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

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.