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 Method: A systematic review of the published and unpublished literature was conducted.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.

A Study of Implicit Leadership Theories Among Business & Management Undergraduate Students

This qualitative study explores the subjective experience of being led by investigating the impact of their Implicit Leadership Theories (ILTs) on followers’ cognitive processes, affective responses and behavioural intentions towards leadership-claimants. The study explores how such responses influence the quality of hierarchical work-place relationships using a framework based on Leader-Member Exchange (LMX) Theory. The research uses focus groups to elicit descriptions of ILTs held by forty final year undergraduate Business and Management students. The data was then analysed using an abductive process permitting an interpretative understanding of the meanings participants attach to their past experiences and future expectations. This research addresses a perceived gap by making a theoretical contribution to knowledge and understanding in this field, focusing on how emotional responses affect their behaviour, how this impacts on organisational outcomes, and what the implications are for HRD practitioners. The findings support previous research into the content and structure of ILTs but extend these by examining the impact of affect on workplace behaviour. Findings demonstrate that where follower ILT needs are met then positive outcomes ensued for participants, their superiors, and their organisations. Conversely, where follower ILT needs are not matched, various negative effects emerged ranging from poor performance and impaired well-being, to withdrawal behaviour and outright rebellion. The research findings suggest dynamic reciprocal links amongst outcomes, behaviours, and LMX, and demonstrate an alignment of cognitive, emotional and behavioural responses that correspond to either high-LMX or low-LMX relationships, with major impacts on job satisfaction, commitment and well-being. Copyright