Introduction: The present study was aimed at investigating the effectiveness of cognitive-behavioral group therapy in quality of life and hope among patients with multiple sclerosis (MS).
Materials and Methods: In this clinical trial, using a quasi-experimental pretest-posttest control group design, 20 MS patients were selected through available sampling among the patients in Mashhad Multiple Sclerosis Association in 2016 and were randomly assigned into two experimental and control groups, each containing 10 subjects. The experimental group underwent cognitive-behavioral group therapy in 10 weekly sessions of 2 hours and the control group did not receive this treatment. In the pretest and posttest, Quality of Life Questionnaire-Short Form (SF-36) and Snyder Adult Hope Scale (AHS) were implemented on all the subjects of the experimental and control groups. Data was analyzed using analysis of covariance and t-test.
Results: The results demonstrated that cognitive-behavioral group therapy significantly leads to increased overall index of quality of life and hope (p<0.001) in the experimental group compared to the control group. Further, out of quality of life components, dimensions of physical function, role limitation due to physical problems, fatigue or vitality, emotional health and general health of the experimental group showed a greater increase at the end of the intervention relative to the control group (p<0.001) and concerning other subscales, the difference between the two groups was not significant.
Miller J. Multiple sclerosis. In: Ronald P, editor. Merritts text book of, neurology. 10 ed. Philadelphia: Lippincott & Wilkins; 2000.
Coleman CI, Sidovar MF, Roberts MS, Kohn C. Impact of mobility impairment on indirect costs and health-related quality of life in multiple sclerosis. Plos One. 2013; 8(1):1-8.
National Multiple Sclerosis Society. Multiple Sclerosis Information Sourcebook. New York, NY: Information Resource Center and Library of the National Multiple Sclerosis Society; 2006.
Harizchi ghadim S, Ranjbar kuchsaryi F, Talebi M, Zakaria M. Effects of ''written emotional expression" on anxiety and depression in patients with multiple sclerosis. Iran J Neurol. 2013; 8(25):465–75. ]In Persian[
Chiaravalloti ND, Deluca J. Cognitive impairment in multiple sclerosis. Lancet Neurology. 2008; 7(12):1139-51.
Zhang H, Wisniewski SR, Bauer MS. Comparison of perceived quality of life across clinical states in bipolar disorder: Data from first 2000 Systematic Treatment Enhancement Program For bipolar Disorder (STEP-BD) participants. Compr Psychiatry 2006; 47(3):161-8.
Al-Akour N, Khader YS, Shatnawi NJ. Quality of life and associated factors among Jordanian adolescents with type 1 diabetes mellitus. J Diabetes Complications. 2010; 24(1):43-7.
Łabuz-Roszak B, Kubicka-Bączyk K, Pierzchała K, Horyniecki M, Machowska-Majchrzak A, Augu¬styńska-Mutryn D, Kosałka K, Michalski K, Pyszak D, Wach J. Quality of life in multiple sclerosis–association with clinical features, fatigue and depressive syndrome. Psychiatria Polska. 2013; 3:433-441.
Janssens A, Doorn PA, Boer JB, Meche FGA, Passchier J, & Hintzen RQ. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurologica Scandinavica. 2003; 108(6): 389–395.
Rudick RA, Miller D, Clough JD. Quality of life in multiple sclerosis, comparison with inflammatory bowel disease and rheumatoid arthritis. Archives of Neurology. 1992; 49(12):1-3.
Yousefi A, Shaghaghi F, Dehestani M, Barghi Irani Z. The relationship between Quality of Life (QoL) and psychological capital with illness perception in MS Patients. Health Psychol. 2012; 1(1):1-15. [In Peraian]
Tyszka AC, Farber RS. Exploring the relation of health-promoting behaviors to role participation and health-related quality of life in women with multiple sclerosis: a pilot study. Am J Occup Ther. 2010; 64(4):650-59.
Snyder CR, Lopez SJ. Handbook of Positive Psychology. US: Oxford University Press; 2001.
