Preprints
Experienced Anxiety and Coping Styles vs Adherence in Patients with Myasthenia Gravis
Weronika Jung-Plath1, Marcelina Skrzypek-Czerko1, Agata Zdun-Ryżewska2, Małgorzata Bilińska3
1 Division of Neurological and Psychiatric Nursing, Institute of Nursing and Midwifery, Medical University of Gdańsk, Poland
2 Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Poland
3 Department of Adult Neurology, University Clinical Center in Gdańsk, Poland
Abstract
Introduction. Myasthenia Gravis (MG) is a rare chronic immunological disease associated with a disorder of the neuromuscular junction. It is characterised by a variability of clinical symptoms. Myasthenia Gravis can be divided into two types: ocular and generalised. Patients with Myasthenia Gravis suffer from a sense of anxiety that results from the clinical picture and severity of the disease. They use a variety of coping strategies to manage this tension. Adherence, i.e. complying with therapeutic recommendations, is important for patient functioning and the effectiveness of pharmacotherapy in this group of patients.
Aim. This study aims to present ways of coping with experienced anxiety and how this affects adherence in patients with Myasthenia Gravis.
Material and Methods. The study was conducted in a group of 67 patients with MG. The majority were women. Literature analysis and a diagnostic survey were used for this purpose. Research tools included a survey questionnaire developed by the authors, which consisted of three parts and five standardised scales.
Results. The study showed that people with the generalised form of Myasthenia Gravis had higher levels of anxiety. As such, there may be greater limitations with this form of the disease. Myasthenia Gravis patients predominantly use emotion-oriented coping, which according to the literature is the least effective way. A medium level of adherence predominates in patients, indicating that patients are aware of the need to comply with medical recommendations.
Conclusions. The respondents are characterised by a medium level of adherence. There was a significant correlation between anxiety severity and adherence level. As the level of medication increases, adherence to treatment recommendations decreases. Myasthenia Gravis patients who use the distraction strategy exhibit higher levels of adherence. In contrast, MG patients follow treatment recommendations to a lesser extent with an avoidance strategy. The duration of the illness is not linked to the level of anxiety or the use of coping strategies to manage tension that involve moving on to something else or behavioural disengagement. (JNNN 2024;13(4):131–138)
Key Words: adherence, anxiety, coping, Myasthenia Gravis
References:
[1] Kozyra B., Opio M. Cecha lęku i jej konsekwencje u chorych na miastenię gravis. Neuropsychiatr Neuropsychol. 2021;16(3–4):168–175.
[2] Jayam Trouth A., Dabi A., Solieman N., Kurukumbi M., Kalyanam J. Myasthenia gravis: a review. Autoimmune Dis. 2012:2012:874680.
[3] Salsabila K., Mutiara H., Hanriko R. Miastenia Gravis: Etiologi, Patofisiologi, Manifestasi Klinis, Penegakkan Diagnosis dan Tatalaksana. Medula. 2023;13(1):115–121.
[4] Dresser L., Wlodarski R., Rezania K., Soliven B. Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations. J Clin Med. 2021;10(11):2235.
[5] Bubuioc A.M., Kudebayeva A., Turuspekova S., Lisnic V., Leone M.A. The epidemiology of myasthenia gravis. J Med Life. 2021;14(1):7–16.
[6] Bilińska M., Sitek E.J. Jakość życia i akceptacja choroby w miastenii. Post Psychiatr Neurol. 2007;16(2):139–143.
[7] Jung-Plath W., Skrzypek-Czerko M., Bilińska M., Zdun-Ryżewska A. Assessment of the Myasthenia Gravis Patients’ Quality of Life. J Neurol Neurosurg Nurs. 2023;12(2):74–83.
[8] Ybarra M.I., Kummer A., Frota E.R., Oliveira J.T., Gomez R.S., Teixeira A.L. Psychiatric disorders in myasthenia gravis. Arq Neuropsiquiatr. 2011;69(2A):176–179.
[9] Brola W., Ziomek M., Czernicki J. Zespół zmęczenia w przewlekłych chorobach neurologicznych. Neurol Neurochir Pol. 2007;41(4):340–349.
[10] Rozmilowska I.M., Adamczyk-Sowa M.H., Czyzewski D. The Myasthenia Gravis-specific Activities of Daily Living scale as a useful outcome measure and in routine clinical management in Polish patients. Neurol Neurochirur Pol. 2018;52(3):368–373.
[11] Rozmilowska I., Adamczyk-Sowa M., Pierzchala K., Czyzewski D. Validity and reliability of the Polish version of myasthenia gravis — Quality of life questionnaire — 15 item. Neurol Neurochir Pol. 2017;51(4):311–318.
[12] Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370.
[13] Juczyński Z. Narzędzia pomiaru w promocji i psychologii zdrowia. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa 2001.
[14] Kubica A., Kosobucka A., Michalski P. i wsp. Skala adherence w chorobach przewlekłych — nowe narzędzie do badania realizacji planu terapeutycznego. Folia Cardiol. 2017;12(1):19–26.
[15] Dudek D., Siwek M. Współistnienie chorób somatycznych i depresji. Psychiatria. 2007;4(1):17–24.
[16] Su Y., Wang X., Xing Y. et al. The analysis of factors affecting medication adherence in patients with myasthenia gravis: a cross-sectional study. Ther Adv Neurol Disord. 2024;17:17562864231206877.
[17] Vitturi B.K., Pellegrinelli A., Valerio B.C.O. Medication adherence in patients with myasthenia gravis in Brazil: a cross-sectional study. Acta Neurol Belg. 2020;120(1):83–89.
[18] Kardas P., Lewek P., Matyjaszczyk M. Determinants of patient adherence: a review of systematic reviews. Front Pharmacol. 2013;4:91.
[19] Yu J., Xie L., Chen S. et al. Social support and medication adherence among adult myasthenia gravis patients in China: the mediating role of mental health and self-efficacy. Orphanet J Rare Dis. 2024;19(1):143.