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Asadollahzadeh E, Ebadi Z, Owji M, Rezaeimanesh N, Sahraian MA, Moghadasi AN. Exploring the relationship between disability status, depression, and quality of life in individuals with multiple sclerosis. Mult Scler Relat Disord 2024; 87:105629. [PMID: 38781883 DOI: 10.1016/j.msard.2024.105629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/30/2024] [Accepted: 04/13/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Depression and the presence of a disability emerge as noteworthy predictors of the quality of life (QoL) in patients with multiple sclerosis (MS). In this article, we explore the relationship between disability status, depression, and quality of life in individuals with multiple sclerosis. METHODS A total of 150 patients participated in this cross-sectional study. A Persian translation of the Multiple Sclerosis Quality of Life-54 questionnaire was utilized to assess their health-related quality of life (QoL), while the patients' disability levels were measured using the Expanded Disability Status Scale. Additionally, we assessed patients' depression levels using the 21-item BDI-II scale. The questionnaire data were analyzed using SPSS version 25. RESULTS A total of 150 MS patients participated in the study, with a mean age of 33.4 years (SD = 3.1). The majority were female (n = 71.2 %). The mean EDSS score was 3.7 (SD = 1.8). In the correlation analysis, we found that EDSS scores were not significantly correlated with mental QoL (r = -0.180, p = 0.109), but were significantly correlated with lower physical QoL (r = -0.393, p 0.001). Depression scores were significantly correlated with mental QoL (r = -0.776, P 0.001) and physical QoL (r = -0. 726, P 0.001). The results reveal that both EDSS and Beck scores significantly affect mental and physical health, explaining 62 % and 60 % of their variances, respectively. CONCLUSION Our findings indicate a significant relationship between physical quality of life and EDSS scores in MS patients. Higher EDSS scores consistently corresponded to more significant physical impact, as evidenced by higher impact ratings. Conversely, there was no clear association between EDSS scores and mental quality of life. Furthermore, increased depression levels were linked to reduced levels of both mental and physical well-being. These results emphasize the intricate interplay between the physical aspects of quality of life and their implications for the progression and severity of MS in patients.
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Affiliation(s)
- Elnaz Asadollahzadeh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran
| | - Zahra Ebadi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran
| | - Mahsa Owji
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran
| | - Nasim Rezaeimanesh
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical, Sciences, Tehran, Iran.
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Amaslidou A, Ierodiakonou-Benou I, Bakirtzis C, Nikolaidis I, Tatsi T, Grigoriadis N, Nimatoudis I. Multiple sclerosis and mental health related quality of life: The role of defense mechanisms, defense styles and family environment. AIMS Neurosci 2023; 10:354-375. [PMID: 38188008 PMCID: PMC10767059 DOI: 10.3934/neuroscience.2023027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Background Multiple sclerosis is a demyelinating chronic neurologic disease that can lead to disability and thus to deterioration of quality of life. Psychological parameters such as ego defense mechanisms, defense styles and family environment are important factors in the adaptation process, and as such they can play important roles in QoL. This study aims to assess the psychological factors as well as the clinical and demographic characteristics related to mental health quality of life (MHQoL). Methods This was an observational, cross-sectional study conducted in a sample of 90 people with MS in the years 2018-2020. All participants completed the following questionnaires: MSQoL-54, DSQ-88, LSI, FES-R, SOC, BDI-II, STAI. Disability was assessed using EDSS. Results In multiple linear regression, significant roles were played by depression (R2: 41.1%, p: 0.001) and, to a lesser extent, the event of a relapse (R2: 3.5%, p: 0.005), expressiveness (R2: 3.6%, p < 0.05) and image distortion style (R2: 4.5%, p: 0.032). After performing a hierarchical-stepwise analysis (excluding depression), the important factors were maladaptive defense style (R2: 23.7%, p: 0.002), the event of relapse (R2: 8.1%, p < 0.001), expressiveness (R2: 5.5%, p: 0.004) and self-sacrificing defense style (R2: 2.4%, p: 0.071). Conclusion Psychological factors play important roles in MHQoL of people with multiple sclerosis. Thus, neurologists should integrate in their practice an assessment by mental health specialists. Moreover, targeted psychotherapeutic interventions could be planned i to improve QoL.