Herth KA. The relationship between level of hope and level of coping response and other variables in patients with cancer. Oncol Nurs Forum 1989; 16:67–72.
Elliott TR, Witty TE, Herrick S, Hoffman JT. Negotiating reality after physical loss: hope, depression and disability. J Pers Soc Psychol 1991; 61:608–13.
Gottschalk LA. Hope and other deterrents to illness. Am J Psychother 1985; 39:515– 24.
Udelman DL, Udelman HD. Affects, neurotransmitters, and immunocompetence. Stress Medicine 1991; 7:159–62.
Staats S. Quality of life and affect in older persons: hope, time frames, and training effects. Current Psychology: Research and Reviews 1991; 10:21–30.
Shoae Kazemi M, Momeni Javid M. Relationship between quality of life & hope in breast cancer patients after surgery. J Breast Dis of Iran. 2009; 2(3, 4): 20-7. [In Persian]
Snyder R, Anderson J."Hope and health: measuring the will and ways" handbook of social and clinical Psychology: the Health Perspective. NewYork: program press; 1991:285-305.
Rasouli M, Bahramian J, Zahrakar K. The effect of hope therapy on quality of life in multiple sclerosis patients. Iranian Journal of Psychiatric Nursing. 2013; 1(4):54-65. ]In Persian[
Rezaii A, Refahi Zh, Ahmadikhah MA. Effectiveness of group logo therapy to reduce depression in patients with cancer. Journal of Psychological Models and Methods. 2012; 2(7): 37-46. ]In Persian[
White, C. Cognitive behavioral principles in managing chronic disease. The Western Journal of Medicine. 2001; 175(5): 338–342.
Wang ZD, Xia YF, Zhao Y, Chen LM. Cognitive behavioural therapy on improving the depression symptoms in patients with diabetes: a meta-analysis of randomized control trials. Bioscience Reports. 2017; 37 BSR20160557. DOI: 10.1042/BSR20160557.
Kirchner LDF, Jorge CC, Dos Reis MDJD. Group cognitive-behavioral therapy for chronic pain adults: review of Brazilian trials. Rev Dor. São Paulo. 2015; 16(3):210-4.
Adina JO, Maritim EK, Sindabi AM, Disiye MA. Effect of cognitive behavior therapy on depressive symptoms among HIV-Infected outpatients in Kenya. International Journal of Psychology and Psychological Therapy. 2017; 17(2): 161-173.
Jeyanantham K, Kotecha D, Thanki D, Dekker R, Lane DA. Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev. 2017; 22:731–741. DOI 10.1007/s10741-017-9640-5.
Shareh H, Robati Z, Oladi F, Jafarnia V. The effectiveness of cognitive behavioral group therapy on depression, hope and adjustment in patients with Hepatitis B. Zahedan J Res Med Sci. 2017; 19(5):e9423.
Van den Akker LE, Beckerman H, Collette EH, Twisk JW, Bleijenberg G, Dekker J, Knoop H, De Groot V. Cognitive behavioral therapy positively affects fatigue in patients with multiple sclerosis: Results of a randomized controlled trial. Mult Scler. 2017; 23(11):1542-.1553.doi:10.1177/1352458517709361.
Clancy M, Drerup M, Sullivas AB. Outcomes of cognitive-behavioral treatment for insomnia on insomnia, depression, and fatigue for individuals with multiple sclerosis. Int J MS Care. 2015; 17(6): 261–267.doi: 10.7224/1537-2073.2014-071.
Pahlavanzadeh P, Abbasi S, Alimohammadi N. The effect of group cognitive behavioral therapy on stress, anxiety, and depression of women with multiple sclerosis. Iranian Journal of Nursing and Midwifery Research. 2017; 22(4):271-275. ]In Persian[
Hind D, Cotter J, Thake A, Bradburn M, Cooper C, Isaac C, House A. Cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: a systematic review and meta-analysis. BMC Psychiatry 2014, 14:5.
