Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis

Background: Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. Objective: The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. Method: A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Results: Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. Conclusion: There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

Interpersonal Relationships in the Primary Classroom: an Analysis of Social and Affective Outcomes

Recent research regarding the quality of relationships in primary classrooms has focused largely on the enhancement and development of cognitive skills. The study reported here focused on a range of social and affective outcomes with the intention of broadening our understanding of the classroom as an interactive system, from the child's perspective. This paper provides empirical evidence on children's perceptions at Key Stage 2 (pupil age 7-11 years) of their relationships with teachers, other adults and children. Data were collected via an attitudinal questionnaire survey in nine primary schools in England. Results indicate that, in addition to the development of social skills, children also valued academic confidence, learning and the involvement of their parents in homework, and that these were associated with the interactions and routines established within the primary classroom settings. Some variations in terms of pupil age, teacher career phase, and the socio-economic context of the school were identified; however, the importance of the relationship between pupil and teacher remained consistent across schools.