Research shows relationships are key to quality of life with multiple sclerosis

June 12, 2014
photo of nursing student talking to older patient

For patients with multiple sclerosis, a holistic approach to treatment is key.

Multiple Sclerosis is a chronic disease that affects much more than the body. It takes more than treating the disease to help a patient, it requires treating the entire person.

Chronic diseases, especially those as severe as multiple sclerosis, can greatly impact the mental status of patients and their overall quality of life. It is this idea of “quality of life” that Brian Holland, assistant professor at the Texas A&M Health Science Center (TAMHSC) College of Nursing, seeks to understand and improve through nursing research.

Multiple sclerosis is an autoimmune disease that can negatively affect the physical, emotional, and social aspects of patients’ lives. Medical treatment regimens often focus on physical symptom management and overlook other factors that can negatively influence quality of life. Holland’s recent doctoral dissertation examined the relationships between health care providers and patients.

The most important finding in Holland’s study was the link between perceived health care provider engagement and patient quality of life. Holland found that if a health care provider-patient relationship was based on mutual respect and collaborative decision-making, it was more likely to ensure effective health outcomes and an improved quality of life.

“What we see is that the more empowered patients feel, the more they will adhere to treatment regimens and ultimately experience an improved quality of life,” Holland said. “This is extremely important for patients of chronic diseases because the patient is so instrumental in their decision-making and long-term treatment management.”

Holland explains that multiple sclerosis can often result in feelings of loss of control. His research findings suggest that the more engaging a patient’s relationship with their health care providers, and the more personalized that relationship is, the more empowered patients feel and thus, improve overall health outcomes.

So what makes a good relationship? Holland found that since multiple sclerosis is a disease that affects everyone differently, care must be personalized to provide the greatest benefit. Many individuals experience depression, anxiety and social isolation related to the disease, and stress in employment and social settings due to physical limitations and symptoms like incontinence, which can make the disease seem more unbearable.

“The best treatment includes addressing all of these issues through care that is tailored to the patient’s specific needs,” Holland said. “A holistic approach involves personalizing the patient’s care. Listening and incorporating them into the decision making process is very important, as well as maximizing health services.”

Holland says that nurses are particularly well positioned to improve these relationships by promoting effective engagement. Not only can nurses serve as liaisons between the physician and the patient, but can facilitate the transfer of information to the patient.

“It’s a revolving circle of behavior,” said Holland. “A better provider-patient relationship leads to better treatment adherence, which leads to better quality of life, which fosters improved health outcomes – and it all goes back to a better provider-patient relationship.”

In the next phase of his research, Holland will expand his focus on improving health outcomes by enhancing the relationship between patients and their health care providers. He plans to identify and target factors that could serve as the basis of educational programs for healthcare providers caring for those with multiple sclerosis. He said that further research is also needed to gain a greater understanding of what specific factors increase the transfer of quality information from the health care provider to the patient.

It is in this capacity that nursing research is particularly instrumental. Fostering comprehensive, caring relationships is one of the main goals of nursing, and basing that care on research can broaden the reach of academic nursing across populations.

— Katherine Hancock

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