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The critical importance of optimism when you have MS

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  • The critical importance of optimism when you have MS

    Researchers dug into what can seriously affect quality of life in MS. Does optimism, positivity, matter? Yup. A lot. -D

    Multiple Sclerosis and Related Disorders

    Available online 1 October 2021, 103293
    In Press, Journal Pre-proof

    The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review


    Under a Creative Commons license
    open access

    • MS is an unpredictable disease associated with much uncertainty. The expectations people with MS (PwMS) form about the future may influence their quality of life (QOL)
    • Positive thoughts about the future such as self-efficacy expectations appear to be particularly beneficial for the QOL of PwMS
    • There is inconclusive evidence regarding the possible impacts of negative expectations (e.g. fears or worries) on QOL in MS.
    • Interventions targeted at fostering positive thoughts about future capabilities may be effective in increasing QOL in PwMS.


    Multiple Sclerosis (MS) is a highly variable condition characterised by uncertainty of disease course which can make formation of expectations about the future difficult. This systematic review aimed to examine associations between expectations, or Future Oriented Cognitions (FOCs), and Quality of Life (QOL) in people with MS (PwMS).

    Following PRISMA guidelines, literature up to October 2019 was searched using Medline, EMBASE, PsycINFO and Web of Science. Quantitative studies that investigated relationships between FOC and QOL in PwMS (assessed using a standardised QOL assessment) were considered for inclusion. After data extraction, results were analysed using narrative synthesis, focusing on the valence of FOCs (positive, negative, unvalenced). Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). All stages of the review were patient-led by a person with MS.

    A total of 13 studies met the review inclusion criteria, with a combined sample size of 4,179. Of these studies, 11 involved measures of positive FOCs, most commonly self-efficacy, one measured a negative FOC, with one FOC unclassified. Nine studies found significant associations between QOL and self-efficacy. Although other positively valenced constructs were less frequently reported, significant associations with higher QOL were also evidenced.

    Identifying ways to foster positive FOCs, particularly self-efficacy, may have beneficial effects on QOL. More research is needed to understand the impacts of negative FOCs on QOL to determine whether these processes could be meaningfully targeted in interventions.

    Dave Bexfield

  • #2
    I love their conclusions! Is it any wonder why I'm so darn bubbly all the time? -D

    4.4. Conclusions

    Currently, the treatment of MS tends to focus on clinical aspects of the disease and symptom management, with less attention paid to psychological experiences of coping with disease. There is a growing recognition that the expectations patients form about illness may influence a range of outcomes, including health attitudes and behaviours, as well as treatment satisfaction, adherence and decision making (Coulter, 2006).

    Our review suggests that thoughts about the future may also influence many aspects of QOL in MS, and that recognising this is an important aspect of MS care, especially given the unpredictable nature of the disease. In particular, our findings highlight the importance of fostering positive expectations in patients, including self-efficacy in one's abilities to manage the effects of MS and treatment.

    These findings have implications for both clinicians and PwMS. For example, based on these results, we recommend that clinicians acknowledge the feelings of uncertainty that may be experienced by PwMS and carefully consider how to foster positive FOCs regarding treatment and symptom management during consultations, without setting unrealistic expectations. Similarly, we recommend that PwMS identify ways in which they may be empowered to feel in control over aspects of their condition while also learning to accept their diagnosis.

    While the development of such expectations may be aided by the provision of education and support, needs for these supports continue to be unmet (McCabe et al., 2015). More research into the influence of other forms of expectations, such as negative or unvalenced FOCs, may give further insight into how best to develop interventions tailored at supporting PwMS.
    Dave Bexfield


    • #3
      Attitude is everything where health is concerned.
      I was told I had M.S. OK fine I said and kept working.
      My legs stopped working properly, OK fine, I'll use a chair.
      My left arm doesn't work well. OK Fine, I'll use a power chair so I'm not just going in circles!
      I can't do my job any longer, OK fine, I'll go on disability.

      20 years into my M.S. journey, I have cancer.
      OK fine, cut out my colon and I'll poop in a bag.
      It's all good, it doesn't change who I am, just slows me down a bit getting things done.
      I'll add, that a healthy dose of faith injected into your life sure helps too!
      Retired engineer, now hobby farmer with goats, chickens, an old dog,and a lazy barn cat!
      Watch my goats at
      Active in amateur radio
      Linux geek, blogging at
      M.S. since 2000


      • #4
        I agree, might be wrong but I believe our own outlook has a great impact on our progress. B4 MS I don't recall really hearing about it. Since dx I have met a lot of people with it that I didn't even know about. The common denominator is that they keep going. My old job was too physical, and very stressful- no good. I started driving a dump truck, low stress and it doesn't require much of my legs. When my sons are finished college I may consider something else. It sucks that I have to use walking sticks to take my dog for nature hikes but it feels great! I've discovered a joy of helping people with my mini backhoe. Neighbors want to pay me 4 helping, but it feels good to be useful. When the next challenge arises I'll adapt.


        • #5
          Hi just looking for tips on how to stay positive when u have a relapse with ms