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Affiliation(s)
- Anthi Amaslidou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioanna Ierodiakonou-Benou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Bakirtzis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nikolaidis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Theano Tatsi
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Batista AR, Silva S, Lencastre L, Guerra MP. Biopsychosocial Correlates of Quality of Life in Multiple Sclerosis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14431. [PMID: 36361311 PMCID: PMC9656802 DOI: 10.3390/ijerph192114431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Multiple sclerosis (MS) is a demyelinating chronic disease that has had increasing prevalence over the last years. We have investigated whether the perceived quality of life is reduced in multiple sclerosis patients compared to control participants with a cross-sectional approach, and how it relates to sociodemographic, clinical, and psychosocial variables in MS with multiple regression. To that end, a group of MS patients (n = 50) and a control group (n = 50) that was matched for age and education level filled in the WHOQOL-BREF (perceived quality of life across four domains) and a sociodemographic questionnaire. The participants in the MS group also filled in a clinical questionnaire and three instruments measuring psychosocial variables (the DASS-21 for depression, anxiety, and stress, the Brief-COPE for coping skills, and the Meaning in Life Scale). The results showed that the perceived quality of life was lower in the MS group than in the control group. Multiple regression models incorporating the variables that showed significant correlations with the quality of life indicated that age, professional status, recovery from relapses, depression, active coping, and meaning in life predicted at least one domain of the quality of life. Meaning in life predicted the quality of life in all four of the domains. Although the quality of life in MS is linked to multiple biopsychosocial variables, meaning in life seems crucial.
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Han V, Skorvanek M, Smit M, Turcanova Koprusakova M, Hoekstra T, Dijk JP, Tijssen MA, Gdovinova Z, Reijneveld SA. Prevalence of non-motor symptoms and their association with quality of life in cervical dystonia. Acta Neurol Scand 2020; 142:613-622. [PMID: 32579704 DOI: 10.1111/ane.13304] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/12/2020] [Accepted: 06/21/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Non-motor symptoms (NMS) are commonly present along with motor impairment in patients with cervical dystonia (CD) and have a significant impact on health-related quality of life (HRQoL). However, the prevalence of NMS and their association with dystonia are still unclear. The aim of our study was to assess the prevalence of depression, anxiety, fatigue, apathy, pain, sleep problems, and excessive daytime sleepiness (EDS) in CD using different evaluation approaches and to explore their association with HRQoL relative to that of motor symptoms. MATERIALS AND METHODS We enrolled 102 Slovak patients with CD. The severity of both motor and non-motor symptoms was assessed using validated scales. HRQoL was determined by the 36-item Short Form Health Survey (SF-36). Association of NMS with poor HRQoL was assessed using multiple regressions. RESULTS The most frequent NMS in our sample were sleep impairment (67.3%), anxiety (65.5%), general and physical fatigue (57.5% and 52.9%, respectively), depression (47.1%), mental fatigue (31.4%), apathy (30.4%), reduced activity (29.4%), EDS (20.2%), and reduced motivation (18.6%). Univariate analysis showed that NMS, but not motor symptoms, were significantly linked to poor HRQoL, with EDS being most commonly associated with poor HRQoL, followed by disrupted sleep, depression, and fatigue. CONCLUSIONS The prevalence of NMS among patients with CD is high, and some NMS are strongly associated with poor HRQoL, while motor impairment was not associated with the severity of NMS or poor HRQoL. Actively diagnosing and treating NMS should therefore be a routine part of the clinical management of patients with CD.
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Affiliation(s)
- Vladimir Han
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia
- Department of Neurology University Hospital L. Pasteur Kosice Slovakia
- Graduate School Kosice Institute for Society and Health Faculty of Medicine Safarik University Kosice Slovakia
| | - Matej Skorvanek
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia
- Department of Neurology University Hospital L. Pasteur Kosice Slovakia
| | - Marenka Smit
- Department of Neurology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Monika Turcanova Koprusakova
- Department of Neurology University Hospital in Martin Martin Slovakia
- Department of Neurology Jessenius Faculty of Medicine Comenius University in Bratislava Martin Slovakia
| | - Tialda Hoekstra
- Department of Community and Occupational Medicine University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Jitse P. Dijk
- Graduate School Kosice Institute for Society and Health Faculty of Medicine Safarik University Kosice Slovakia
- Department of Community and Occupational Medicine University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Marina A.J. Tijssen
- Department of Neurology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Zuzana Gdovinova
- Department of Neurology Faculty of Medicine Safarik University Kosice Slovakia
- Department of Neurology University Hospital L. Pasteur Kosice Slovakia
| | - Sijmen A. Reijneveld
- Department of Community and Occupational Medicine University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
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Rezapour A, Almasian Kia A, Goodarzi S, Hasoumi M, Nouraei Motlagh S, Vahedi S. The impact of disease characteristics on multiple sclerosis patients' quality of life. Epidemiol Health 2017; 39:e2017008. [PMID: 28231687 PMCID: PMC5434226 DOI: 10.4178/epih.e2017008] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/19/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the quality of life (QoL) of patients with multiple sclerosis (MS), and to investigate the effects of characteristics of MS such as disease course, severity, and relapses on patients' QoL. METHODS This was a cross-sectional study, in which 171 patients were enrolled. Health-related QoL was assessed using the Persian version of the Multiple Sclerosis Quality of Life-54 questionnaire. To measure patients' disability status, we used the Expanded Disability Status Scale. Other variables included in the study were disease course and relapses of the disease. RESULTS The average scores for patients' physical and mental QoL were 60.9±22.3 and 59.5±21.4, respectively. In a bivariate analysis, disease course, severity of the disease, and relapses were significantly associated with the physical and mental health composite scores. In a hierarchal regression analysis, disease course, severity of the disease, and relapses were responsible for 38 and 16% of the variance in physical and mental QoL, respectively. It was also observed that relapses were a strong predictor of both physical and mental QoL. CONCLUSIONS Our results showed that disease characteristics significantly affected both dimensions of QoL. It is therefore suggested that health care providers should be aware of these characteristics of MS to more successfully improve MS patients' QoL.
