Self-rated health and employment status in patients with multiple sclerosis

Purpose. The aim is to explore the association between self-rated health and employment status in patients with multiple sclerosis (MS) when controlling for age, gender, functional disability, disease duration, anxiety and depression. Method. One hundred eighty-four people with MS completed a sociodemographic questionnaire that included questions on employment status, the first item of the Short Form-36 Health Survey and the Hospital Anxiety and Depression Scale. Functional disability was assessed using the Expanded Disability Status Scale. The probability of good self-rated health in employed persons was investigated using stepwise logistic regression analyses. Results. Patients with MS who reported good self-rated health were 2.46 times more likely to be employed (95% confidence interval [CI]: 1.08-5.59). Patients without anxiety were 2.64 times more likely to be employed (95% CI: 1.23-5.67). Patients with higher EDSS scores were 0.49 times less likely to be employed (95% CI: 0.33-0.70). Age, gender, disease duration and the presence of depression did not show an increased chance of patient employment. Conclusions. Patients with MS with good self-rated health are more likely to be employed, even after adjusting for age, gender, education, functional disability, disease duration, depression and anxiety. Dependent on the findings of longitudinal studies unravelling the relevant causal pahways, self-rated health might be used as a quick and cheap prognostic marker, which could warn about the possible loss of employment, or changes in functional disability

Is Poor Sleep Quality Associated With Greater Disability in Patients With Multiple Sclerosis?

Poor sleep is a serious burden for patients with multiple sclerosis (MS). The aim of this study is to assess whether the association between sleep quality and disability in MS patients is direct or mediated by depression, pain, and fatigue. We collected data from 152 patients with MS who filled out the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory and one item of the Short Form-36 regarding pain. The relationship between poor sleep and disability was found to be indirect, mediated by depression (p &lt;0.05), pain (p &lt;0.001) and physical fatigue (p &lt;0.01). Treatment of sleep disturbances may have beneficial effects beyond improving sleep. It may reduce depression, pain, and physical fatigue, which in turn may lessen disability.</p

Management of multiple sclerosis patients in central European countries: current needs and potential solutions

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Reliabilita a validita slovenskej verzie a modifikacia Stanfordskeho dotaznika hodnotiaceho zdravie pomocou indexu disability (HAQ) u pacientov s reumatoidnou artritidou. [Reliability and validition of the Slovak modified version of the Stanford Health As

BACKGROUND: Functional disability is one of the most important consequences of RA in the patient's daily life. The HAQ has been widely used in its self administered form for the assessment of disability. A sensitive and valid instrument is needed for a Slovak population with RA. OBJECTIVE: To evaluate reliability and validity of the Slovak version of the HAQ in patients with RA and to explore relationships between HAQ score and disease activity and to provide information concerning utilization of this instrument in clinical practice. METHODS: In preparing the Slovak version of the HAQ careful attention has been paid to the translation, in terms of linguistic and conceptual equivalence, in order to preserve the original purpose of the instrument. The wording of some items required adaptation to the current activities of daily living and Slovak lifestyle. The sample consisted of 160 RA-patients, out of which 135 were women and 25 were men. The inclusion criteria were the following: age from 20 to 70 years at the onset of the study, diagnosis of RA according to the ARA criteria. The exclusion criteria were the presence of another serious disease or very disabling RA (stage IV of the Steinbrocker's classification). To analyze the data t-test, correlations, one-way analysis of variance (ANOVA), and principal component analysis (PCA) available in the SPSS/PC+ statistical package were used. RESULTS: The Cronbach's coefficient of reliability alpha for the HAQ total scale was 0.94. The results of PCA showed that the 20 HAQ items loaded on four components for which the eigen values were greater than 1, accounting for 70% of overall interpersonal variability. Orthogonal varimax rotation of the principal components provided factor loadings reflecting the eight dimensions within the HAQ. Validity of the HAQ was examined further by means of known-groups technique. The HAQ was found to be sensitive to differentiate between the Steinbrocker's functional capacity groups, as well as between males and females. Moreover, significant correlations (p < or = 0.01) were found between the HAQ and the C-reactive protein, the ESR, the NHP-pain, the Ritchie articular index, the Steinbrocker's functional capacity (r = 0.31-0.62) and disease duration (p < or = 0.05, r = 0.17). CONCLUSION: The results of the current investigation provide support for reliability and construct validity of the Slovak version of the HAQ in patients with RA. The HAQ has sufficient discriminant ability. The index disability can be used as an criterion of severity of RA, as a criterion of effectiveness in therapeutical trials for patient stratification of the Slovak population with RA

