Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change

2005 ◽  
Vol 231 (1-2) ◽  
pp. 29-34 ◽  
Author(s):  
Ralph H.B. Benedict ◽  
Elizabeth Wahlig ◽  
Rohit Bakshi ◽  
Inna Fishman ◽  
Frederick Munschauer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Behavior Change ◽  
Mood Disorder ◽  
Physical Disability ◽  
And Behavior

The Impact of Health Anxiety in Multiple Sclerosis: A Replication and Treatment Case Series

2017 ◽  
Vol 46 (2) ◽  
pp. 148-167 ◽  
Author(s):  
Neil Carrigan ◽  
Leon Dysch ◽  
Paul M. Salkovskis
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Cognitive Behaviour Therapy ◽  
Health Anxiety ◽  
Case Series ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
The Impact

Background: Multiple sclerosis (MS) is commonly associated with psychological complications. Previous research by Hayter and colleagues (2016) found that in patients with MS, health anxiety (HA) can account for part of the variance in quality of life (QoL) independent of physical and cognitive impairment caused by the disease. MS patients with HA perceived their intact physical and cognitive performance as impaired relative to those without HA and attributed the impairment to MS. These misperceptions might be useful targets in the treatment of HA in MS using cognitive behaviour therapy (CBT). Aims: Study 1 sought to replicate the main findings from Hayter et al. (2016). Study 2 examined the impact of HA-focused CBT in a case series. Method: In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group. They completed assessments of cognitive and physical functioning before rating their performance on these tasks, followed by measures of QoL, mood and physical disability. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. Results: Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. Conclusion: Given the high rates of HA in MS patients and its impact on QoL, this case series suggests that a brief CBT intervention could significantly improve patients’ wellbeing.

Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction

2001 ◽  
Vol 7 (4) ◽  
pp. 231-235 ◽  
Author(s):  
M W Nortvedt ◽  
T Riise ◽  
K-M Myhr ◽  
A-M Landtblom ◽  
A Bakke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Bladder Dysfunction ◽  
Survey Methods ◽  
Normal Population ◽  
Cross Sectional ◽  
Sf 36 ◽  
Multiple Sclerosis Patients

Objective: Physical disability explains only part of the reduced quality of life found among multiple sclerosis (MS) patients. Bladder dysfunction and sexual disturbance are frequent and distressing problems for MS patients. We therefore estimated the relationship between the presence and degree of sexual disturbance/bladder dysfunction and the patients' quality of life as measured by the SF-36 Health Survey. Methods: We performed a cross-sectional study of all individuals with the onset of MS between 1976 and 1986 in Hordaland County, Norway. The disease duration at examination was 9-19 years; 194 patients (94%) participated. Results: Fifty-three per cent of the patients with low physical disability (Expanded Disability Status Scale (EDSS)≤44.0) reported disease-related sexual disturbance and 44% had bladder dysfunction according to the Incapacity Status Scale. The corresponding figures for the patients with a high physical disability (EDSS>44.0) were 86 and 81% respectively. The patients with sexual disturbance had markedly and significantly reduced scores on all eight SF-36 scales, this was after adjustment for disease development measured by the EDSS. The patients without sexual disturbance scored 0.5 s.d. lower than a normal population on the social functioning scale, whereas those with marked sexual disturbance scored 1.5 s.d. lower. Similar results were found for the patients with bladder dysfunction. Conclusion: Bladder and sexual problems are associated with a marked reduction in the quality of life, also among patients with otherwise low disability. This underlines the need for identifying and treating these problems.

scholarly journals Cognition and Physical Disability in Predicting Health-Related Quality of Life in Multiple Sclerosis

2011 ◽  
Vol 13 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Marietta Hoogs ◽  
Sukhmit Kaur ◽  
Audrey Smerbeck ◽  
Bianca Weinstock-Guttman ◽  
Ralph H. B. Benedict
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Self Report ◽  
Task Completion ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Physical Hrqol

Many studies have shown that multiple sclerosis (MS) has a significant impact on patient health-related quality of life (HRQOL), but the relative contributions of physical versus cognitive disability are not well established. Most studies have relied on HRQOL outcomes that depend largely on patient mood, life satisfaction, and personal happiness. The Sickness Impact Profile (SIP) is a measure of HRQOL known for its relatively strong emphasis on task completion and activities of daily living. As such, the SIP may be less influenced by depression. We sought to determine the relative influence of physical disability and cognition, above and beyond demographic and disease variables, in predicting HRQOL. Patients (n = 132) and healthy controls (n = 26) underwent complete neuropsychological evaluation using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery and a series of self-report measures assessing depression, fatigue, and HRQOL. The SIP was also administered. Correlation analysis and group comparisons revealed significant associations between cognition and HRQOL outcomes. Logistic regression models comparing the Expanded Disability Status Scale (EDSS) and cognitive tests in predicting poor physical HRQOL retained both EDSS and Symbol Digit Modalities Test (SDMT) performance, while models predicting poor psychosocial and poor overall HRQOL retained only the SDMT. These findings support cognition as a significant predictor of overall HRQOL, psychosocial HRQOL, and, interestingly, physical HRQOL.