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Affiliation(s)
- Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abdollah Almasian Kia
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Goodarzi
- Department of Health Economics, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Hasoumi
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Soraya Nouraei Motlagh
- Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sajad Vahedi
- Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran
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Krops LA, Jaarsma EA, Dijkstra PU, Geertzen JHB, Dekker R. Health Related Quality of Life in a Dutch Rehabilitation Population: Reference Values and the Effect of Physical Activity. PLoS One 2017; 12:e0169169. [PMID: 28060949 PMCID: PMC5217970 DOI: 10.1371/journal.pone.0169169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 12/13/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To establish reference values for Health Related Quality of Life (HRQoL) in a Dutch rehabilitation population, and to study effects of patient characteristics, diagnosis and physical activity on HRQoL in this population. METHOD Former rehabilitation patients (3169) were asked to fill in a questionnaire including the Dutch version of the RAND-36. Differences between our rehabilitation patients and Dutch reference values were analyzed (t-tests). Effects of patient characteristics, diagnosis and movement intensity on scores on the subscales of the RAND-36 were analyzed using block wise multiple regression analyses. RESULTS In total 1223 patients (39%) returned the questionnaire. HRQoL was significantly poorer in the rehabilitation patients compared to Dutch reference values on all subscales (p<0.001) except for health change (p = 0.197). Longer time between questionnaire and last treatment was associated with a smaller health change (p = 0.035). Higher age negatively affected physical functioning (p<0.001), social functioning (p = 0.004) and health change (p = 0.001). Diagnosis affected outcomes on all subscales except role limitations physical, and mental health (p ranged <0.001 to 0.643). Higher movement intensity was associated with better outcomes on all subscales except for mental health (p ranged <0.001 to 0.190). CONCLUSIONS HRQoL is poorer in rehabilitation patients compared to Dutch reference values. Physical components of HRQoL are affected by diagnosis. In rehabilitation patients an association between movement intensity and HRQoL was found. For clinical purposes, results of this study can be used as reference values for HRQoL in a rehabilitation setting.
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Affiliation(s)
- Leonie A. Krops
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- * E-mail:
| | - Eva A. Jaarsma
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Pieter U. Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands
| | - Jan H. B. Geertzen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands
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A systematic review of anxiety amongst people with Multiple Sclerosis. Mult Scler Relat Disord 2016; 10:145-168. [PMID: 27919483 DOI: 10.1016/j.msard.2016.10.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/05/2016] [Accepted: 10/10/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify factors that are associated with anxiety in people with MS (PwMS). It aimed to examine the strength of evidence for factors associated with anxiety symptoms and identify limitations of existing studies. METHOD AND RESULTS One hundred and thirty one studies met inclusion criteria and were included in the review. A narrative synthesis was then conducted. Anxiety was found to be associated with a variety of demographic, physical, psychological, cognitive and social factors. A consistent finding was that anxiety was strongly associated with both high level of disability and low quality of life. A strong association between anxiety and depression was also found. CONCLUSION Implications for these results are discussed and a preliminary model of understanding anxiety in the context of MS is outlined. Given the overlap between anxiety and depression, a transdiagnostic treatment approach is suggested. In light of the shortcomings of extant studies, suggestions for future research are offered.
