Mikula Pavol, Timkova Vladimira, Linkova Marcela, Vitkova Marianna, Szilasiova Jarmila, Nagyova Iveta
Department of Social and Behavioural Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia.
Department of Neurology, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Košice, Slovakia.
Front Psychol. 2020 Mar 18;11:504. doi: 10.3389/fpsyg.2020.00504. eCollection 2020.
Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation ( < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.
疲劳和睡眠质量差是多发性硬化症（MS）患者报告的最常见问题。另一方面，社会支持通常被发现与神经疾病患者的生活质量呈正相关。研究还表明，与普通人群相比，MS患者的自杀意念（SI）水平有所升高。因此，本研究的目的是评估MS患者疲劳、社会支持和SI之间的关联。在184名被要求参与这项横断面研究的MS患者中，156人同意参与（应答率69.8%；75%为女性；平均年龄：39.95±9.97岁）。患者填写了多维疲劳量表-20、匹兹堡睡眠质量指数、多维感知社会支持量表以及一般健康问卷-28中侧重于评估SI的子量表。模型对年龄、性别、疾病持续时间、功能残疾和睡眠质量进行了控制。数据采用多元线性回归分析。SI与较低的睡眠质量以及四种类型的疲劳呈正相关：总体疲劳、精神疲劳、活动减少和动力下降（P<0.05）。身体疲劳与SI无显著关联。在所有模型中，社会支持与SI呈负相关。所研究的最终模型解释了SI总方差的24.3%至29.7%。SI与睡眠质量和疲劳均有关联，但身体疲劳除外。医生提供的关于睡眠管理的信息，以及针对为MS患者提供支持的人群（家人、朋友和重要他人）的心理社会干预可能会降低SI水平。
