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Self perceived emotional functioning of spanish patients with amyotrophic lateral sclerosis: a longitudinal study.

Mora JS, Salas T, Fajardo ML, Iváñez L, Rodríguez-Santos F - Front Psychol (2013)

Bottom Line: Emotional functioning correlated significantly with the physical disabilities at first and second evaluation, less so at third.Hopelessness did not correlate with any physical disability at the third evaluation.On average, Spanish patients with ALS cope with their disease, overcoming depression, which is not felt often, and with just mid levels of emotional dysfunction.

View Article: PubMed Central - PubMed

Affiliation: ALS Unit, Department of Neurology, Hospital Carlos III Madrid, Spain.

ABSTRACT

Background: ALS is a neurodegenerative disease of the entire motor system that most frequently ends with respiratory arrest in few years. Its diagnosis and the rapid progression of the motor dysfunctions produce a continued emotional impact. Studies on this impact are helpful to plan adequate psychotherapeutic strategies.

Objective: To assess and analyze: First: How the patients with ALS perceive their emotional health. Second: The emotional impact of their physical disabilities. Third: The physical disabilities with highest emotional impact. Fourth: The feelings with highest emotional impact.

Methods: Up to 110 Spanish patients with ALS were assessed less than 1 year from diagnosis, then twice more at 6 month intervals, using the ALS Quality of Life Assessment Questionnaire (ALSAQ-40) validated for use in Spanish. Descriptive analysis and correlation between variables were obtained.

Results: Worries about the future, of lack of freedom, and of being a burden were prevalent feelings. On average depression was felt only "sometimes." Only 25% of the variations in the emotional state were explained by changes in the physical state at first evaluation, and 16% at the last one. Emotional functioning correlated significantly with the physical disabilities at first and second evaluation, less so at third. Communication disabilities always had the highest impact. Depression at first evaluation and hopelessness at the next two evaluations had the highest emotional impact. Hopelessness did not correlate with any physical disability at the third evaluation. On the whole, emotional dysfunction was self perceived as intermediate (between none and worst), and remained stable at 1 year follow up, in both bulbar and spinal onset patients.

Conclusions: Physical dysfunctions per se have a limited role in patients´ emotional distress. Communication disabilities, as well as feelings of depression at early stages of illness, and of hopelessness later on, had the most impact. This requires their careful therapeutic attention. On average, Spanish patients with ALS cope with their disease, overcoming depression, which is not felt often, and with just mid levels of emotional dysfunction.

No MeSH data available.


Related in: MedlinePlus

Dispersion graph for emotional functioning and total combined physical functions at the third evaluation.
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Figure 2: Dispersion graph for emotional functioning and total combined physical functions at the third evaluation.

Mentions: To calculate how much the physical disability may be directly responsible for the emotional distress experienced by the patients, we carried out a dispersion diagram and calculated its linear regression. We used the EMO score as dependent variable and the sum of the scores of the physical areas (MOB, ADL, EAT, COM) as independent variables. The hypothesis establishes that there is no relationship whatsoever between the two variables. To calculate the linear regression with 5% error and 95% confidence interval, we obtained y = 8.298 + 0.191x with a correlation coefficient R = 0.51 and a determination coefficient of R2 = 0.25. This indicates that only 25% of the variations that occur in the emotional state are explained by the changes in the physical state. The same analysis at the last evaluation produced the linear regression equation y = 7.80 + 0.16x, with a correlation coefficient of R = 0.42 and a determination coefficient of R2 = 16. This shows an even smaller relationship between emotional and physical functions: only 16% of the variations that occur in the emotional state at the third evaluation, when patients experience more severe disabilities, are explained by the variations in the physical state (Figure 2).


Self perceived emotional functioning of spanish patients with amyotrophic lateral sclerosis: a longitudinal study.

Mora JS, Salas T, Fajardo ML, Iváñez L, Rodríguez-Santos F - Front Psychol (2013)

Dispersion graph for emotional functioning and total combined physical functions at the third evaluation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539828&req=5

Figure 2: Dispersion graph for emotional functioning and total combined physical functions at the third evaluation.
Mentions: To calculate how much the physical disability may be directly responsible for the emotional distress experienced by the patients, we carried out a dispersion diagram and calculated its linear regression. We used the EMO score as dependent variable and the sum of the scores of the physical areas (MOB, ADL, EAT, COM) as independent variables. The hypothesis establishes that there is no relationship whatsoever between the two variables. To calculate the linear regression with 5% error and 95% confidence interval, we obtained y = 8.298 + 0.191x with a correlation coefficient R = 0.51 and a determination coefficient of R2 = 0.25. This indicates that only 25% of the variations that occur in the emotional state are explained by the changes in the physical state. The same analysis at the last evaluation produced the linear regression equation y = 7.80 + 0.16x, with a correlation coefficient of R = 0.42 and a determination coefficient of R2 = 16. This shows an even smaller relationship between emotional and physical functions: only 16% of the variations that occur in the emotional state at the third evaluation, when patients experience more severe disabilities, are explained by the variations in the physical state (Figure 2).

Bottom Line: Emotional functioning correlated significantly with the physical disabilities at first and second evaluation, less so at third.Hopelessness did not correlate with any physical disability at the third evaluation.On average, Spanish patients with ALS cope with their disease, overcoming depression, which is not felt often, and with just mid levels of emotional dysfunction.

View Article: PubMed Central - PubMed

Affiliation: ALS Unit, Department of Neurology, Hospital Carlos III Madrid, Spain.

ABSTRACT

Background: ALS is a neurodegenerative disease of the entire motor system that most frequently ends with respiratory arrest in few years. Its diagnosis and the rapid progression of the motor dysfunctions produce a continued emotional impact. Studies on this impact are helpful to plan adequate psychotherapeutic strategies.

Objective: To assess and analyze: First: How the patients with ALS perceive their emotional health. Second: The emotional impact of their physical disabilities. Third: The physical disabilities with highest emotional impact. Fourth: The feelings with highest emotional impact.

Methods: Up to 110 Spanish patients with ALS were assessed less than 1 year from diagnosis, then twice more at 6 month intervals, using the ALS Quality of Life Assessment Questionnaire (ALSAQ-40) validated for use in Spanish. Descriptive analysis and correlation between variables were obtained.

Results: Worries about the future, of lack of freedom, and of being a burden were prevalent feelings. On average depression was felt only "sometimes." Only 25% of the variations in the emotional state were explained by changes in the physical state at first evaluation, and 16% at the last one. Emotional functioning correlated significantly with the physical disabilities at first and second evaluation, less so at third. Communication disabilities always had the highest impact. Depression at first evaluation and hopelessness at the next two evaluations had the highest emotional impact. Hopelessness did not correlate with any physical disability at the third evaluation. On the whole, emotional dysfunction was self perceived as intermediate (between none and worst), and remained stable at 1 year follow up, in both bulbar and spinal onset patients.

Conclusions: Physical dysfunctions per se have a limited role in patients´ emotional distress. Communication disabilities, as well as feelings of depression at early stages of illness, and of hopelessness later on, had the most impact. This requires their careful therapeutic attention. On average, Spanish patients with ALS cope with their disease, overcoming depression, which is not felt often, and with just mid levels of emotional dysfunction.

No MeSH data available.


Related in: MedlinePlus