Cosio D, Ling J, Siddique J, Mohr DC. The effect of telephone-administered cognitive behavioral therapy on quality of life among patients with multiple sclerosis. Ann Behavior Med. 2011; 41(2):227-34.
Van Kessel K, Morris MR, Willoughby E, Chalder T, Johnson MH, Robinson E. A randomized controlled trial of cognitive behavior therapy for multiple sclerosis fatigue. Psychosomatic Medicine. 2008; 70: 205-213.
Bishop M, Stenhoff DM, Shepard L. Psychosocial adaptation and quality of life in multiple sclerosis: Assessment of the disability centrality model. The Journal of Rehabilitation. (2007); 1(73).
Bieling PJ, McCabe RE, Antony MM. Cognitive- behavioral therapy in groups. London: Guilford; 2006.
Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey manual and interpretation guide. New England Medical Center. The Health Institute: Boston, MA; 1993.
Jenkinson C, Wright L, Coulter A. Criterion validity and reliability of the SF-36 in a population sample. Quality of Life Research. 1994; 3(1):7–12.
Montazeri A, Goshtasebi A, Vahdaninia M, et al. The short form health survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research Journal. 2005; 14(3): 875-882. ]In Persian[
Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, Yoshinobu L, Gibby J, Langelle C, Harney P. The will and the ways: development and validation of an individual- differences measure of hope. Journal of Personality and Social Psychology. 1991; 60 (4): 570-585.
Snyder CR, Lopez SG. Positive psychology: the scientific and practical explorations of human strengths. New York Published by Oxford University Press; 2007.
Ghobary B, Lavasani M, Rahimi H. Hope, purpose in life, and mental health in college students. International Journal of the Humanities. 2007; 5(5):127-132.]In Persian [
Kermani Z, Khodapanahi M, Heidari M. Psychometrics features of the Snyder hope scale. Journal of Applied Psychology. 2011; 5(19): 7-23.]In Persian[
Khalaji T. The investigation of relation of hope, sources of school educational control and the academic achievement of girls in pre-university period of Tehran in the academic year 2006-2007; M.A. Thesis, Azahra University; 2007. [In Persian]
Nordin L, Rorsman LA. Cognitive behavioural therapy in multiple sclerosis: A randomized controlled pilot study of an acceptance and commitment therapy. J Rehabil Med. 2012; 44:87-90.
Graziano F, Calandri E, Borghi M, Bonino S. The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: A randomized controlled trial. Clinical Rehabilitation. 2014; 28(3):264–274.
Sinclair VG, Scroggie J. Effects of a cognitive behavioral program for women with multiple sclerosis. J Neurosci Nurs. 2005; 37(5):249–57, 276.
Mokhtari S, Neshtdoost HT, Molavi H. The effectiveness of cognitive behavioral group on depression and somatization in patients with multiple sclerosis. J Psychol. 2008; 12:242-51. ]In Persian[
Hoseyni S. The effect of group cognitive therapy in reducing depression and increasing mental health of patients with multiple sclerosis. Tehran: Alzahra University; 2005. [In Persian]
Omrani S, Mirzaeian B, Aghabagheri H, Hassanzadeh R, Abedini M. Effectuality of cognitive-behavioral therapy on the life expectancy of patients with multiple sclerosis. The Journal of Mazandaran University of Medical Sciences. 2012; 22(93): 58-65. [In Persian]
Aghabagheri H, Mohammadkhani P, Omrani S, Farahmand V. The efficacy of mindfulness-based cognitive therapy group on the increase of subjective well-being and hope in patients with multiple sclerosis. Journal of Clinical Psychology. 2012; 1 (13):23-31. ]In Persian[
Ghara Zibaei F, Aliakbari Dehkordi M, Alipour A, Mohtashami T. Efficacy of group logo therapy in the perceived stress and life expectancy in MS patients. Journal of Research in Psychological Health. 2012; 6(4):12-20. ]In Persian[.