Abstract
Comfort may be considered as the material aspect of well-being, and its limitation, defined as discomfort, exacerbates both the patient's and caregivers' difficulties. Discomfort results from the interaction of a patient's environment, treatment, and from the nature and severity of elementary deficits, such as spasticity, ranges of motion, pain, postural disorders, motor deficit and fatigue, bladder problems, insufficient ventilatory control, and also psychological difficulties. Although discomfort reduction may represent a major challenge in disabled persons, discomfort is usually underestimated in the assessment of deficiencies, disabilities, handicap, and even in quality of life (QOL) estimations. In this paper, we explain why discomfort may be a crucial problem in severe multiple sclerosis (MS) and argue for a systematic assessment of discomfort in the follow-up of the disease, especially in the following domains: dressing, washing, maintaining posture in a wheelchair and bed, food intake, mastication and swallowing, bowel control, urinary and feces emission, and also sexual life. The way to enhance comfort in MS patients is then analyzed.
References
Jun 11, 1992·Medical Care·J E Ware, C D Sherbourne
Aug 1, 1992·Journal of Neurosurgery·R D Penn
Aug 1, 1992·Neurology·B G WeinshenkerG P Rice
May 1, 1991·Neurology·S M RaoF Unverzagt
Sep 1, 1991·Acta Neurologica Scandinavica·E StenagerK Jensen
May 1, 1991·Neurology·S M RaoF Unverzagt
Mar 1, 1991·Pain·M I JohnsonJ W Thompson
Jan 1, 1990·Scandinavian Journal of Urology and Nephrology·A C Kinn, P O Larsson
Oct 1, 1990·Annals of Neurology·B J SnowD B Calne
Feb 1, 1990·Annals of Neurology·F A DavisJ Rush
Apr 1, 1990·Annals of Neurology·C T BeverK P Johnson
Aug 1, 1989·Journal of Neurology, Neurosurgery, and Psychiatry·G OchsP Weinmann
Aug 1, 1989·Neurology·G P SechiG Rosati
Dec 1, 1988·Neurology·D E MoulinG C Ebers
Jan 1, 1988·Eye·J LeeC Hogg
Oct 1, 1984·Neurology·J C SipeM B Oldstone
Nov 1, 1983·Neurology·J F Kurtzke
Nov 1, 1995·Neurology·L B KruppR Grimson
Jun 1, 1995·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·B G VickreyG W Ellison
Jul 1, 1995·Neurology·J P Hooge, W K Redekop
Apr 1, 1995·Neurology·M A GrazkoB Jabbari
Sep 1, 1994·Journal of the Neurological Sciences·L Ferini-StrambiS Smirne
Oct 1, 1994·Disability and Rehabilitation·H Laman, G J Lankhorst
Jan 1, 1994·Annals of Neurology·R T Schapiro
Aug 1, 1994·Annals of Neurology·R J LeighL F Dell'Osso
Jun 1, 1994·Current Opinion in Neurology·R T Schapiro, S L Langer
Feb 1, 1994·Journal of Neurology, Neurosurgery, and Psychiatry·C J FowlerC G Fowler
Jun 1, 1994·Research in Nursing & Health·E E Gulick
Jan 1, 1994·Neurology·M RodriguezL Kurland
Feb 1, 1993·Journal of Neurosurgery·J R CoffeyB Gill
Feb 1, 1993·Clinical Nursing Research·M T O'Brien
Mar 1, 1993·Journal of Neurology, Neurosurgery, and Psychiatry·C D BettsC J Fowler
Jan 1, 1996·Archives of Physical Medicine and Rehabilitation·P AzouviB Bussel
Mar 1, 1996·Neurology·A D SadovnickD W Paty
Jun 1, 1996·Journal of Neurology·J DressnandtB Conrad
Sep 1, 1996·Archives of Physical Medicine and Rehabilitation·S C SmeltzerS D Cook
Aug 1, 1996·Journal of Neurology·A J Thompson
Jan 1, 1996·Journal of the Neurological Sciences·B Sharrack, R A Hughes
Dec 1, 1996·Archives of Neurology·G ValiquetteP Maede-D'Alisera
Jan 1, 1997·Neurology·K J Aronson
Mar 1, 1997·Journal of Neurology, Neurosurgery, and Psychiatry·G P RiceG C Ebers
Jun 1, 1997·Annals of Neurology·L Averbuch-HellerR J Leigh
Feb 25, 1998·Archives of Physical Medicine and Rehabilitation·R P Di FabioR T Schapiro
May 26, 1998·Multiple Sclerosis : Clinical and Laboratory Research·D A RossiterA J Thompson
Jun 18, 1998·Archives of Physical Medicine and Rehabilitation·P GallienR Brissot
Aug 26, 1998·Neurology·O A Khan
Sep 2, 1998·Current Opinion in Neurology·A J Thompson
Oct 31, 1998·Clinical Rehabilitation·S HesseM T Jahnke
Nov 17, 1998·Seminars in Neurology·A J Thompson
Apr 17, 1999·Archives of Physical Medicine and Rehabilitation·A GiannantoniG Vespasiani