Fatigue, Physical Disability and Self-Efficacy as Predictors of the Acceptance of Illness and Health-Related Quality of Life in Patients with Multiple Sclerosis

Multiple sclerosis (MS) is a chronic progressive demyelinating disease of the central nervous system that leads to permanent disability and many neurological symptoms, making everyday functioning difficult. The predictors of the acceptance of illness and the health-related quality of life in people with MS include the degree of disability, neurological symptoms and psychosocial factors, such as personal resources. The aim of our study is to determine the relationships among disability, fatigue, self-efficacy, acceptance of illness and quality of life. The study group consisted of 137 people diagnosed with multiple sclerosis—73 women and 64 men. EDSS, GNDS, LSES, AIS and MSIS-29 were used in the present study. The results show that all tested variables were significantly correlated with each other. Disability and fatigue were significant predictors of both the physical and psychological aspects of patients’ quality of life. Self-efficacy was a significant predictor of both the acceptance of illness and the psychological aspect of patients’ quality of life. Based on the current research study, it can be concluded that factors of a biomedical nature explain other aspects of struggling with the disease, rather than psychological resources.

Development, Validation, and Internal Consistency of the Positive Psychology-Based Acceptance of Illness Scale (PAIS): A Culturally-Appropriate Japanese Measure

Acceptance of illness has been shown to improve the well-being of individuals suffering from chronic illnesses. We developed a new acceptance of illness scale, “Positive Psychology-Based Acceptance of Illness Scale: PAIS,” for HTLV-1 associated myelopathy (HAM) patients, one of the intractable neurological diseases with a chronic course. The validity and internal consistency of this PAIS were examined in 260 HAM patients in Japan. Exploratory factor analysis extracted four factors with 21 items: “Loving myself as I am”; “Experiencing the grace of illness”; “Feeling a loving connection with others”; and “Developing as a mature person”. Cronbach’s α was .83 to .88, except for Factor 4 which was slightly low at 0.64, and internal consistency was confirmed. A significant correlation was found between the PAIS and the index of convergent validity. The study’s findings are an important step toward a more comprehensive concept of acceptance of illness.

Validation and reliability of the Bahasa Malaysia language version of the Acceptance of Illness Scale among Malaysian patients with cancer

Cancer is a life-threatening disease, and the challenges in accepting the diagnosis can bring a devastating emotional impact on the patient’s mental and psychological wellbeing. Issues related to illness acceptance among cancer patients are not well studied in Malaysia. To date, the Acceptance of Illness Scale has not been translated to the Malay language (Bahasa Malaysia) nor validated for use in the oncology setting. The objective of the study is to translate, validate and determine the reliability of the Bahasa Malaysia version of the Acceptance of Illness Scale among Malaysian patients with cancer. A total of 129 patients newly diagnosed with cancer were consecutively sampled and the scale was administered via face-to-face interviews. A pilot test (n = 30) was conducted and test-retest reliability was determined. The Bartlett Test of Sphericity was statistically significantly (p<0.001), while the Kaiser-Mayer-Olkin (KMO) measure of sampling adequacy was adequate at 0.84. Scale item mean scores ranged between 3.02 and 4.33, while the item-total correlation ranged between 0.50 to 0.66 (p<0.05). The internal reliability coefficient was 0.84. The test-retest reliability indicated a high correlation, r = 0.94 with p = 0.001. The Bahasa Malaysia version of the Acceptance of Illness Scale is a valid and reliable instrument that is appropriate for use in Malaysian patients with cancer. Use of this scale to assess illness acceptance among the Malay-speaking patients with cancer can act as a guide for delivery of psycho-oncological services to help patients have a better mental wellbeing and life adjustment in living with cancer.

The impact of the acceptance of illness on the quality of life of patients with atrial fibrillation

Funding Acknowledgements Type of funding sources: None. Background. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. AF and the complications associated with it interfere with the physical, mental and social well-being of a person, thus affecting the quality of life. An important factor affecting the quality of life of patients with AF is the acceptance of illness (AI). In spite of the large problem related to this subject, the analysis of the relation between the acceptance of illness and the quality of life of patients with AF is insufficient. The aim of the study was to assess the impact of the acceptance of illness on the quality of life of patients with AF. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess the acceptance of illness and Arrhythmia-Specific questionnaire In Tachycardia and Arrhythmia (ASTA) to assess quality of life. Results. The majority of patients were secondary educated (64.27%), lived in a city (78.58%), were inactive (57.15%), were hospitalized 3-5 times (42.85%), had a cardiostimulator (23.80%) or underwent ablation (22.62%) during the last year. The average result of the acceptance of illness was 27.67 ± 7.70. 48.8% of patients had a high level of the acceptance of illness, 38.09% average, and 13.11% did not accept their illness. The mean result of quality of life for the whole studied group was (ASTA III) 25.64 ± 8.64. As regards the severity of symptoms (ASTA II) the mean result was 17.15 ± 5.89. Correlation analysis showed that the higher the level of the acceptance of illness the higher the quality of life (r = 0.640; p = 0.002) and lower the severity of AF symptoms (r=-0.51, p &lt; 0.001). Conclusions. Patients with AF present a moderate level of disease acceptance and quality of life. The acceptance of illnessis the independent predictor and significantly increases quality of life of patients with AF.

What affects the acceptance of illness in patients with atrial fibrillation?

Funding Acknowledgements Type of funding sources: None. Background. Patients with atrial fibrillation (AF) have symptoms that require advanced treatment. The most common include palpitations, dyspnea, dizziness, tiredness, chest pain and anxiety. Both the symptoms and treatment and its complications adversely affect the perception of the disease among patients with AF. The research proves that acceptance of illness (AIS) is a factor positively influencing the quality of life, but also the adaptation to the therapeutic recommendations of patients with chronic diseases. There is little research on factors increasing the level of AIS among patients with AF. The aim of the study is to determine the level of acceptance of illness in patients with AF and factors influencing the level of acceptance of illness. Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess disease acceptance and International Physical Activity Questionnaire (IPAQ) to assess physical activity. Sociodemographic and clinical data were taken from the hospital register. Results. In the study group the average result of acceptance of illness (AIS) was 27.67 ± 7.70. 48.8% of patients had a high degree of disease acceptance, 38.09% average, and 13.11% had no acceptance. The examined patients showed a lack of physical activity (IPAQ = 0.92 ± 0.40). In comparative analyses women had lower level of AIS than men (27.36 ± 7.37 vs. 27.86 ± 7.97; p = 0.01), patients more often hospitalized due to AF lower than patients less frequently hospitalized (26.30 ± 6.11 vs. 30.55 ± 8.55; p = 0.02). Lower level of AIS was observed in patients with comorbidities (34 ± 6.25 vs. 22 ± 6.66; p &lt; 0.001). Smokers had higher level of AIS than non-smokers (28.66 ± 6.65 vs. 27.00 ± 7.56; p = 0.02), similarly, physically active persons than inactive ones (26.48 ± 8.27 vs. 23.07 ± 10.58; p = 0.01). In correlation analysis, physical activity turned out to be an important determinant having a positive effect on the level of AIS (r = 0.220; p = 0.03). Conclusions. Patients with AF have moderate level of acceptance of illness and low level of physical activity. A higher level of AIS is observed in men, without comorbidities, less frequently hospitalized and smokers. The important determinant having positive influence on AIS is physical activity.