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What Biopsychosocial Factors Explain Self-management Behaviors in Multiple Sclerosis? The Role of Demographics, Cognition, Personality, and Psychosocial and Physical Functioning

  • Elizabeth S. Gromisch
    Correspondence
    Corresponding author Elizabeth S. Gromisch, PhD, Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health of New England, 490 Blue Hills Avenue, Hartford, CT 06112.
    Affiliations
    Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health of New England, Hartford, CT

    Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT

    Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT

    Department of Neurology, University of Connecticut School of Medicine, Farmington, CT
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  • Lindsay O. Neto
    Affiliations
    Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health of New England, Hartford, CT

    Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
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  • Aaron P. Turner
    Affiliations
    Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA

    Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA

    Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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      HIGHLIGHTS

      • Modifiable and nonmodifiable factors of self-management are not fully understood.
      • Co-occurring diabetes was negatively related to overall self-management in persons with multiple sclerosis.
      • Subjective and objective prospective memory were significant contributors.
      • The results suggest several directions for future self-management interventions.

      Abstract

      Objectives

      To examine the biopsychosocial correlates of overall and individual self-management behaviors in persons with multiple sclerosis (MS), including demographics, co-occurring medical diagnoses, cognition, personality traits, and psychosocial and physical functioning as variables.

      Design

      Prospective cross-sectional cohort study.

      Setting

      Community-based comprehensive MS center.

      Participants

      Adults with MS (n=112) who completed a brief neuropsychological battery that included a self-report survey and performance-based measures of cognitive function.

      Interventions

      Not applicable.

      Main Outcome Measures

      The MS Self-management Scale–Revised total score was the primary outcome and its 5 subscales (Healthcare Provider Relationship/Communication, Treatment Adherence/Barriers, Social/Family Support, MS Knowledge and Information, Health Maintenance Behaviors) were secondary outcomes.

      Results

      Disease-modifying therapy usage (β=0.39), social support (β=0.31), subjective prospective memory (β=−0.25), emotional well-being (β=0.20), and histories of diabetes (β=−0.18) and high cholesterol (β=0.15) were significantly associated with overall self-management in a multivariate model. Correlates of individual self-management behaviors are also described.

      Conclusions

      The findings provide insights into the biopsychosocial characteristics contributing to the overall and individual self-management behaviors of persons with multiple sclerosis. The next steps will be to evaluate these factors in a clinical intervention.

      Keywords

      List of abbreviations:

      DMT (disease-modifying therapy), MIST (Memory for Intentions Test), MS (multiple sclerosis), MSSM-R (Multiple Sclerosis Self-management Scale–Revised), PwMS (persons with multiple sclerosis)
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