Background
Joyce Miller is a 39-year-old woman who works part-time as a home economics teacher with no history of multiple sclerosis (MS) in the family. She lives with her partner and has two young children. Her partner frequently has to work offshore, which can be a challenge. She has a very outgoing personality and a thriving social life. Her parents are supportive, and they live nearby and help with the children. Joyce has a history of anxiety and depression that comes and goes.
Multiple Sclerosis
Multiple sclerosis is a disabling health condition. Nevertheless, such people can lead rewarding and fulfilling lives. To achieve this goal, they must adjust early to the diagnosis itself and its implications, and minimize the symptoms of the disease by accessing professional support and support from significant others, such as family and friends. Gibson and Frank (2002) point out that those whose disability is static, those with relapse, and those whose course is progressive may need support (Gibson & Frank, 2002). ASeveralfactors have been implicated in complicating the lives of those with MS. These factors include initial challenges in making the diagnosis, uncertainty of progression, remission and relapse, absence of cure or support, diversity of disabilities and symptoms, doctor’s lack of disease experience, inadequate professional support, and co-morbidities, such as depression, anxiety, and pain (Brocklehurst & Laurenson, 2008).
MS has a serious impact on the immediate relations with the patient (Fawcett & Lucas, 2006), partner, children, and parents. For the partner, the impact may involve poor health characterised by depression and back pain, social isolation, low libido and other sexual problems, and financial hardship because of poor work productivity that may lead to loss of employment. For children, diagnosis and course of MS would mean additional household chores, decreased social opportunities, increased parental nagging, relinquished parental support, and psychological difficulties such as anxiety, fear, and bitterness; and fear that they will acquire MS. For the parents, MS means that they will need to step in and support their child and grandchildren (Gibson & Frank, 2002).
Vulnerability and Resilience
Various definitions of vulnerabilities have been provided. Heaslip and Ryden (2013) have discussed various definitions of vulnerabilities. Vulnerability can be expressed as a continuum, along which people would move based on their experience at a given time. In regard to this, certain people may be more vulnerable because of a balance of inherent characteristics and some broader forces of the society (Heaslip & Ryden, 2013). From this view, vulnerability can be seen as having many layers analogous to an onion. Based on Heaslip and Ryden (2013), this definition reflects the changing nature of vulnerability and identifies the potential of acquired vulnerability related to wider circumstances. This definition is especially useful to practitioners because it allows them to discover how different factors can make people vulnerable. People with disabling conditions such as MS need to be resilient to prolong their lives.
According to Heaslip and Ryden (2013), resilience denotes a person’s psychological attitude to cope successfully with stress and recurrent adverse experiences. Therefore, resilience has the capacity to improve and alleviate experiences of vulnerability. Various interdependent and cross-cultural influences can help mitigate vulnerability by improving the person’s resilience. Resilience can be increased by various factors. These factors are: increased access to resources, positive social relationships and support, esteemed social and personal identity, high sense of control and personal power; awareness of cultural beliefs, principles, and practices; and experience acceptance and justice.
Joyce is vulnerable because the disease has reduced her social and economic abilities (Fawcett & Lucas, 2006). She has developed eye problems that interfere with her work, as she cannot see properly. Also, her experience of incontinence reduces her self-esteem and makes her anxious about the progress of her disease. Consequently, she cannot perform personal hygiene and cannot be able to support her children and partner. Due to her disability, she may develop a fear of being abandoned by her partner.
Various factors contribute to the resilience of Joyce against the disabling symptoms of MS (Flaskerud & Winslow, 1998). These factors are her family, friends, counsellor, and environmental factors (exercise and diet). Joyce’s parents helped her by taking care of her children. Her friends could help her by sympathising with her and keeping her company whenever they can. The partner can contribute to Joyce’s resilience against the symptoms of MS by helping her with household chores such as laundry and utensils, among others. A counsellor may help her cope overcome her depression and anxiety, restore her self-esteem (Maclean, 2010). Counselling provides Joyce with a means to talk about the challenges or troubles she is facing without disruption and with guaranteed confidentiality (Multiple Sclerosis Society (MSS), 2017).
References
Brocklehurst, H. & Laurenson, M. (2008). A concept analysis examining the vulnerability of older people. British Journal of Nursing, 17(21).
Brooker, C., Nicol, M. (2011). Alexander’s nursing practice. (4th ed). Edinburgh: Churchill Livingstone.
Erien, J. A. (2006). Who speaks for the vulnerable? Orthopedic Nursing, 25(2).
Fawcett, T.N. & Lucas, M. (2006). Multiple sclerosis: Living the reality. British Journal of Nursing, 15(1), pp. 46-51.
Flaskerud, J. H., & Winslow, B. J. (1998). Conceptualising vulnerable population health-related research. Nursing Research, 47(69), pp. 78.
Gibson, J., & Frank, A. (2002). Supporting individuals with disabling multiple sclerosis. Journal of the Royal Society of Medicine, 95 (12), 580-586.
Heaslip, V., & Ryden, J. (2013). Understanding vulnerability: A nursing and healthcare approach. New York: Elsevier
Maclean, R. (2010). Multiple sclerosis: Understanding a complex neurological condition. Nursing Standard, 24(28), pp. 50-56.
Multiple Sclerosis Society (MSS). (2017). Getting help.
