Structured Abstract
Multiple Sclerosis Structured Abstract - MS #10
Training to improve social interaction skills for persons with multiple sclerosis
CITATION: Gordon, P. A., Lam, C. S., & Winter, R. (1997). Interaction strain and persons with multiple sclerosis: Effectiveness of a social skills program. Journal of Applied Rehabilitation Counseling, 28(3), 5-11.
LEVEL OF EVIDENCE: IB3b
RESEARCH OBJECTIVE/QUESTION
"This study examined the effects of a social skills training program focused on teaching persons with MS techniques to increase their socialization skills to enable them to present themselves more favorably to others in order to combat negative stereotypes and facilitate positive social interactions" (p. 6).
DESIGN
|
x |
RCT |
|
Single Case |
|
Case Control |
| |
Cohort |
|
Before-After |
|
Cross Sectional |
Clients with MS were randomly assigned into either a treatment or a control group. Baseline information was gathered. The treatment group received eight sessions, then posttreatment data were gathered and analyzed.
SAMPLING PROCEDURE
Sample was solicited from a group of 250 outpatients by letter. 42 responded; 26 met inclusion criteria.
SAMPLE
|
N = 26 |
Mean age = 44.5 |
Male = 7 |
Female = 19 |
All participants had MS, no mental illness, were between ages 18 and 65, were available, were approved to be in study by their therapist, spoke English, and had the cognitive ability to participate.
No indication of disability status provided.
No analysis was conducted to determine whether control and treatment groups were similar. The control group members were younger, and better educated but tended to have clerical jobs.
OUTCOMES
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x |
Life roles |
|
Tasks |
|
Activities |
| |
Abilities/habits |
x |
Capacities |
OUTCOME AREAS
|
Outcome Area |
Measures |
Reliability |
Validity |
|
Social avoidance anxiety |
Social Avoidance and Distress Scale (SADS) |
Cronbach's alpha .83 - .90 |
Reported |
|
Self-efficacy for social skills |
Self-Efficacy Questionniare for Social Skills (SEQSS) |
Coefficients alpha in general .9 and above |
Correlated well with other tests of self-efficacy. |
|
Self-esteem |
Tennessee Self-Concept Scale (TSCS) |
Test-retest from .6 - .92 |
Convergent and discriminant with other self-concept measures. |
|
Thoughts before and during social interactions |
Social Interaction Self-Statement test (SISST) |
Cronbach's alpha .83 - .85 |
NR |
NR=Not Reported
INTERVENTION
Description
Treatment group (n = 13) - Group program that focused on topics related to social strain, including assertiveness training, presentation of self, acknowledgement of disability, and interpersonal communication.
Control group (n = 13) - wait listed
Who delivered
Not stated
Setting
Clinic
Frequency
Once a week for 1.5 hours
Duration
8 weeks
RESULTS
Statistical methods were inadequately reported. There was no significant effect for treatment (F(2,19) = .51) between the control and treatment on the SADS. There was no effect of social skills training on self-esteem, self-efficacy, or positive self-referent thoughts (F(2,19) = 2.08). No interaction analysis was performed.
CONCLUSIONS
Biases - sample size, dropouts
This study suggests that training clients with MS on social skills does not significantly improve those skills.
Limitations:
- Small sample size (11 per group). There may indeed have been a difference between the two groups but this sample size was too small to detect it.
- Treatment and control may have been different at pretest.
- Unclear how statistical analysis was done (on difference score or on posttest score?). Limited reporting of results.
- Two treatment participants did not attend all sessions and two control participants did not return for follow-up. No effort was made to examine the dropouts for differences.
COMMENTARY
This study suggests an interesting area of research for OT. Improving the ability of persons with disabilities to participate in social activities is a useful area. Although the results were not significant, this may have been due to Type II error. Further research in this area is warranted.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Nancy Baker, ScD, OTR, and Linda Tickle-Degnen, PhD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
