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Women who coped successfully with progressive MS learned to confront their diagnosis and live with its unpredictable changesCommentary

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Question

How are 7 precursors of change expressed in women who are coping effectively with progressive multiple sclerosis (MS), and how do they change in intensity over time?

Design

Qualitative study.

Setting

A midwestern state in the USA.

Patients

10 women who were 46–68 years of age (mean age 56 y); had progressive-relapsing, secondary progressive, or primary progressive MS for ⩾8 years (mean 17 y); did not have current major depression; and were assessed (by self or physician) as coping successfully with the disease.

Methods

For each precursor of change, women were asked about the intensity of the precursor currently and at diagnosis, and to account for the change between the time of diagnosis and now. Interviews were transcribed and analysed thematically.

Main findings

Expressions of each of the 7 precursors to change are described. (1) Sense of necessity. Women felt a sense of necessity more intensely at the time of diagnosis; they urgently wanted to know what was going to happen to them. This feeling subsided with time as they learned how the disease changed from day to day. They learned to accept it. (2) Willingness to experience anxiety or difficulty. This precursor was stronger at …

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