Abstract

Background & Objectives: The pandemic of COVID–19 disease and the implementation of preventive policies have greatly impacted society from a psychological and physical point of view. Accordingly, the general wellbeing of multiple sclerosis (MS) patients was affected during this period. In other words, the mental health of multiple sclerosis patients has declined due to the daily stresses of this disease, frequent visits to hospital centers, and economic problems caused by this disease. The wellbeing and quality of life of MS patients significantly decreases compared to normal people and limits their functions. In treating MS, it seems logical to use non–non-pharmacological methods that can reduce the problems and improve the quality of life of these patients. The present study aimed to compare the effectiveness of the logotherapy approach and education based on acceptance and commitment to the general wellbeing of patients with MS.

Methods: The research method was quasi–experimental with a pretest–posttest design and a control group. The statistical population included all patients with MS at the Raad Mehrabani Charitable Institute in Arak City, Iran, in 2021. A total of 45 patients were included in the study with available sampling and then were randomly assigned to 3 groups of 15, including two experimental groups, logotherapy and commitment and acceptance therapy group, and one control group. The experimental groups received logotherapy and acceptance and commitment therapy for 14 sessions of 45 minutes. The inclusion criteria were as follows: suffering from primary progressive MS, female gender, age range from 20 to 50 years, sufficient reading and writing literacy to complete the questionnaires, participation in training sessions, participants' willingness and written consent, not suffering from psychological disorders and chronic physical diseases, not participating in other counseling and therapy groups at the same time (based on the participant's medical record and self–report). The exclusion criteria were as follows: the absence of more than two sessions in the treatment protocol, not having enough trust in the group, unwillingness to continue cooperation, not doing the tasks included in the treatment protocol, and not completing the questionnaire. The measurement tool in this research was the General Wellbeing Scale (Dupuy, 1978). To statistically analyze the data, descriptive statistics and inferential statistics methods were used. For descriptive data analysis, percentage, frequency, mean, and standard deviation were used. For inferential analysis of data, 1–way analysis of variance, analysis of covariance, and Bonferroni's post hoc test were used in SPSS version 23. The significance level of the tests was 0.05.
Results: After adjusting for the pretest effect, there was a significant difference between the average scores of the experimental groups and the control group in the posttest in the general wellbeing variable (p<0.001). Also, the eta square value indicated that 53.7% of the changes in the scores of the groups in the general wellbeing variable (difference between the groups in the posttest) was due to the implementation of the independent variable (logotherapy and acceptance and commitment therapy). Both intervention of logotherapy and acceptance and commitment therapy significantly affected general wellbeing in patients with MS compared to the control group (p<0.001). Regarding the effectiveness of the two treatment methods, there was a statistically significant difference in the general wellbeing variable between the groups of logotherapy and acceptance and commitment therapy (p<0.001).
Conclusion: Based on the research findings, both logotherapy and acceptance and commitment therapy effectively improve the general wellbeing of patients with MS. However, in terms of comparison, acceptance and commitment therapy is significantly more effective than logotherapy.