mode:remove_FC converted:23.10.2017

                Neurosciences
                coping,education,multiple sclerosis,stress,transactional model
                Neurosciences
                coping, education, multiple sclerosis, stress, transactional model

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