Perception of multiple sclerosis impact and self-management in patients with multiple sclerosis: mediating effect of coping strategies
ECTRIMS Online Library. Wilski M. 09/13/19; 279577; 320
Maciej Wilski
Maciej Wilski
Contributions
Abstract

Abstract: 320

Type: Scientific Session

Abstract Category: RIMS - Multi-disciplinary rehabilitation

M. Wilski1, W. Brola2,3, M. Tomczak4

1Department of Physical Culture of People with Disabilities, University School of Physical Education, Poznan, 2Department of Neurology, Specialist Hospital, Konskie, 3The Faculty of Medicine and Health Science, Institute of Physiotherapy, Jan Kochanowski University, Kielce, 4Department of Psychology, Poznan University of Physical Education, Poznan, Poland

Background: Low self-management in multiple sclerosis (MS) is considered to be one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Studies analyzing the interactions of self-management level with modifiable psychological variables can improve the knowledge necessary to design interventional programs aimed at promoting patient activation. Our research indicates the role of coping strategies in the process of self-management.
Purpose: This study aimed to determine whether different coping strategies mediate the relationship between perception of MS impact and self-management in MS patients.
Method: In this cross-sectional study, a total of 382 patients with MS were included. The patients completed Multiple Sclerosis Self-Management Scale - Revised, Coping Inventory for Stressful Situations, and Multiple Sclerosis Impact Scale - 29 (MSIS-29). The demographic and clinical characteristics of the patients were collected using a self-report survey and neurological assessment. A mediation analysis was used to test the study hypothesis.
Results: Problem-oriented coping was found not to be a significant mediator in the relationship between the impact of MS and self-management. Emotion-focused coping was found to be a significant mediator in this relationship (indirect effect: -.0524 [-.0795,-.0274], a standardized effect:-.1072 [-.1656,-.0552]). In this case, there was a positive relationship between impact of MS and the emotional style and a negative relationship between emotional style and self-management. In addition, avoidance-oriented style was an important mediator: (indirect effect: -.0170 [-.0384,-.0004], a standardized effect:-.0384 [-.0772,-.0007]). There was negative relationship between impact of MS and avoidance style and positive relationship between avoidance and self-management. Hence, the emotion-focused and avoidance-focused coping strategies can be considered as mediators of the relationship between impact of MS and self-management in MS.
Conclusions: Self-management in MS conditioned by the perceived impact of MS can be regulated by reducing the emotional coping and surprisingly, increasing avoidance strategies. Our study indicates the key role of the medical-staff in the process of helping patients with MS in self-management activities and produces new knowledge for potential psychological intervention aimed at improving self-management by patients.
Disclosure: Wilski: nothing to disclose
Brola: nothing to disclose
Tomczak: nothing to disclose

Abstract: 320

Type: Scientific Session

Abstract Category: RIMS - Multi-disciplinary rehabilitation

M. Wilski1, W. Brola2,3, M. Tomczak4

1Department of Physical Culture of People with Disabilities, University School of Physical Education, Poznan, 2Department of Neurology, Specialist Hospital, Konskie, 3The Faculty of Medicine and Health Science, Institute of Physiotherapy, Jan Kochanowski University, Kielce, 4Department of Psychology, Poznan University of Physical Education, Poznan, Poland

Background: Low self-management in multiple sclerosis (MS) is considered to be one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Studies analyzing the interactions of self-management level with modifiable psychological variables can improve the knowledge necessary to design interventional programs aimed at promoting patient activation. Our research indicates the role of coping strategies in the process of self-management.
Purpose: This study aimed to determine whether different coping strategies mediate the relationship between perception of MS impact and self-management in MS patients.
Method: In this cross-sectional study, a total of 382 patients with MS were included. The patients completed Multiple Sclerosis Self-Management Scale - Revised, Coping Inventory for Stressful Situations, and Multiple Sclerosis Impact Scale - 29 (MSIS-29). The demographic and clinical characteristics of the patients were collected using a self-report survey and neurological assessment. A mediation analysis was used to test the study hypothesis.
Results: Problem-oriented coping was found not to be a significant mediator in the relationship between the impact of MS and self-management. Emotion-focused coping was found to be a significant mediator in this relationship (indirect effect: -.0524 [-.0795,-.0274], a standardized effect:-.1072 [-.1656,-.0552]). In this case, there was a positive relationship between impact of MS and the emotional style and a negative relationship between emotional style and self-management. In addition, avoidance-oriented style was an important mediator: (indirect effect: -.0170 [-.0384,-.0004], a standardized effect:-.0384 [-.0772,-.0007]). There was negative relationship between impact of MS and avoidance style and positive relationship between avoidance and self-management. Hence, the emotion-focused and avoidance-focused coping strategies can be considered as mediators of the relationship between impact of MS and self-management in MS.
Conclusions: Self-management in MS conditioned by the perceived impact of MS can be regulated by reducing the emotional coping and surprisingly, increasing avoidance strategies. Our study indicates the key role of the medical-staff in the process of helping patients with MS in self-management activities and produces new knowledge for potential psychological intervention aimed at improving self-management by patients.
Disclosure: Wilski: nothing to disclose
Brola: nothing to disclose
Tomczak: nothing to disclose

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