Improving the quality of life of multiple sclerosis patients through coping strategies in routine medical practice

Abstract

Multiple sclerosis (MS) has a major impact on quality of life (QoL). Coping strategies which may influence QoL have not been identified. Furthermore, there is no coping scale designed to measure coping in MS patients and concise enough for routine medical practice. We used 46 items and 7 coping dimensions; we successively reduced the minimum number of dimensions through confirmatory factor analysis (CFA) and Rasch modelling. The resulting scale was submitted to psychometric validation via an independent cross-sectional analysis. After administration to 331 MS patients, we eliminated 10 of the 46 initial items; a CFA iterative algorithm identified a positive coping (PC) group and a negative coping (NC) group; an iterative reduction algorithm led to a final 10 items questionnaire, which was tested in an independent, new cross-sectional sample of 457 patients. Psychometric tests, including the Rasch model and CFA, successfully validated the scale, confirming the two dimensions and the absence of differential item functioning. The correlation between coping and QoL increased to 0.59 and 0.62 for NC and PC, respectively, compared with 0.33 found with existing scales. Our findings justify a one-dimensional overall coping scale (PC + NC). The effect of coping on QoL can be evaluated simply by adding together a positive and a negative coping strategy, for which we developed a short 10-item scale, which can be considered as an effective means of measuring the impact of coping on QoL and is ideal in routine medical practice.

The Andersen Likelihood Ratio Test with a Random Split Criterion Lacks Power

“…Such a split into random subsamples was first proposed as part of a graphical inspection of the invariance of 1-PL Rasch model item parameters (Hambleton & Murray, 1983), and was soon employed for the LRT (e.g., Maier & Philipp, 1985, 1986Maier, Philipp, Buller, & Schiegel, 1987). There are numerous examples of using a random split (e.g., Devy, Lehert, Varlan, Genty, & Edan, 2015;Gnambs & Batinic, 2011;Kliem et al, 2015;Koller & Alexandrowicz, 2010;Rusch, Mair, Lowry, & Treiblmaier, 2013). However, little is known about Type I error and power of an LRT with a random split.…”

A Group Cognitive Behavioural Therapy Improves Quality of Life of Multiple Sclerosis Patients and Delays Disease Progression: A Multi-Centre Controlled Trial

“…At baseline, we measured alexithymia (TAS-20) scale [31], Beck Depression inventory [31], Anxiety STA-I [31], emotional distress (POMS) [31], assertiveness and selfesteem scales [31], [32]. Neuropathic pain scale (DN4), severity fatigue scale (FSS), sleeping disorder scales (Epworth), EDSS [33] and self-filled validated short TLS-QoL 10 [27] and DC10 [28] scales were used at every visit. All the scales were administered in conformity with CBT.…”

“…QoL was strongly correlated with disease severity, which was essentially interpreted as QoL deterioration caused by disease progression [1], [5], [7]. However, another interpretation in the opposite direction was suspected [28], in which improving QoL may be slow disease development and delay disease progression.…”

“…The essential concern of QoL in this pathology motivated us to provide further investigation on the beneficial effect of CBT. Aware of these methodological problems, we postponed the therapy trial, in concentrating first to the development of adapted measurement tools: a literature review [27], [28] showed that there was no scale of QoL or coping conducted in the same time specific to MS and adapted to routine practice. A first cross-sectional study of 331 patients [27] identified a short MS-specific optimized QoL scale of 10 items (TLS-QoL 10).…”

“…A first cross-sectional study of 331 patients [27] identified a short MS-specific optimized QoL scale of 10 items (TLS-QoL 10). In the same study, the authors developed an optimized short MS-specific coping scale [28], measuring the negative and positive coping and providing a total score (Devy Coping Scale (DC-10)). The two scales were validated by an independent second study in 521 MS patients, providing accurate, specific and short questionnaires for both QoL and coping, fully adapted to routine medical practice.…”