Anna L Kratz, Jade Treder, Josiah Goga, Evan Smith, Dawn Ehde
We identified 11 minor themes (italicized in parentheses) organized under nine major themes: Definitions of PSW, temporal characteristics (daily variability, change over time, hope follows grief), psychological contributors to PSW (silver linings and flexibility and acceptance), behavioral contributors to PSW (creative outlets/hobbies, symptom management), social contributors to PSW (supporters and partners, contribution/responsibility, finding community, setting boundaries), spirituality, environmental barriers, social/cultural barriers, and health and function barriers. Themes informed a conceptual model of PSW as a dynamic, individualized equilibrium between distress and satisfaction shaped by shifting facilitators and barriers; resilience buffers the effects of barriers to PSW.
PURPOSE/OBJECTIVE: Psychosocial wellness (PSW), a construct incorporating emotional/psychological well-being and social/collective well-being, is not well defined in people with multiple sclerosis (MS). We conducted a qualitative study of definitions and experiences of PSW, facilitators and barriers, and associations with distress and resilience to inform an empirically grounded person-centered conceptual model of PSW in MS.
RESEARCH METHOD/DESIGN: Five focus groups (∼90 min) were conducted via videoconference with 40 adults with MS from the United States between March and April 2024. Focus groups were facilitated by a clinical psychologist using a semistructured guide and were audio-recorded, transcribed, deidentified, and analyzed using thematic analysis within a constructivist framework to generate a PSW conceptual model.
RESULTS: We identified 11 minor themes (italicized in parentheses) organized under nine major themes: Definitions of PSW, temporal characteristics (daily variability, change over time, hope follows grief), psychological contributors to PSW (silver linings and flexibility and acceptance), behavioral contributors to PSW (creative outlets/hobbies, symptom management), social contributors to PSW (supporters and partners, contribution/responsibility, finding community, setting boundaries), spirituality, environmental barriers, social/cultural barriers, and health and function barriers. Themes informed a conceptual model of PSW as a dynamic, individualized equilibrium between distress and satisfaction shaped by shifting facilitators and barriers; resilience buffers the effects of barriers to PSW.
CONCLUSION/IMPLICATIONS: Qualitative themes informed an empirically grounded, person-centered model of PSW in MS. Participants' descriptions highlight concrete, teachable strategies-such as psychological flexibility, value-based role redefinition, boundary setting, activity adaptations, and savoring-that could be leveraged to support living well with MS. (PsycInfo Database Record (c) 2026 APA, all rights reserved).