Work capacity and health-related quality of life among individuals with multiple sclerosis reduced by fatigue: a cross-sectional study

Abstract

BackgroundAmong individuals diagnosed with the chronic neurologic disease, multiple sclerosis (MS), a majority suffers from fatigue, which strongly influences their every-day-life. The aim of this study was to investigate work capacity and health-related quality of life (HRQoL) in a group of MS patients and also to investigate if work capacity and HRQoL could be predicted by background factors, fatigue, heat sensitivity, cognitive dysfunction, emotional distress or degree of disability.MethodsA descriptive, cross-sectional, designed survey was undertaken A questionnaire was sent to 323 individuals diagnosed with MS, aged between 20 and 65 years, with physical disability on the expanded disability status score (EDSS) in the interval 0 ≥ EDSS ≤ 6.5, living in Östergötland county in eastern Sweden. Questions on background factors, occupation and work, together with the health-related quality of life short form instrument (SF-36), the fatigue severity scale (FSS), the perceived deficit questionnaire (PDQ) and the hospital anxiety depression scale (HAD) were posed. Associations between variables were analyzed using Pearson’s and Spearman’s correlations. Differences between groups were tested using the Chi-square test, the Mann Whitney U-test, and the Student’s t-test. Predictive factors were analyzed using multiple linear and multiple logistic regression analysis.ResultsOf those who completed the questionnaire (n = 257, 79.6%), 59.8% were working. Work capacity was found significantly more among men (p < 0.005), those with a higher level of education (p < 0.001), those reporting less fatigue (p < 0.001), and those having no heat sensitivity (p = 0.004). For work capacity, significant predictors were low physical disability (EDSS), low fatigue, higher level of education, male sex and lower age. Those with work capacity showed significantly higher HRQoL than those who had no work capacity (p < 0.001). Levels of fatigue, cognition and emotional distress were found to be major contributing factors for HRQoL.ConclusionsWork capacity and HRQoL among individuals diagnosed with MS are highly influenced by fatigue which can be considered as a key symptom. Work capacity was influenced by heat-sensitivity, cognitive difficulties and emotional distress and significant predictive factors besides fatigue, were physical disability (EDSS), age, sex, and level of education. Remaining at work also gives a better HRQoL.

The Associations Between Fatigue, Disability, and Mobility and the Quality of Life in Patients with Multiple Sclerosis

“…The effects of fatigue on the quality of life of MS patients have been the subjects of some previous studies (15,28); for example, Flensner et al suggested that the capacity and quality of life in MS patients may be strongly affected by fatigue (2). In addition, it has been suggested that MS symptoms (depression, pain, and fatigue) have negative impacts on the quality of life (15).…”

“…Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system (1), which is more common in young adults from 20 to 40 years old (2)(3)(4)(5), and is more widespread in women than in men (3)(4)(5). This disease can cause blurred and double vision, muscle weakness, impaired balance and coordination, increased sensations of depression (average to severe), cognitive impairment, pain, forgetfulness, a lack of concentration, fatigue, tremors, dizziness, impaired bowels, and bladder and sexual dysfunctions in affected people (4,6).…”

“…These studies have shown a lower level in the quality of life of MS patients in terms of their physical and mental health, independence, social relationships, and satisfaction with their environments, when compared with the normal groups (5). In addition, higher levels of depression and fatigue in patients with MS were observed, when compared to the healthy subjects (2). Reports have shown that factors such as the age, education level, duration and type of the disease (6), and physical disability affect the quality of life (3).…”

Kartlegging av funksjon ved kronisk utmattelsessyndrom

“…Pasientene anga betydelig utmattelse med en gjennomsnittlig totalskår på FSS-skalaen på 6,6, mot 3 for friske kontrollpersoner. Til sammenlikning skårer multippel sklerose-pasienter uten arbeidskapasitet 5,3 (13).…”

Utmattelse ved inflammatorisk tarmsykdom

“…«Fatigue» kan defineres som en overveldende følelse av tretthet, utmattelse og manglende energi (3). Fenomenet er vanlig ved en rekke kronisk inflammatoriske sykdommer, det påvirker livskvaliteten (4) og reduserer i mange tilfeller arbeidsevnen (5).…”