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Berrigan LI, Fisk JD, Patten SB, Tremlett H, Wolfson C, Warren S, Fiest KM, McKay KA, Marrie RA. Health-related quality of life in multiple sclerosis: Direct and indirect effects of comorbidity. Neurology 2016; 86:1417-1424. [PMID: 26962068 DOI: 10.1212/wnl.0000000000002564] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 01/05/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the direct and indirect influences of physical comorbidity, symptoms of depression and anxiety, fatigue, and disability on health-related quality of life (HRQoL) in persons with multiple sclerosis (MS). METHODS A large (n = 949) sample of adults with MS was recruited from 4 Canadian MS clinics. HRQoL was assessed using the patient-reported Health Utilities Index Mark 3. Expanded Disability Status Scale scores, physical comorbidity, depression, anxiety, and fatigue were evaluated as predictors of HRQoL in a cross-sectional path analysis. RESULTS All predictors were significantly associated with HRQoL and together accounted for a large proportion of variance (63%). Overall, disability status most strongly affected HRQoL (β = -0.52) but it was closely followed by depressive symptoms (β = -0.50). The direct associations of physical comorbidity and anxiety with HRQoL were small (β = -0.08 and -0.10, respectively), but these associations were stronger when indirect effects through other variables (depression, fatigue) were also considered (physical comorbidity: β = -0.20; anxiety: β = -0.34). CONCLUSIONS Increased disability, depression and anxiety symptoms, fatigue, and physical comorbidity are associated with decreased HRQoL in MS. Disability most strongly diminishes HRQoL and, thus, interventions that reduce disability are expected to yield the most substantial improvement in HRQoL. Yet, interventions targeting other factors amenable to change, particularly depression but also anxiety, fatigue, and physical comorbidities, may all result in meaningful improvements in HRQoL, as well. Our findings point to the importance of further research confirming the efficacy of such interventions.
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Affiliation(s)
- Lindsay I Berrigan
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - John D Fisk
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott B Patten
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Helen Tremlett
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Christina Wolfson
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Sharon Warren
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Kirsten M Fiest
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Kyla A McKay
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ruth Ann Marrie
- From the Department of Psychology (L.I.B.), St. Francis Xavier University, Antigonish; Department of Psychiatry (L.I.B., J.D.F.), Department of Medicine (J.D.F.), Dalhousie University, Halifax; Departments of Psychiatry and Community Health Sciences (S.B.P.), Cumming School of Medicine, University of Calgary; Division of Neurology, Faculty of Medicine (H.T., K.A.M.), University of British Columbia, Vancouver; Departments of Epidemiology & Biostatistics, Occupational Health, & Medicine (C.W.), McGill University, Montreal; Faculty of Rehabilitation Medicine (S.W.), University of Alberta, Edmonton; and Departments of Internal Medicine (K.M.F., R.A.M.) and Community Health Sciences (R.A.M.), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Tabrizi FM, Radfar M. Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis. Int J MS Care 2015; 17:268-74. [PMID: 26664332 DOI: 10.7224/1537-2073.2014-046] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Quality of life (QOL) is impaired in multiple sclerosis (MS) in part due to physical disability. MS-associated fatigue and poor sleep are common and treatable features of MS that affect QOL. We assessed the association between fatigue, sleep quality, and QOL in people with MS. METHODS Cross-sectional data were collected from 217 patients with MS. Health-related QOL (MS Quality of Life-54), fatigue (Fatigue Severity Scale [FSS]), and sleep quality (Pittsburgh Sleep Quality Inventory [PSQI]) were assessed. Expanded Disability Status Scale scores were also provided by a qualified neurologist. RESULTS The mean ± SD age of the 217 patients was 32.6 ± 8.6 years, and 79% were female. One hundred fifty-two patients (70.0%) were classified as poor sleepers based on PSQI scores; 122 (56.2%) had significant fatigue based on FSS results. The mean ± SE physical (PCS) and mental (MCS) health composite scores of the MSQOL-54 were 40.12 ± 1.27 and 43.81 ± 1.61, respectively. There was a strong statistically significant positive correlation between PCS scores and MCS (r = 0.58), FSS (r = 0.49), and PSQI (r = 0.52) scores. MCS scores were strongly correlated with FSS (r = 0.53) and PSQI (r = 0.35) scores. Age exhibited statistically significant negative correlations with PCS (r = -0.21) and MCS (r = -0.58) scores, and was statistically significantly correlated with FSS (r = 0.23) and PSQI (r = 0.21) scores. Expanded Disability Status Scale scores were strongly correlated with FSS scores. CONCLUSIONS These findings support screening of fatigue severity and sleep quality and their effects on QOL.
