Factors Associated with Adjustment and Coping

Although the literature in this field includes primarily qualitative studies, with small sample sizes that limit generalization, evidence has been presented to suggest that the following factors are important to the psychological response of persons with LTMV. 

Communication. A number of studies have highlighted the stress associated with communication difficulties in the LTMV population (6,8). One of the most widely reported stressors is when patients cannot speak or make themselves understood, or understand what their caregivers are trying to communicate. Therefore, health care professionals need to facilitate communication to reduce the frustration and stress of the patient. When speech is severely impaired, communication board or computer-based communication is associated with much less frustration (6). 

Finding meaning. Spirituality is of assistance to those on LTMV coping with adversity (9,10). It appears that spiritual beliefs foster hope in these individuals, enhancing their coping ability. 

Managing emotions. Individual and group interventions can assist patients in managing their emotions. Management includes techniques, such as relaxation, training, music therapy, education, and information sharing (15). 

Meaningful activities. Participation in individually relevant activities, such as hobbies, religious activities, and recreational activities, are reported to be sources of happiness among persons with ALS (9). Similar findings have been reported among children. Getting out of the house and engaging in social activities increases satisfaction (10). 

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