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Supporting wellbeing in motor neurone disease for patients, carers, social networks, and health professionals: A scoping review and synthesis

Published online by Cambridge University Press:  22 August 2017

Melanie Harris ,
Geoff Thomas ,
Mary Thomas ,
Paul Cafarella ,
Allegra Stocks ,
Julia Greig  and
R. Doug McEvoy
Melanie Harris*
Affiliation:
Adelaide Institute for Sleep Health, Flinders University, Daw Park, South Australia, Australia
Geoff Thomas
Affiliation:
Thomas Motor Neurone Research Project, Adelaide Institute for Sleep Health, Flinders University, Daw Park, South Australia, Australia
Mary Thomas
Affiliation:
Thomas Motor Neurone Research Project, Adelaide Institute for Sleep Health, Flinders University, Daw Park, South Australia, Australia
Paul Cafarella
Affiliation:
Department of Respiratory Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia
Allegra Stocks
Affiliation:
Department of Speech Pathology, Repatriation General Hospital, Daw Park, South Australia, Australia.
Julia Greig
Affiliation:
Department of Speech Pathology, Repatriation General Hospital, Daw Park, South Australia, Australia.
R. Doug McEvoy
Affiliation:
Adelaide Institute for Sleep Health, Flinders University, Daw Park, South Australia, Australia
*
Address correspondence and reprint requests to: Melanie Harris, Adelaide Institute for Sleep Health, c/o Sleep Health Service, Repatriation General Hospital, C-Block, Daws Road, Daw Park, South Australia 5041, Australia. E-mail: melanie.harris@flinders.edu.au.
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Abstract

Objective:

Disease management in motor neurone disease (MND) is focused on preserving quality of life. However, the emphasis has so far been on physical symptoms and functioning and not psychosocial wellbeing. MND affects the wellbeing of carers, of family and social network members, and of healthcare providers, as well as of the patients. We therefore aimed to assess and synthesize the knowledge about maximizing MND-related psychosocial wellbeing across all these groups.

Method:

We used a systematic search and selection process to assess the scope of the literature along with a narrative synthesis of recent high-quality reviews.

Results:

The original studies were mainly observational studies of patients and, to a lesser extent, of carers. There were few interventional studies, mainly of patients. There were very few studies of any type on wellbeing in their wider social network or in healthcare professionals. All the review literature looked at MND patient or carer wellbeing, with some covering both. No reviews were found of wellbeing in other family members, patients' social networks, or their healthcare professionals. The reviews demonstrated wellbeing problems for patients linked to psychosocial issues. Carer wellbeing is also compromised. Psychotherapies, social supports, improved decision supports, and changes to healthcare delivery are among the suggested strategies for improved patient and carer wellbeing, but no proven interventions were identified for either. Early access to palliative care, also not well-tested but recommended, is poorly implemented.

Significance of results:

Work on interventions to deal with well-established wellbeing problems for patients and carers is now a research priority. Explicit use of current methods for patient and public involvement and for design and testing of interventions provide a toolkit for this research. Observational research is needed in other groups. There is a potential in considering needs across patients' social networks rather than looking individually at particular groups.

Keywords

Motor neurone diseaseWellbeingSocial networkIntervention research

Information

Type
Review Article
Information
Palliative & Supportive Care , Volume 16 , Issue 2 , April 2018 , pp. 228 - 237
Copyright
Copyright © Cambridge University Press 2017 

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