The effect of Betty Newman System Model on death anxiety, fear of progression, and psychosocial adjustment to the disease in patients with Multiple Sclerosis

Determining the effect of Betty Newman's systemic model on death anxiety, fear of disease progression, and psychosocial adjustment to the disease in patients with multiple sclerosis.

Randomized clinical trial with two control and experimental groups, with parallel groups, on 72 patients with Multiple Sclerosis, randomized using a four-size randomized block design.

MS Academic Committee affiliated with Shahrekord University of Medical Sciences and MS Association The control group will receive only routine training. In addition to routine care, the intervention group will receive a care program based on the Betty Newman nursing model. The intervention group will receive a program based on the Betty Newman model in 4 sessions, each session lasting 40 minutes, in groups (3 groups of 12 people) using educational videos, whiteboards and podcasts and lectures in the community and clinic environment to reduce the likelihood of encountering stressors or reducing reactions to stressors and strengthening flexible and natural defense lines with a focus on the nursing process.

1. Willingness to participate in the study and complete the informed consent form 2. Age 20 years and older 3. Definite diagnosis of multiple sclerosis in patients based on medical records 4. Being literate enough to read and write and understand the research questionnaire 5. Absence of other incurable diseases 6. EDSS criterion less than 4

The intervention group will receive an educational intervention based on Betty Newman's systems model in four sessions, while the control group will only receive routine hospital education.

Death anxiety, Fear of disease progression, and Psychosocial adjustment to illness

The random assignment method of the samples to the groups was in the form of random blocks of four without permutation. For this purpose, first the letter A was considered for the control group and the letter B for the experimental group, and the different four-letter forms of the two groups (ABBA, ABAB, AABB, BAAB, BABA, BBAA) were written on six cards and placed in a sealed and opaque envelope. These envelopes were placed in a box, and the researcher did not know which group the units under study would be placed in until the card was selected. Then, the researcher determined which group the patients entering the study would be placed in by removing one of the envelopes from the box. This process continued until all the cards were removed from the bo,x and the cards were returned to the box again, and this random selection was repeated three times to provide the desired sample size.