Development and feasibility of the Help to Overcome Problems Effectively (HOPE) self-management intervention for people living with multiple sclerosis

Purpose: To describe the development and feasibility of a self-management intervention called the Help to Overcome Problems Effectively (HOPE: MS) intervention, aimed at improving the physical and psychological wellbeing of people living with Multiple Sclerosis (MS). Method: HOPE: MS is an innovative, six week group-based, manualised self-management intervention combining positive psychology theory and practice and cognitive behavioural therapy (CBT). Participants (N=21) recruited via a local East Midlands branch of the MS Society attended one of three HOPE: MS interventions and completed self-reported outcome measures in week 1 and week 6. The following outcome measures were used: The Multiple Sclerosis Impact Scale; Multiple Sclerosis Fatigue Severity Scale; The Multiple Sclerosis Self-Efficacy Scale; The Adult State Hope Scale; The Hospital Anxiety and Depression Scale; The Positive and Negative Affect Scale.Results: Post-intervention ( 6 weeks) mean scores decreased in the physical impact (baseline M=65.6, SD=17.4; 6 weeks M=55.1, SD=17.9, 95% CI [-4.39, -16.47] and the psychological impact of MS (baseline M= 24.0, SD=7.3; 6 weeks M=18.9; SD=6.3, 95% CI [-2.54, -7.66]). There was also decrease in the mean fatigue severity scores (baseline 49.4, SD=13.3, 6 weeks M=41.1, SD=14.4, 95% CI [-2.65, -13.44]). There was a mean decrease in depression scores (baseline M=6.9, SD=3.5; 6 weeks M=4.2, SD=2.8, 95% CI [-1.43, -4.00]). There were smaller mean decreases in anxiety (baseline M=7.6, SD=3.4; 6 weeks M=6.7 (4.0), 95% CI [0.69, -2.50]) and negative affect (baseline M=22.9, SD=6.8; 6 weeks M=20.8 (8.1), 95% CI [0.69, -2.50]) see table 3). Mean MS self-efficacy scores (baseline 21.7, SD=4.2; 6 weeks M=24.1, SD=4.7, 95% CI [0.23, 4.53]), mean total hope scores (baseline M=23.3, SD=10.7; 6 weeks M=32.2 (10.6), 95% CI [4.91, 12.9]), hope agency scores (baseline M=10.5, SD=5.7; 6 weeks M=15.7 (6.2), 95% CI [2.37, 8.01]).hope pathways (baseline M=12.9, SD=6.0; 6 weeks M=16.6 (4.9), 95% CI [2.00, 5.43]) and positive affect scores increased (baseline M=27.3, SD=7.1; 6 months M=32.2, SD=8.4, 95% CI [0.42, 9.39]). Participants positively rated the intervention quality and delivery. Conclusions: This feasibility study showed that the HOPE: MS was acceptable and useful to people living with MS. Further robust evaluations using an randomised controlled trial design with longer follow ups are needed to confirm early promising results of the HOPE: MS