Longitudinal Changes in Quality of Life and Related Psychosocial Variables in Australians with Multiple Sclerosis

Abstract

This study explored changes in quality of life (QOL) and psychosocial variables in a large cohort of people with multiple sclerosis (MS). A total of 1287 Australians with MS were administered self-report questionnaires at baseline and 24 months later to examine the impact of disease severity and duration, perceived stress, self-efficacy, depression, and social support on QOL and self-care. Over the 2-year survey period, MS remained stable for 70% of respondents. Disease severity correlated with social support at baseline but not at 24 months, when the only significant correlation with disease severity was that of the World Health Organization Quality of Life-100 instrument (WHOQOL-100) domain of Level of Independence. Although QOL improved across the WHOQOL-100 domains Physical, Psychological, Level of Independence, Social Relationships, and Environment, decreases were found in the WHOQOL-100 facet overall QOL and well-being as well as self-efficacy over the same time period. Hierarchical multiple regression was used to assess the utility of four control measures. MS disease severity and MS disease duration were entered at Step 1, explaining 16.1% of the variance in QOL. After entry of perceived stress, self-efficacy, social support, and the Depression, Anxiety and Stress Scale-21 (DASS-21) at Step 2, the total variance explained by the model as a whole was 55.8% (F6,1028 = 216.495, P < .001). Thus, even in the presence of stable disease and improvement in some WHOQOL-100 domains, overall QOL and self-efficacy had decreased at 2 years after the collection of baseline data. Loss of self-efficacy, increased stress, and depression are key factors in reduced QOL in people with MS.

Self-Efficacy as a Longitudinal Predictor of Perceived Cognitive Impairment in Individuals With Multiple Sclerosis

“…Consistent with previous research, demographic and physical disability were not predictive of PCI. 44,45 Taken together, results suggest that individuals' perceptions of their abilities to manage their symptoms predict the presence and severity of perceived cognitive impairment, which has important implications for predicting positive health outcomes (e.g., community integration) and for designing successful self-management interventions.…”

“…It featured a longitudinal design with a large sample of community-dwelling individuals with MS. A review of the current literature revealed only two longitudinal studies of self-efficacy in MS, one as a predictor of health-related quality of life, 45 and the other on physical activity behaviors. 48 However, neither study explicitly investigated PCI.…”

Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): Importance of adopting a biopsychosocial model

“…34,35 Other psychological or person-specific factors include anxiety, self-efficacy, and coping. 36 Perceived social support has also been shown to be a significant factor associated with QOL in MS. 28 These factors have been shown to greatly contribute to QOL above and beyond disease variables. In fact, Wollin et al (2013) found that depression, anxiety, self-efficacy, social support, and stress accounted for an additional 40% of the variance in predicting QOL when disease severity and duration were accounted for.…”

“…In fact, Wollin et al (2013) found that depression, anxiety, self-efficacy, social support, and stress accounted for an additional 40% of the variance in predicting QOL when disease severity and duration were accounted for. 36 Self-efficacy has consistently been hailed as a great determinant in MS with regard to several outcomes, including health status, 37 adherence to treatment, 38 disease management, 39 adjustment, 40 physical and social functioning, 41 and physical activity and HRQOL. 42 A more recent investigation found self-efficacy to be a significant predictor of physical, social, and cognitive functioning in MS, even when taking into account neurologic impairment and depression.…”

Selected health behaviors moderate the progression of functional limitations in persons with multiple sclerosis: Eleven years of annual follow-up

“…age, gender) or clinical (duration of MS) variables that provide only limited explanatory power for the progression of functional limitations [9,10,11,12,13]. In a widely cited study conducted before the advent of disease-modifying medications, Weinshenker and colleagues found that 50% of persons with MS require the use of an assistive device for walking 15 years after diagnosis and 10% require a wheelchair to support mobility [14].…”