Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland.
Collegium Medicum, Jan Kochanowski University, Kielce, Poland.
PLoS One. 2021 Mar 11;16(3):e0248135. doi: 10.1371/journal.pone.0248135. eCollection 2021.
Low level of self-management in people with multiple sclerosis (MS) is considered to be a predominant factor that leads to poor rehabilitation efficacy. Studies focusing on the relationship between self-management and psychological variables that can be modified could contribute to expanding the knowledge needed to propose interventional programs aiming at patient activation. This study aimed to analyze whether coping strategies play a mediating role in the association between the perceived impact of MS and level of self-management in people with MS. The cross-sectional study included 382 people with MS. The participants completed the Multiple Sclerosis Self-Management Scale-Revised, Multiple Sclerosis Impact Scale-29, and Coping Inventory for Stressful Situations. The study hypothesis was evaluated using mediation analysis. The STROBE checklist specifically prepared for cross-sectional research was applied in this study for reporting. Results indicate that the emotion- and problem-focused strategies of coping can be treated as mediating the association between the MS impact and level of self-management in people with MS. A negative relationship was found between the perceived MS impact and problem-oriented coping, while a positive relationship was found between problem-oriented coping and self-management. Furthermore, a positive relationship was found between the MS impact and emotion-oriented coping, while a negative relationship was found between emotion-oriented coping and self-management. The indirect role of avoidance-oriented coping was not significant. Our study confirms the role played by coping strategies in individuals' self-management. In MS, self-management determined by perceived MS impact can be controlled by decreasing emotional-coping while increasing problem-coping strategies. Our study imparts new knowledge regarding the potential interventions for improving the level of self-management in people with MS. It indicates that recognition of individuals' illness perceptions as well as maladaptive coping strategies can help health professionals identify those who might be having lower level of self-management.
低水平的自我管理被认为是多发性硬化症（MS）患者康复效果不佳的主要因素。关注自我管理与可改变的心理变量之间关系的研究，可以为提出旨在激活患者的干预计划提供必要的知识。本研究旨在分析应对策略是否在 MS 对患者的影响与 MS 患者自我管理水平之间的关系中起中介作用。这项横断面研究共纳入 382 名 MS 患者。参与者完成了多发性硬化症自我管理量表修订版、多发性硬化症影响量表-29 和应激情境应对量表。采用中介分析来评估研究假设。本研究专门应用了为横断面研究准备的 STROBE 清单来报告。结果表明，情绪和问题为导向的应对策略可以作为 MS 对患者的影响与 MS 患者自我管理水平之间关系的中介。MS 对患者的影响与问题为导向的应对呈负相关，而问题为导向的应对与自我管理呈正相关。此外，MS 对患者的影响与情绪为导向的应对呈正相关，而情绪为导向的应对与自我管理呈负相关。回避为导向的应对的间接作用不显著。我们的研究证实了应对策略在个体自我管理中的作用。在 MS 中，通过感知 MS 影响来确定的自我管理可以通过减少情绪应对，同时增加问题应对策略来控制。本研究为提高 MS 患者自我管理水平的潜在干预措施提供了新的知识。它表明，识别个体的疾病认知和适应不良的应对策略可以帮助卫生专业人员确定那些可能自我管理水平较低的患者。
