Existential Disruption in Multiple Sclerosis Care: An Integrative Review of Identity and Meaning.

Abstract

Purpose: 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. Design: Integrative review. Method: 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. Findings: : 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. Conclusions: 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.