Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity.

BACKGROUND: People with multiple sclerosis (MS) report lower health-related quality of life (HRQoL). Improvements in quality of life can be made by identifying the factors that contribute to HRQoL in MS, which are both person specific and disease related.

OBJECTIVE: The primary objective of this study was to examine the mutual roles of acceptance, coping, and MS severity on HRQoL.

MATERIALS AND METHODS: This study included 382 patients with MS who completed the 29-item Multiple Sclerosis Impact Scale, Coping Inventory for Stressful Situations, and Acceptance of Illness Scale. A standardized questionnaire was used to collect patient clinical and demographics data. General MS severity was determined using the Expanded Disability Status Scale.

RESULTS: Six variables, acceptance of illness (β = -0.24, p < 0.001), emotional coping strategy (β = 0.40, p < 0.001), avoidance coping strategy (β = -0.19, p < 0.001), illness duration (β = -0.18, p < 0.001), age at the time of the study (β = 0.14, p = 0.009) and problem coping strategy (β = -0.09, p = 0.05), were found to be the significant correlates of HRQoL in MS. The model that included these variables explained 36% of variance in self-management in MS.

CONCLUSION: Psychological variables are more salient correlates of HRQoL in MS than the objective clinical variables, such as the severity or type of MS. Specifically, this study showed that MS patients who accept their illness and use more problem-solving and avoidance coping strategies and less emotional coping strategies assess their HRQoL highly.