Abstract：
BACKGROUND: People with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These \"invisible\" symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This \'Neuropsychological Intervention for Managing Invisible Symptoms\' in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the \'Triflex\' of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters.
METHODS: 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires RESULTS: Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the \"invisible\" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection.
CONCLUSIONS: Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.
METHODS: 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires RESULTS: Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the \"invisible\" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection.
CONCLUSIONS: Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.
摘要：
背景：患有MS（pwMS）的人通常会出现一系列隐藏症状，包括认知障碍，焦虑和抑郁,疲劳,疼痛,和感官困难。这些“看不见的”症状会显著影响健康，关系,就业和生活目标。我们开发了一种新颖的定制在线小组神经心理干预措施，将心理教育和认知康复与接受和承诺疗法（ACT）知情方法相结合，用于急性三级医院的pwMS。MS（NIMIS-MS）中的“管理隐形症状的神经心理学干预”包括6个疗程，每个都有心理教育和行为部分。内容包括围绕管理认知困难的心理教育，疲劳,疼痛,睡眠和其他不愉快的感觉在MS的一般方法的理解，监测,识别模式和潜在的触发因素。介绍了具体的认知康复和疲劳管理策略。ACT知情组件专注于心理灵活性的“Triflex”的三个核心ACT领域(Harris，2019)：在场，打开,做重要的事。
方法：118pwMS参加了NIMIS-MS组干预，在18个月的时间内，在6周的阻滞中进行了14次。评估有效性和可接受性，参与者完成了抑郁和焦虑(HADS)的测量，功能损害(WSAS)，价值-进度(VQ)和价值-障碍(VQ)，NIMIs-MS组干预前后接受MS(MSAS)。在最后一次会议后的焦点小组期间以及通过在线反馈问卷获得定性反馈结果：事后分析显示，在完成NIMIS-MS组之后，抑郁和焦虑症状显着降低，对MS的接受度显着提高。定性反馈显示，参与者报告说，他们觉得更有能力在完成小组后管理MS的“隐形”症状，并受益于使用基于ACT的策略和技术。与会者高度重视NIMIS-MS小组期间发展起来的同行支持。在线格式被认为比面对面的团体更容易获得，由于对旅行时间的关注较少，成本,疲劳,舒适和感染。
结论：评估表明，我们的新型NIMIS-MS组是可以接受的，为患有MS的个体提供神经心理学干预的有益和可行的方法。
方法：118pwMS参加了NIMIS-MS组干预，在18个月的时间内，在6周的阻滞中进行了14次。评估有效性和可接受性，参与者完成了抑郁和焦虑(HADS)的测量，功能损害(WSAS)，价值-进度(VQ)和价值-障碍(VQ)，NIMIs-MS组干预前后接受MS(MSAS)。在最后一次会议后的焦点小组期间以及通过在线反馈问卷获得定性反馈结果：事后分析显示，在完成NIMIS-MS组之后，抑郁和焦虑症状显着降低，对MS的接受度显着提高。定性反馈显示，参与者报告说，他们觉得更有能力在完成小组后管理MS的“隐形”症状，并受益于使用基于ACT的策略和技术。与会者高度重视NIMIS-MS小组期间发展起来的同行支持。在线格式被认为比面对面的团体更容易获得，由于对旅行时间的关注较少，成本,疲劳,舒适和感染。
结论：评估表明，我们的新型NIMIS-MS组是可以接受的，为患有MS的个体提供神经心理学干预的有益和可行的方法。
