Subjective well-being of adults with multiple sclerosis during COVID-19: Evaluating stress–appraisal–coping and person–environment factors.

Abstract

Background: People with multiple sclerosis (MS) have been coping with high levels of stress during the ongoing coronavirus pandemic, affecting their employment, physical, and mental health, and overall life satisfaction. Objective: This study evaluated constructs of the stress-appraisal-coping theory and positive person-environment factors as predictors of subjective well-being for adults with MS. Method: Participants included 477 adults with MS recruited through the National Multiple Sclerosis Society. Hierarchical regression analysis was used to determine the incremental variance in subjective well-being accounted for by demographic covariates, functional disability, perceived stress, stress appraisal, coping styles, and positive person-environment contextual factors. Results: Positive stress appraisal and coping flexibility were significantly associated with subjective well-being at the bivariate correlation level and at the step they were entered into the regression model. Marital status, household income, functional disability, perceived stress, hope, core self-evaluations, and social support were significant predictors in the final model, accounting for 60% of the variance in subjective well-being scores (R 2 = .60, f 2 = 1.48; large effect size). Conclusions: Findings from this study support a stress management and well-being model based on constructs of Lazarus and Folkman's stress-appraisal-coping theory and positive person-environment contextual factors, which can inform the development of theory-driven and empirically supported stress management and wellbeing interventions for people with MS during the ongoing global health crisis. Impact and ImplicationsThe coronavirus disease 2019 (COVID-19) has significantly disrupted the lives of people around the world and disproportionately affected the disability community, including people with multiple sclerosis (MS). In addition to managing stressors and challenges associated with chronic disease, people with MS must also cope with high levels of stress and anxiety during the ongoing pandemic, which can acutely affect their physical health, mental health, and life satisfaction. Therefore, effective stress management and well-being interventions that can be provided remotely, in person, and blended are needed to help individuals with MS manage disease complications and stress levels. This study evaluated constructs of the stress-appraisal-coping theory and positive person-environment contextual factors as predictors of subjective well-being in adults with MS. Findings suggested that positive personality traits and supportive environments may play a role as protective factors against perceived stress and facilitate subjective well-being. Importantly, findings of this study can be used to guide the development of theory-driven and empirically supported stress management, health promotion, and psychological interventions for people with MS during and beyond the COVID-19 pandemic.

Psychometric validation of the Patient-Reported Outcomes Measurement Information System Global Health Scale for people with multiple sclerosis.

“…MS is a complex, chronic, inflammatory, and autoimmune neurological disorder that primarily affects the central nervous system. It is characterized by a broad spectrum of neurological symptoms including pain, stress, sleep problems, fatigue, depression, weakness, vision problems, gait difficulties, cognitive changes, and emotional changes (Iwanaga et al, 2023; B. Lee et al, 2022; NMSS, 2023b; Rumrill et al, 2020).…”

“…Lee et al, 2022; NMSS, 2023b; Rumrill et al, 2020). Symptoms such as these not only present immense physical challenges for individuals, but they are also a significant source of mental and emotional stress (Iwanaga et al, 2023).…”

“…Research indicates that the ongoing risk associated with COVID-19, even in the postpandemic period, has a negative and significant effect on the physical, mental, and social health (global health) of people with MS (Iwanaga et al, 2023; Ling et al, 2022; Manacorda et al, 2021). Managing MS symptoms and daily stressors of life, along with COVID-19-related stress and current, sociopolitical stress in America can be very challenging, significantly affecting immune function and the global health of people with MS (American Psychological Association [APA], 2023; Homayuni et al, 2021; Iwanaga et al, 2023; Wolbring & Escobedo, 2023).…”

“…Research indicates that the ongoing risk associated with COVID-19, even in the postpandemic period, has a negative and significant effect on the physical, mental, and social health (global health) of people with MS (Iwanaga et al, 2023; Ling et al, 2022; Manacorda et al, 2021). Managing MS symptoms and daily stressors of life, along with COVID-19-related stress and current, sociopolitical stress in America can be very challenging, significantly affecting immune function and the global health of people with MS (American Psychological Association [APA], 2023; Homayuni et al, 2021; Iwanaga et al, 2023; Wolbring & Escobedo, 2023). Fortunately, research highlights the benefits of a healthy diet, exercise, not smoking, ongoing preventive care, and management of other secondary health conditions to reduce stress and improve global health and employment opportunities for people with MS, and gainful employment then further improves their global health and subjective well-being (SWB; NMSS, n.d.).…”