mahmoud sharifian

Patients with multiple sclerosis usually experience a wide range of psychological problems. This study aimed to investigate the mediating role of spiritual health in the relationship of irrational beliefs and dysfunctional attitudes with psychological well-being in the patient with multiple sclerosis by the Structural equation modeling approach.

This study was a correlational – descriptive design based on structural equation modeling. The study population consisted of all patients with multiple sclerosis who referring to the Iranian Multiple Sclerosis Association in 2017. 120 patients were selected by the available sampling method. Instruments for gathering data were Irrational beliefs questionnaire (Jones, 1986), dysfunctional attitude scale (Weissman & Beck, 1978), Spiritual Well-Being Scale from Paloutzian and Ellison (1982) and psychological wellbeing scale (Reef, 2002). Then, the data were analyzed using SPSS and Lisrel software and statistical tests such as Regression Analysis and Path Analysis.

Results showed that irrational beliefs and dysfunctional attitudes have a negative and direct effect on psychological well-being and spiritual health has a positive and direct effect on psychological well-being in the patient with multiple sclerosis. Also, the results of path analysis indicated that spiritual health have a mediating role in the relationship between irrational beliefs with psychological well-being, but the mediating the role of spiritual health in the relationship between irrational beliefs and psychological well-being was not significant.

It seems that designing training interventions based on irrational beliefs, dysfunctional attitudes, and spiritual health can increase the probability of psychological well-being among patients with multiple sclerosis.

Pain intensity and catastrophizing along with psychological distress is an important problem in patients with multiple sclerosis. The aim of this research was to investigate the effectiveness of mindfulness therapy based on Islamic-Iranian approaches on pain intensity, pain catastrophizing and psychological distress in women with multiple sclerosis.

This study was a quasi-experimental pretest - posttest with control group. The study population was consisted of all women with multiple sclerosis who were members of Iran multiple sclerosis Society at 2019. The sample consisted of 30 (15 for each group) women with multiple sclerosis that were selected by as a voluntary and randomly recruits to each of groups. Then, the participants in the experimental group participated in 8 sessions of 90 min of mindfulness therapy based on Islamic-Iranian approaches, while the control group did not receive any therapy. Instruments for gathering data were West Haven-Yale Multidimensional Pain Inventory (1995), Pain Catastrophizing Scale (1995) and Kessler Psychological Distress Scale (2003). Then, the data were analyzed using SPSS.v21 software and statistical tests such as MANCOVA and ANCOVA.

The results of ANCOVA indicate that the mindfulness therapy based on Islamic-Iranian approaches had significant impact on pain intensity (F=19.17, P=0.000) and psychological distress (F=42.81, P=0.000). Furthermore, results of MANCOVA showed that mindfulness therapy based on Islamic-Iranian approaches had significant impact on pain catastrophizing (F=34.77, P=0.000) and subscales of rumination (F=208.77, P=0.000) and magnification (F=5.20, P=0.000).

Based on the findings of this study, mindfulness therapy based on Islamic-Iranian approaches decreases pain intensity, pain catastrophizing and psychological distress in women with multiple sclerosis and represents new horizons in clinical interventions and thus could be used as an effective interventional method.  So, it seems that this intervention is an applicable treatment for women with multiple sclerosis.