{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T17:56:45Z","timestamp":1781459805028,"version":"3.54.1"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Holist Nurs"],"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    Multiple sclerosis (MS) disrupts daily life, identity, and anticipated futures. While clinical care has advanced, less attention has been given to how individuals experience changes in meaning, self-concept, and continuity over time. This review synthesizes current evidence on existential disruption in MS and examines how identity and meaning are affected across the disease trajectory.\n                    <jats:bold>Design:<\/jats:bold>\n                    Integrative review.\n                    <jats:bold>Method:<\/jats:bold>\n                    An integrative review was conducted using Whittemore and Knafl's methodology. A systematic search of CINAHL, PubMed, MEDLINE, and PsycINFO identified 25 studies published between 2015 and 2025.\n                    <jats:bold>Findings: :<\/jats:bold>\n                    Existential disruption emerged as a dynamic and recurring process shaped by identity disruption, uncertainty, stigma, and meaning-making across the illness trajectory. These experiences extended beyond diagnosis and were reactivated during disease transitions. Meaning-making processes supported adaptation by maintaining continuity of self rather than resolving disruption.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Identity and meaning are central to living with MS yet remain underrecognized in clinical care. This review advances a conceptual understanding of existential disruption as an ongoing process of negotiating self-continuity. Nursing practice may be strengthened by approaches that attend to existential experience as part of holistic, person-centered care.\n                  <\/jats:p>","DOI":"10.1177\/08980101261456436","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:38:36Z","timestamp":1781235516000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Existential Disruption in Multiple Sclerosis Care: An Integrative Review of Identity and Meaning"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8149-4409","authenticated-orcid":false,"given":"Lisa","family":"Kelly","sequence":"first","affiliation":[{"name":"Texas Woman's University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanam","family":"Shin","sequence":"additional","affiliation":[{"name":"Texas Woman's University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"issue":"2","key":"e_1_3_2_2_1","first-page":"501","article-title":"Living with multiple sclerosis: Chronic illness experience and need for integrative care","volume":"12","author":"Anand D.","year":"2017","unstructured":"Anand D., Awasthy S., Anand R. 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The mediating role of acceptance in the relationship between existential fulfillment and resilient coping among patients with multiple sclerosis. International Journal of Behavioral Sciences, 19(1), 9\u201316. https:\/\/doi.org\/0.30491\/IJBS.2025.491770.2175","journal-title":"International Journal of Behavioral Sciences"},{"issue":"11","key":"e_1_3_2_22_1","first-page":"1291","article-title":"Reducing stigma, enhancing psychological well-being and identity in multiple sclerosis: A narrative review of current practices and future directions","volume":"13","author":"Montesano C.","year":"2025","unstructured":"Montesano C., Liberali G., Azzali G., Buzzachera C., Angilletta S., Alessandria M., Guidetti L., De Giorgio A. (2025). Reducing stigma, enhancing psychological well-being and identity in multiple sclerosis: A narrative review of current practices and future directions. 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