Shahrbanian Shahnaz, Duquette Pierre, Ahmed Sara, Mayo Nancy E
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University Health Center, McGill University, Royal Victoria Hospital Site, Ross Pavilion R4.27, 687 Pine Ave W, Montreal, QC, H3A 1A1, Canada.
Faculty of Physical Education and Sport Science, Buali Sina University, Hamedan, Iran.
Qual Life Res. 2016 Feb;25(2):477-491. doi: 10.1007/s11136-015-1098-0. Epub 2015 Aug 9.
The symptoms of multiple sclerosis (MS) often cause physical and mental dysfunction, which interferes with a person's ability to participate in life's roles. Identification of the strength of the contributors to participation would help prioritize intervention approaches for its improvement. The objective of this study was to estimate the extent to which pain and other MS-related symptoms, physical function, psychological variables, and individual characteristics predict participation in people with MS.
This was a cross-sectional study. Study sample was a center-stratified random sample of 188 persons with MS. Subjects completed a battery of self-report and performance-based measures that assessed participation and domains affecting participation. To model the relationships among variables, a conceptual framework based on the Wilson and Cleary model was tested. Structural equation modeling aimed at identification of the predictors of participation within the hypothesized theoretical model.
Fatigue (β = 0.63, p < 0.0001), physical function (β = 0.37, p < 0.0001), and psychological variables (β = 0.15, p = 0.04) were found to be as significant direct predictors of participation. Pain (β = 0.4, p < 0.0001) and age (β = 0.12, p < 0.0001) were significant indirect predictors through fatigue and physical function, respectively. Together these effects explained 88 % of the variance of participation, 35 % of the variance in psychological variables, and 29 % of the variance in physical function.
Fatigue, physical function, pain, and psychological variables were most important contributors for participation in persons with MS.
多发性硬化症（MS）的症状常导致身体和心理功能障碍，干扰患者参与日常生活角色的能力。确定影响参与度的因素的强度将有助于确定改善参与度的干预方法的优先级。本研究的目的是评估疼痛和其他与MS相关的症状、身体功能、心理变量以及个体特征对MS患者参与度的预测程度。
这是一项横断面研究。研究样本是188名MS患者的中心分层随机样本。受试者完成了一系列基于自我报告和表现的测量，以评估参与度以及影响参与度的各个领域。为了建立变量之间的关系模型，对基于Wilson和Cleary模型的概念框架进行了测试。结构方程模型旨在确定假设理论模型中参与度的预测因素。
发现疲劳（β = 0.63，p < 0.0001）、身体功能（β = 0.37，p < 0.0001）和心理变量（β = 0.15，p = 0.04）是参与度的重要直接预测因素。疼痛（β = 0.4，p < 0.0001）和年龄（β = 0.12，p < 0.0001）分别通过疲劳和身体功能成为重要的间接预测因素。这些影响共同解释了参与度方差的88%、心理变量方差的35%和身体功能方差的29%。
疲劳、身体功能、疼痛和心理变量是MS患者参与度的最重要影响因素。
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