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Affiliation(s)
- Fatemeh Moghaddam Tabrizi
- Nursing and Midwifery Department, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Moloud Radfar
- Nursing and Midwifery Department, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Browne C, Salmon N, Kehoe M. Bladder dysfunction and quality of life for people with multiple sclerosis. Disabil Rehabil 2015; 37:2350-8. [PMID: 25801920 DOI: 10.3109/09638288.2015.1027007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Bladder dysfunction affects 75% of people with multiple sclerosis (MS). People with MS are reluctant to seek treatment for this distressing symptom. This is the first-known study to explore in depth how bladder dysfunction interferes with quality of life for people with MS. METHODS Nineteen individual semi-structured interviews were conducted (M = 8, F = 11). Participants had a definite diagnosis of MS, aged between 37 and 64 years and had at least one bladder dysfunction symptom. The audio-recorded interviews lasted up to 90 min and were transcribed verbatim. RESULTS Thematic analysis within NVivo10 yielded two key themes: (1) Disruptions and loss and (2) ways of knowing. "Disruptions and Loss" explores how bladder dysfunction interrupted daily living activities and how this contributed to experiencing loss. "Ways of knowing" portrays the types of knowledge that existed around bladder dysfunction. Participants described using their experiential knowledge to self-manage bladder symptoms without advice from healthcare providers. CONCLUSIONS Bladder dysfunction imposes major disruptions on daily life. People with MS attempt to self-manage their bladder symptoms, despite current barriers to navigating existing healthcare infrastructure. Understanding these barriers and the individual strategies employed by people with MS are the first steps in facilitating independent management of bladder dysfunction. Implications for Rehabilitation Each individual's experience of bladder dysfunction is unique. Healthcare professionals must be prepared to discuss all disruptions and losses associated with bladder dysfunction for people with MS. People with MS have a vast range of knowledge in relation to their own bladder symptoms and healthcare professionals need to explore their existing self-management strategies during assessment. People with MS and healthcare professionals need to be educated on the wider health implications relating to bladder dysfunction.
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Affiliation(s)
- Catherine Browne
- a Department of Clinical Therapies , University of Limerick , Limerick , Ireland and
| | - Nancy Salmon
- a Department of Clinical Therapies , University of Limerick , Limerick , Ireland and
| | - Maria Kehoe
- b Community Physiotherapy Department , Kildare/West Wicklow, Co. Kildare , Ireland
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Snyder S, Foley FW, Farrell E, Beier M, Zemon V. Psychological and physical predictors of illness intrusiveness in patients with multiple sclerosis. J Neurol Sci 2013; 332:41-4. [DOI: 10.1016/j.jns.2013.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
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12
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Vitkova M, Rosenberger J, Krokavcova M, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction. Disabil Rehabil 2013; 36:987-92. [DOI: 10.3109/09638288.2013.825332] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Papuć E, Stelmasiak Z. Factors predicting quality of life in a group of Polish subjects with multiple sclerosis: accounting for functional state, socio-demographic and clinical factors. Clin Neurol Neurosurg 2011; 114:341-6. [PMID: 22137087 DOI: 10.1016/j.clineuro.2011.11.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 08/13/2011] [Accepted: 11/05/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Quality of life (QoL) has presently a firmly established position as an important endpoint in medical care. Multiple sclerosis (MS) is a chronic neurological disease with considerable effect on patients' QoL. QoL of MS patients from many European countries has already been assessed but little is known on health-related QoL of Polish subjects with MS. Few studies have taken into consideration multiple predictors of QoL. The aim of this study was to elicit the most relevant factors that determine QoL of Polish group of MS patients. Socio-demographic and clinical factors as well as the influence of disability level were analyzed in this study. PATIENTS AND METHODS 173 MS patients and 86 healthy controls underwent assessment using the Mini Mental Status Examination, WHOQOL-100, Beck Depression Inventory and Fatigue Severity Scale. Data were analyzed by a stepwise linear regression analysis. RESULTS MS patients had significantly worse global QoL and worse QoL in physical and psychological health domains, lower level of independence, worse social relations and were less satisfied with the surrounding environment they lived in compared with healthy controls (p<0.05). MS subjects had also higher level of depression and fatigue compared to healthy controls (p<0.05). CONCLUSIONS The study determined that the strongest predictors of global QoL of Polish MS patients were depression, disability level and fatigue.
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Affiliation(s)
- Ewa Papuć
- Department of Neurology, Medical University of Lublin, Poland.
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