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Albishi AM, Alruwaili MB, Alsubiheen AM, Alnahdi AH, Alokaily AO, Algabbani MF, Alrahed Alhumaid LA, Alderaa AA, Aljarallah S. Cross-cultural adaptation and validation of the Arabic version of the Multiple Sclerosis Impact Scale-29. Disabil Rehabil 2024:1-8. [PMID: 38738778 DOI: 10.1080/09638288.2024.2350618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE The Multiple Sclerosis Impact Scale-29 (MSIS-29) is a patient self-reported outcome (PRO) that measures patients' quality of life, and it is divided into two sub-scales for the physical (PHYS) and psychological (PSYCH) domains. This study aimed to translate the MSIS-29 into Arabic, cross-culturally adapt it, and examine its psychometric properties. MATERIALS AND METHODS One hundred fifty patients with MS completed the MSIS-29-Ar, the Functional Assessment of Multiple Sclerosis (FAMS), and the Short-Form Health Survey (SF-36). After one week, 60 participants were asked to complete the MSIS-29-Ar again to examine test-retest reliability. RESULTS The MSIS-29-Ar was clear and understandable among patients with MS in Saudi Arabia. The internal consistency for the MSIS-29-Ar-PHYS was excellent, with a Cronbach's alpha of 0.955, and was good for the MSIS-29-Ar-PSYCH, with a Cronbach's alpha of 0.891. The test-retest reliability for MSIS-29-Ar-PHYS was ICC2,1 = 0.97; 95% confidence interval (0.93, 0.99) and ICC2,1 = 0.95.; 95% confidence interval (0.897, 0.976) for MSIS-29-Ar-PSYCH domains. The minimal detectable change with 95% confidence (MDC95) was 10.28 and 13.37 for the MSIS-29-Ar-PHYS and MSIS-29-Ar-PSYCH, respectively. No floor and ceiling effects were observed. Convergent and divergent validity was supported by 75% of the predefined hypotheses and correlated with the other health-related quality-of-life measures, SF-36 and FAMS. CONCLUSION The MSIS-29-Ar questionnaire is a valid and reliable outcome measure among Saudi patients with MS.IMPLICATION FOR REHABILITATIONRehabilitation specialists can confidently interpret patient scores in the MSIS-29-Ar to measure physical and psychological factors impacting patients' quality of life with Multiple Sclerosis (MS).Patients with unchanged clinical status will have similar scores in the MSIS-29-Ar with repeated scale administrations over time.The MSIS-29-Ar can be used in clinical practice and research studies to measure factors that impact the quality of life in Arabic-speaking patients with MS.
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Affiliation(s)
- Alaa M Albishi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Malak B Alruwaili
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M Alsubiheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali H Alnahdi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad O Alokaily
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maha F Algabbani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Lolwah A Alrahed Alhumaid
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Asma A Alderaa
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Salman Aljarallah
- Department of Medicine, Neurology section, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Najafi P, Hadizadeh M, Cheong JPG, Motl RW, Abdullah S, Mohafez H, Poursadeghfard M. Effects of tele-exercise training on physical and mental health and quality of life in multiple sclerosis: Do the effects differ by modality and clinical disease course? Mult Scler Relat Disord 2023; 80:105129. [PMID: 37977056 DOI: 10.1016/j.msard.2023.105129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/01/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Tele-exercise training has improved mental and physical health and quality of life (QOL) in people with multiple sclerosis (PwMS), but there is little known about the comparability of effects across modalities and clinical disease courses. OBJECTIVE To evaluate the effect of tele-Pilates and tele-yoga training on physical and mental factors and QOL in PwMS, with a focus on two phenotype classifications - relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS). METHODS Eighty-two persons with RRMS (n = 48) and SPMS (n = 34) were randomly assigned into tele-Pilates (n = 29), tele-yoga (n = 26), or control (n = 27). The tele-exercis training was conducted three times per week for eight weeks. RESULTS Significant time × group interactions were observed for QoL (p = 0.01), physical activity levels (p < 0.001), mental health (p = 0.05), and a decline in depression (p = 0.002) following tele-Pilates and tele-yoga. The corresponding subfactors, including pain, energy, emotional well-being, and role limitation due to emotional and physical problems, have shown significant improvements after interventions compared with control (all p < 0.05). The effects of exercise over control did not depend on MS phenotype (all p > 0.05). DISCUSSION Tele-yoga and tele-Pilates exercises improved QoL and mental and physical health in PwMS, and the benefits were similar across both MS phenotypes. These findings highlight the potential of implementing tele-yoga and tele-Pilates as non-pharmacological mind-body symptomatic treatments for individuals with both RRMS and SPMS.
