Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland.
Division of Rehabilitation Engineering, Institute of Combustion Engines and Transport, Faculty of Machines and Transport, Poznan University Technology, Poland.
Disabil Health J. 2019 Oct;12(4):608-614. doi: 10.1016/j.dhjo.2019.06.003. Epub 2019 Jul 9.
People with multiple sclerosis (MS) report lower health-related quality of life (HRQoL). Improvements in quality of life can be made by identifying the factors that contribute to HRQoL in MS, which are both person specific and disease related.
The primary objective of this study was to examine the mutual roles of acceptance, coping, and MS severity on HRQoL.
This study included 382 patients with MS who completed the 29-item Multiple Sclerosis Impact Scale, Coping Inventory for Stressful Situations, and Acceptance of Illness Scale. A standardized questionnaire was used to collect patient clinical and demographics data. General MS severity was determined using the Expanded Disability Status Scale.
Six variables, acceptance of illness (β = -0.24, p < 0.001), emotional coping strategy (β = 0.40, p < 0.001), avoidance coping strategy (β = -0.19, p < 0.001), illness duration (β = -0.18, p < 0.001), age at the time of the study (β = 0.14, p = 0.009) and problem coping strategy (β = -0.09, p = 0.05), were found to be the significant correlates of HRQoL in MS. The model that included these variables explained 36% of variance in self-management in MS.
Psychological variables are more salient correlates of HRQoL in MS than the objective clinical variables, such as the severity or type of MS. Specifically, this study showed that MS patients who accept their illness and use more problem-solving and avoidance coping strategies and less emotional coping strategies assess their HRQoL highly.
多发性硬化症（MS）患者报告的健康相关生活质量（HRQoL）较低。通过确定导致 MS 患者 HRQoL 的因素，可以改善生活质量，这些因素既有个体特异性又与疾病相关。
本研究的主要目的是检查接受、应对和 MS 严重程度对 HRQoL 的相互作用。
本研究纳入了 382 名 MS 患者，他们完成了 29 项多发性硬化症影响量表、应对压力情况量表和疾病接受量表。使用标准化问卷收集患者的临床和人口统计学数据。一般 MS 严重程度采用扩展残疾状况量表确定。
六个变量，包括疾病接受度（β= -0.24，p<0.001）、情绪应对策略（β= 0.40，p<0.001）、回避应对策略（β= -0.19，p<0.001）、疾病持续时间（β= -0.18，p<0.001）、研究时的年龄（β= 0.14，p= 0.009）和问题应对策略（β= -0.09，p= 0.05），被发现是 MS 患者 HRQoL 的显著相关因素。包含这些变量的模型解释了 MS 自我管理中 36%的方差。
与客观的临床变量（如 MS 的严重程度或类型）相比，心理变量是 MS 患者 HRQoL 的更显著相关因素。具体来说，本研究表明，接受疾病、使用更多问题解决和回避应对策略、较少使用情绪应对策略的 MS 患者对其 HRQoL 的评价较高。