Management of multiple sclerosis the role of coping self-efficacy and self-esteem

Patients with multiple sclerosis (MS) engage in various coping behaviours in order to manage their disease. The aim of this study is to find out if the self-esteem of patients is associated with coping strategies - problem-focused (e.g. making a plan of action when confronted with a problem); emotion focused (e.g. get emotional support from community); and focused on stopping unpleasant emotions and thoughts (e.g. keeping oneself from feeling sad), and if it can enhance or hinder coping efforts in the disease management. We collected data from 155 consecutive MS patients who completed the Coping Self-Efficacy Scale (CSE) and the Rosenberg Self-esteem Scale (RSE). Explained variance for problem-focused coping, emotion-focused coping, and coping focused on stopping unpleasant emotions and thoughts was 33, 24, and 31%, respectively. Self-esteem seems to be associated with coping strategies indicating that feelings of self-worth are linked with the ability to handle difficult life situations and can be helpful in chronic disease management

Management of multiple sclerosis: the role of coping self-efficacy and self-esteem

Patients with multiple sclerosis (MS) engage in various coping behaviours in order to manage their disease. The aim of this study is to find out if the self-esteem of patients is associated with coping strategies - problem-focused (e.g. making a plan of action when confronted with a problem); emotion focused (e.g. get emotional support from community); and focused on stopping unpleasant emotions and thoughts (e.g. keeping oneself from feeling sad), and if it can enhance or hinder coping efforts in the disease management. We collected data from 155 consecutive MS patients who completed the Coping Self-Efficacy Scale (CSE) and the Rosenberg Self-esteem Scale (RSE). Explained variance for problem-focused coping, emotion-focused coping, and coping focused on stopping unpleasant emotions and thoughts was 33, 24, and 31%, respectively. Self-esteem seems to be associated with coping strategies indicating that feelings of self-worth are linked with the ability to handle difficult life situations and can be helpful in chronic disease management.</p

Quality of life in patients with multiple sclerosis in Eastern Slovakia

Purpose. Quality of life (QoL) is an important measure of the burden of disease and could be useful in evaluating patient management and practical interventions. The aim of this study was to explore the association of psychological and clinical variables with QoL in patients with multiple sclerosis (MS). Methods. One hundred and fourteen consecutive patients (mean age 36.1 +/- 10.3 years, 72% female) from one MS centre completed the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale and the Short-Form-36 Health Survey (SF-36). Functional disability was assessed using the Expanded Disability Status Scale. Multiple linear regression analyses were performed to analyse demographic, psychological and clinical data. Results. Functional disability, depression and fatigue were found to be related inversely to the physical health subscale. Disease course, anxiety and depression were associated negatively with the mental health subscale. Conclusions. Functional disability, depression and fatigue were the main variables related to the perceived physical health subscale, and disease course, anxiety and depression to the perceived mental health subscale in the group of patients with MS. Thus, effective treatment of fatigue, anxiety and depression could be assumed to increase a patient's QoL

General Health Questionnaire-28: psychometric evaluation of the Slovak version

Examined the reliability and validity of the Slovak version of the General Health Questionnaire (GHQ-28) in patients (aged 22-70 yrs) with rheumatoid arthritis. The internal consistency and the factor structure of the GHQ-28 are also investigated. Reliability figures and the intercorrelations of the scales indicate that the psychometric qualities of the GHQ-28 in Slovakia are satisfactory. However, at least 6 out of the 28 items appeared to fit better to a different subscale from the original one. General health ratings were more closely associated with subscale anxiety/insomnia. The outcomes are discussed in the light of Western European results. An appendix of the GHQ-28 is provided. (PsycINFO Database Record (c) 2002 APA, all rights reserved)

Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction

Purpose: Bladder, bowel and sexual dysfunction are often overlooked symptoms in patients with multiple sclerosis (MS) and can be associated with lower health-related quality of life (HRQoL). The aim is to explore the association of bladder, bowel and sexual dysfunction with HRQoL in MS patients stratified by disease duration ( 5 years) and controlled for clinical and sociodemographic variables. Methods: The study comprised 223 MS patients (mean age 38.9 +/- 10.8 years, 67% female, mean EDSS 3.0 +/- 1.5) who filled out the Short-Form-36 Health Survey, the Bladder Control Scale, the Bowel Control Scale and the Incapacity Status Scale. The relationships between the variables were analyzed with multiple linear regression using the SF36's Physical Component Summary (PCS) and Mental Component Summary (MCS) as dependent variables. Results: More severe bladder dysfunction was associated with lower PCS in both disease duration groups (beta= -0.35,