Abstract
Objective
To examine the relationship between disease-related risk factors, protective factors,
coping, and resilience on quality of life in adults with multiple sclerosis (MS).
Design
Quantitative descriptive research employing structural equation modeling.
Setting
Online survey fielded to community members associated with the Greater New England
Chapter of the National Multiple Sclerosis Society.
Participants
Convenience sample of 271 individuals with MS.
Intervention
Not applicable.
Main Outcome Measures
The Leeds Multiple Sclerosis Quality of Life (LMSQoL) scale was the primary outcome.
Other measures entered into the model included the Brief Resilience Scale (BRS) and
the Coping Orientation to Problems Experienced (COPE) scale modeled as 2 latent variables:
emotion-based coping and problem-based coping. Disability level, fatigue, walking
impairment, fear of falling, falls, and pain were modeled as a latent variable for
risk factors while physical activity, self-efficacy, social support, optimism, and
health locus of control were modeled as a latent variable of protective factors.
Results
BRS had a total effect of –0.44 on LMSQoL, significant at P<.001. Protective factors also directly and significantly increased QoL (total effect
size –0.46; P<.001). Emotion-based coping and problem-based coping had insignificant effects on
QoL. Risk factors had a complex influence on QoL, mediated by resilience, protective
factors, emotion-based coping, and problem-based coping. Risk factors had total effect
size of 0.32 on quality of life (significant at P<.001). Whereas higher risk factors decreased QoL, both directly and indirectly, resilience
increased the likelihood of higher QoL with a slightly higher effect size. The model
fit the data reasonably well and explained 96.7% of the variance in QoL in people
with MS.
Conclusions
The model suggests that developing interventions that increase protective factors
and broaden and build resilience may contribute to improved quality of life in individuals
with MS.
Keywords
List of abbreviations:
BRS (Brief Resilience Scale), COPE (Coping Orientation to Problems Experienced), LMSQoL (Leeds Multiple Sclerosis Quality of Life), MHLC-C (Multidimensional Health Locus of Control–Form C), MS (multiple sclerosis), QoL (quality of life)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 10, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