Physical Activity in Prevention of Risk and Disability in Some Neurological Diseases

2014 ◽  
Vol 22 (1) ◽  
pp. 21-27
Author(s):  
Józef Opara
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Neurological Diseases ◽  
Review Of The Literature ◽  
Disability Progression ◽  
Multiple Sclerosis Patients

Abstract The question of the role of physical activity in preventing disability in neurological diseases is the issue which is not in doubt. There is well known that physical activity in Parkinson`s disease and in Multiple Sclerosis patients is less than is the case in the general population. Numerous scientific studies have confirmed the low physical activity of people with PD and MS. Improving physical activity delays the progress of physical disability and has the effect on increasing the quality of life in those two diseases. In this paper an descriptive review of the literature devoted to the effect of physical activity on risk of PD and its impact on disability progression in PD and MS has been presented. The different recommendations for physical activity and different methods of assessment have been described.

scholarly journals Ayurveda and Panchakarma: Measuring the Effects of a Holistic Health Intervention

2009 ◽  
Vol 9 ◽  
pp. 272-280 ◽  
Author(s):  
L. A. Conboy ◽  
Ingrid Edshteyn ◽  
Hilary Garivaltis
Keyword(s):  
Quality Of Life ◽  
Behavior Change ◽  
Holistic Health ◽  
Positive Health ◽  
Home Context ◽  
Ayurvedic Treatment ◽  
Using Data ◽  
And Behavior

Ayurveda, the traditional medical system of India, is understudied in western contexts. Using data gathered from an Ayurvedic treatment program, this study examined the role of psychosocial factors in the process of behavior change and the salutogenic process. This observational study examined associations with participation in the 5-day Ayurvedic cleansing retreat program, Panchakarma. Quality of life, psychosocial, and behavior change measurements were measured longitudinally on 20 female participants. Measurements were taken before the start of the program, immediately after the program, and 3 months postprogram. The program did not significantly improve quality of life. Significant improvements were found in self-efficacy towards using Ayurveda to improve health and reported positive health behaviors. In addition, perceived social support and depression showed significant improvements 3 months postprogram after the subjects had returned to their home context. As a program of behavior change, our preliminary results suggest that the complex intervention Panchakarma may be effective in assisting one's expected and reported adherence to new and healthier behavior patterns.

Impact of depression and disability on quality of life in Iranian patients with multiple sclerosis

2007 ◽  
Vol 13 (2) ◽  
pp. 275-277 ◽  
Author(s):  
P Ayatollahi ◽  
S Nafissi ◽  
MR Eshraghian ◽  
H Kaviani ◽  
A Tarazi
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Psychological Health ◽  
Physical Disability ◽  
Clinical Course ◽  
Factors Affecting ◽  
Impact Scale ◽  
Disability Status ◽  
Highly Correlated

Multiple sclerosis (MS) can influence all aspects of a patient's health. This study determines the main factors affecting quality of life (QoL) in Iranian MS patients. QoL (Multiple Sclerosis Impact Scale; MSIS-29), disability (Expanded Disability Status Scale; EDSS) and depression (Beck Depression Inventory; BDI) were assessed in 106 MS patients. EDSS, clinical course and MS duration significantly correlated with physical MSIS-29. Depression highly correlated with both physical and psychological MSIS-29. Regression analyses showed that depression and EDSS predicted physical health. Psychological health was predicted by depression. These findings highlight that depression and physical disability strongly influence QoL in Iranian MS patients. Multiple Sclerosis 2007; 13: 275–277. http://msj.sagepub.com

scholarly journals Measuring the Quality of Life in Patients with Multiple Sclerosis in Clinical Practice: A Necessary Challenge

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Karine Baumstarck ◽  
Laurent Boyer ◽  
Mohamed Boucekine ◽  
Pierre Michel ◽  
Jean Pelletier ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Disease Progression ◽  
Clinical Relevance ◽  
Physical Disability ◽  
Management Of Care

