A Cognitive Occupation-Based programme for people with MS: acceptability, feasibility, and experiences of people with multiple sclerosis

Abstract

Purpose

COB-MS is an eight-session, Cognitive Occupation-Based programme for people with both MS and cognitive difficulty – designed to enhance cognition and daily functioning, through a combination of goal-setting, cognitive strategy engagement, group activities, home-practice activities and one-on-one sessions. This research aims to investigate the acceptability of COB-MS from the perspective of people living with MS, as well as the occupational therapists who facilitated the programme.

Materials and methods

Two content analyses were conducted on interview data from (n = 11) COB-MS participants and (n = 8) COB-MS facilitators. Thematic analysis was also conducted on the participant interview data.

Results

Through a, primary, content analysis, participants reported that the COB-MS provided both a positive experience and quality resources. Qualitative improvement and utilisation of their learning beyond completion of the intervention were also identified. Four themes were identified via, secondary, thematic analysis: (1) Group interaction within COB-MS was vital; (2) Online COB-MS had positive and negative effects on participation; (3) COB-MS as a provider of clarity; and (4) Using learned strategies after the completion of COB-MS. Recommendations for future administration are provided.

Conclusions

Findings suggest COB-MS acceptability, as well as appropriateness and feasibility, indicative of progression to a definitive trial in future research.

Trial registration

ISRCTN: ISRCTN11462710. Registered on 9 September 2019.

IMPLICATIONS FOR REHABILITATION

• Cognitive difficulties associated with multiple sclerosis (MS) impact on daily life activities and are considered invisible MS symptoms. This invisibility and the lack of acknowledgement of such symptoms often adds to the distress experienced by people with MS.

• Occupational therapists are well-placed to address the daily-life impacts of cognitive difficulties in MS.

• The COB-MS is an occupation-focused intervention that aims to enhance daily function.

• The intervention was found to be well-accepted well by people with MS and occupational therapists and can feasibly be delivered in clinical practice.

Keywords:

• Multiple sclerosis
• public and patient involvement (PPI)
• cognition
• occupational therapy

Acknowledgements

Thank you to all of the occupational therapists who completed COB-MS training and delivered the COB-MS intervention in an extremely challenging clinical year. Your time, effort and dedication will be forever appreciated.

Ethical approval

Ethical approval was awarded by Galway University Hospitals on 13.08.2019 Ref C. A 2231.

Disclosure statement

The authors have no conflicts of interest to report.

Data availability

The data that support the findings of this study are openly available in Irish Qualitative Data Archive at: https://repository.dri.ie/catalog/z6044q59n, “A Cognitive Occupation Based programme for People with Multiple Sclerosis qualitative feasibility data” at doi: 10.7486/DRI.z6044q59n.

Notes

1 This sample is representative of occupational therapists in Ireland.

2 NB: the manual had been previously been cross-checked in an iterative process by both researchers and multiple members of the PPI panel [see 21].

Additional information

Funding

This study was funded by a Health Research Board Definitive Intervention and Feasibility Awards (DIFA-FA-2018-027).