Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland.
Department of Musculoskeletal Rehabilitation, Poznań University of Physical Education, Poznań, Poland.
Acta Neurol Scand. 2020 Jul;142(1):50-57. doi: 10.1111/ane.13236. Epub 2020 Mar 23.
Patient's engagement in their own treatment has been shown to improve clinical outcomes. A better understanding of the association between self-management in multiple sclerosis (MS) and potentially modifiable psychological factors may provide clinicians with strategies to design and stimulate better patient activation for self-managing health. Therefore, in this study, we examined whether cognitive factors, namely self-efficacy, acceptance of illness, optimism, and health locus of control (HLC), are associated with self-management in MS.
This is a cross-sectional study. A total of 382 patients with MS who completed the MS Self-Management Scale-Revised and the questionnaires that measure self-efficacy, optimism, illness acceptance, and HLC were included in the study.
A hierarchical multiple regression revealed that power of others' HLC (b = 0.42, P ≤ .001), optimism (b = 0.27, P ≤ .01), internal HLC (b = -0.11, P = .017), and self-efficacy (b = 0.11, P = .031), together with control variables (longer disease duration and higher disability), explained 30% of the variance in the dependent variable.
In the case of MS, self-management is associated with patient's perception that healthcare professionals control their health, higher self-efficacy, optimism, and, surprisingly, lower internal HLC. The results of this study indicate the vital role of the healthcare staff in encouraging the patients with MS toward activities related to self-management and provide new insights on the psychological intervention aimed at improving self-management by patients.
患者参与自身治疗已被证明可改善临床结局。更好地理解多发性硬化症（MS）自我管理与潜在可改变的心理因素之间的关系，可能为临床医生提供设计和激发更好的患者自我管理健康积极性的策略。因此，本研究旨在探讨认知因素（即自我效能感、疾病接受度、乐观主义和健康控制点[HLC]）是否与 MS 的自我管理相关。
这是一项横断面研究。共纳入 382 名完成 MS 自我管理量表修订版和测量自我效能感、乐观主义、疾病接受度和 HLC 的问卷的 MS 患者。
分层多元回归显示，他人 HLC 力量（b=0.42，P≤.001）、乐观主义（b=0.27，P≤.01）、内部 HLC（b=-0.11，P=.017）和自我效能感（b=0.11，P=.031）与控制变量（疾病病程较长和残疾程度较高）一起，共解释了因变量 30%的方差。
在 MS 情况下，自我管理与患者认为医护人员控制其健康、更高的自我效能感、乐观主义以及令人惊讶的是较低的内部 HLC 有关。本研究结果表明医护人员在鼓励 MS 患者参与自我管理相关活动方面发挥着重要作用，并为旨在通过患者提高自我管理的心理干预提供了新的见解。