While the physical disability aspect of multiple sclerosis (MS) is of great importance, quality of life (QoL) measurements are being considered increasingly important with regard to evaluating disease progression, treatment, and the management of care provided to MS patients. Despite the acknowledged need to consider QoL issues, QoL assessment remains underutilized in clinical practice. These issues should be explored and understood to promote the use of measuring QoL in MS clinical practice. We explore the difficulties for clinicians: choosing and determining the most appropriate QoL measure and how to best integrate QoL measurements into clinical practice. This paper discusses several avenues to provide to clinicians arguments of the clinical relevance and accuracy of QoL instruments and ultimately to enhance the use of QoL measures in clinical practice for MS patients.

scholarly journals Quality of life assessment in patients with multiple sclerosis

2009 ◽  
Vol 66 (8) ◽  
pp. 645-650 ◽  
Author(s):  
Darija Kisic-Tepavcevic ◽  
Tatjana Pekmezovic ◽  
Jelena Drulovic
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Rating Scale ◽  
Life Assessment ◽  
Subjective Perception ◽  
Clinical Parameters ◽  
Disability Status

Background/Aim. Multiple sclerosis (MS) is a chronic inflammatory disease of central nervous system. The main physiopatological feature of MS is demyelination. Multiple sclerosis is one of three most common causes of severe disability in youngest people. In patients with MS, apart from complete psychophysical status and objective neurologic status, a subjective perception of symptoms and signs, known as quality of life, must be considered, too. The aim of this study was to estimate a health related quality of life (HRQoL) in patients with multiple sclerosis (MS) and to investigate the correlations between scores of HRQoL and selected demographic and clinical parameters. Methods. A cross-sectional study was performed in patients meeting following inclusion criteria: MS diagnosis (McDonald's criteria), age 18-60 years, the Expanded Disability Status Scale (EDSS) < 8, and written informed consent. Exclusion criteria were exacerbation of MS in the last month, any preexisting major chronic illness and/or psychiatric disorders and antidepressive and/or corticosteroid therapy in the last month. The quality of life was measured by a disease specific instrument, MSQoL-54 (The Multiple Sclerosis Quality of Life). The neurological impairment was assessed using the Expended Disability Status Scale (EDSS) and Mini Mental Scale (MMS). The presence and severity of depression was estimated by the Hamilton Depression Rating Scale (HDRS). The presence and severity of fatigue was assessed by the Fatigue Severity Scale (FSS). Statistical analysis included descriptive statistics and correlation analysis. Results. The higher HRQoL score was registered for mental health (56.3 ? 19.5) than for physical one(51.3 ? 17.9), which means that physical disability had more important influence on quality of life deterioration comparing to mental health. The highest values of HRQoL were observed in domains of Cognitive Functioning (77.4 ? 22.5) and Pain (75.7 ? 25.5). The lowest scores of HRQoL were registered in domains of Role Limitations due to Physical Problems (32.5 ? 42.0) and Role Limitations due to Emotional Problems (44.6 ? 47.8). HRQoL scores statistically significantly correlated with natural history of MS, duration of diseases, employment and marriage status of participants. Deterioration in quality of life scores in the most of MSQoL-54 scales and subscales statistically significantly correlated with the presence and severity of physical disability, depression status and fatigue in patients with MS. Conclusion. This study showed that different demographic and clinical parameters had a major influence on HRQoL impairment in the sample of patients with MS.

Health-related quality of life in secondary progressive multiple sclerosis

2007 ◽  
Vol 13 (3) ◽  
pp. 386-392 ◽  
Author(s):  
A.G. Beiske ◽  
H. Naess ◽  
J.H. Aarseth ◽  
O. Andersen ◽  
I. Elovaara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Disease Progression ◽  
Physical Disability ◽  
Health Related Quality ◽  
Secondary Progressive ◽  
Related Quality ◽  
Health Related ◽  
Sum Scores

Common disability scales in multiple sclerosis (MS) are often weighted towards physical disability. Non-motor symptoms such as depression, fatigue and pain substantially influence wellbeing in MS. Health-related quality of life (HRQoL) measures the broader impact of MS and might indicate less obvious disease burdens. We analysed HRQoL, using the Nottingham Health Profile Part I (NHP-I), among 345 secondary progressive MS (SPMS) patients participating in a randomized trial of interferon-β1a (IFN-β1a), 22 μg subcutaneously weekly, or matching placebo. The results did not reveal any beneficial effect of IFN-β1a in any outcome measure. NHP-I sub- and sum scores were compared for 217 population controls and correlated with demographic and clinical disease variables. SPMS patients had lower NHP-I sum and all subscores than the controls. Patients experiencing disease progression reported worse NHP-I sum scores. Increased fatigue, Expanded Disability Status Scale (EDSS) and Arm Index scores were independently associated with reduction in several NHP-I subscores. SPMS patients had significantly lower HRQoL than controls and physical disability (EDSS and Arm Index), disease progression and fatigue strongly influenced this. MS

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