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中期复发缓解型多发性硬化症患者的疾病相关不确定性感知。

Perceived illness-related uncertainty among patients with mid-stage relapsing-remitting multiple sclerosis.

机构信息

Department of Neurology, Hospital Universitario Puerta de Hierro, Madrid, Spain.

Medical Department, Roche Farma, Madrid, Spain.

出版信息

Mult Scler Relat Disord. 2024 Nov;91:105861. doi: 10.1016/j.msard.2024.105861. Epub 2024 Sep 3.

Abstract

BACKGROUND

Patients with multiple sclerosis (MS) have to deal with a variable disease trajectory often associated with disability and productivity loss.

OBJECTIVE

This study aimed to assess illness-related uncertainty and associated correlates in patients with relapsing-remitting multiple sclerosis (RRMS) beyond the near diagnosis phase.

METHODS

We conducted a multicenter, non-interventional study including patients diagnosed with RRMS (2017 revised McDonald criteria) and a disease duration of 3 to 8 years. Perceived uncertainty was measured using the Mishel Uncertainty of Illness Scale (MUIS). Associations between the MUIS and different patient-based outcome measures were analyzed using Spearman's rank correlation.

RESULTS

A total of 201 patients were studied (mean age (standard deviation): 38.7 (8.4) years, 71.4 % female). The median disease duration (interquartile range) was 6.0 (4.0-7.0) years and the median EDSS score was 1.0 (0.0-2.0). The mean MUIS score was 38.2 (10.8). Perceived uncertainty was positively correlated with fatigue (p < 0.001), symptom severity (p < 0.001), anxiety (p < 0.001), depressive symptoms (p < 0.001), and a threatening illness perception (p < 0.001), and negatively correlated with self-management (p < 0.001), self-efficacy (p < 0.001), processing speed (p < 0.001), knowledge of MS (p = 0.006), and quality of life (p < 0.001).

CONCLUSION

Illness-related uncertainty was common in a population of mid-stage RRMS. Identifying uncertainty and its associated factors may be useful for implementing preventive strategies to help patients cope with the disease throughout life.

摘要

背景

多发性硬化症(MS)患者的疾病轨迹多变,常伴有残疾和生产力损失。

目的

本研究旨在评估缓解-复发型多发性硬化症(RRMS)患者在接近诊断阶段之外的与疾病相关的不确定性及其相关因素。

方法

我们进行了一项多中心、非干预性研究,纳入了诊断为 RRMS(2017 年修订的 McDonald 标准)且病程为 3 至 8 年的患者。使用米舍尔疾病不确定感量表(MUIS)测量患者的感知不确定性。使用 Spearman 秩相关分析 MUIS 与不同患者为基础的结局测量指标之间的关联。

结果

共研究了 201 例患者(平均年龄(标准差):38.7(8.4)岁,71.4%为女性)。中位病程(四分位间距)为 6.0(4.0-7.0)年,中位 EDSS 评分为 1.0(0.0-2.0)。MUIS 评分的平均值为 38.2(10.8)。感知不确定性与疲劳(p<0.001)、症状严重程度(p<0.001)、焦虑(p<0.001)、抑郁症状(p<0.001)和威胁性疾病认知(p<0.001)呈正相关,与自我管理(p<0.001)、自我效能(p<0.001)、处理速度(p<0.001)、多发性硬化症知识(p=0.006)和生活质量(p<0.001)呈负相关。

结论

在 RRMS 中期人群中,与疾病相关的不确定性很常见。识别不确定性及其相关因素可能有助于实施预防策略,帮助患者在疾病的整个生命周期中应对疾病。

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