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Affiliation(s)
- Parisa Najafi
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Maryam Hadizadeh
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia.
| | | | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States.
| | - Suhailah Abdullah
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Hamidreza Mohafez
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia.
| | - Maryam Poursadeghfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Shafiee A, Soltani H, Teymouri Athar MM, Jafarabady K, Mardi P. The prevalence of depression and anxiety among Iranian people with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord 2023; 78:104922. [PMID: 37597350 DOI: 10.1016/j.msard.2023.104922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/21/2023] [Accepted: 07/28/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND There is significant inconsistency regarding the prevalence rate of depression and anxiety among people with multiple sclerosis (MS) in Iran. We sought to conduct this comprehensive meta-analysis to assess the prevalence of depression and anxiety in Iranian multiple sclerosis patients. METHODS A systematic search was conducted on 14 March 2023 in PubMed/MEDLINE, Web of Science, Scopus, Embase, and Iranian national databases. All studies assessing the prevalence of depression and anxiety among Iranian people with MS were included. We used the NEWCASTLE-OTTAWA tool for quality assessment. We pooled the prevalence of individual studies using the random effect model. RESULTS Our systematic search showed 23 articles that meet the eligibility criteria. Most of the included studies were cross-sectional. The most used questionnaire to assess depression and anxiety were Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS), respectively. The overall prevalence of depression and anxiety among Iranian people with MS was 47% (95%CI: 39%-55%%, I2 =94%) and 51% (95%CI: 36%-66%%, I2 =97%), respectively. The results of subgroup and meta-regression analyses showed assessment scale used and the province was significantly associated with the prevalence of the outcomes. Tehran had the most studies published on this topic. The prevalence of depression and anxiety was highest in Kermanshah province. The funnel plot and Egger's regression test did not show a significant source of funnel plot asymmetry for depression (p-value = 0.8138), and anxiety (p-value = 0.8259). CONCLUSION Our study indicates that a significant proportion of people with MS in Iran are affected by depression and anxiety.
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Affiliation(s)
- Arman Shafiee
- Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Hedieh Soltani
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Kyana Jafarabady
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Parham Mardi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Effects of Tele-Pilates and Tele-Yoga on Biochemicals, Physical, and Psychological Parameters of Females with Multiple Sclerosis. J Clin Med 2023; 12:jcm12041585. [PMID: 36836119 PMCID: PMC9966519 DOI: 10.3390/jcm12041585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND People with multiple sclerosis (PwMS) suffer from some comorbidities, including physical and psychiatric disorders, low quality of life (QoL), hormonal dysregulation, and hypothalamic-pituitary-adrenal axis dysfunction. The current study aimed to investigate the effects of eight weeks of tele-yoga and tele-Pilates on the serum levels of prolactin and cortisol and selected physical and psychological factors. METHODS Forty-five females with relapsing remitting multiple sclerosis, based on age (18-65), expanded disability status scale (0-5.5), and body mass index (20-32), were randomly assigned to tele-Pilates, tele-yoga, or control groups (n = 15). Serum blood samples and validated questionnaires were collected before and after interventions. RESULTS Following online interventions, there was a significant increase in the serum levels of prolactin (p = 0.004) and a significant decrease in cortisol (p = 0.04) in the time × group interaction factors. In addition, significant improvements were observed in depression (p = 0.001), physical activity levels (p < 0.001), QoL (p ≤ 0.001), and the speed of walking (p < 0.001). CONCLUSION Our findings suggest that tele-yoga and tele-Pilates training could be introduced as patient-friendly, non-pharmacological, add-on therapeutic methods for increasing prolactin and decreasing cortisol serum levels and achieving clinically relevant improvements in depression, walking speed, physical activity level, and QoL in female MS patients.
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Strijbis EM, Repovic P, Mostert J, Bowen JD, Uitdehaag BM, Cutter G, Koch MW. The MSIS-29 and SF-36 as outcomes in secondary progressive MS trials. Mult Scler 2022; 28:1606-1619. [PMID: 35876467 PMCID: PMC9315187 DOI: 10.1177/13524585221105465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Patient-reported outcome measures (PROMs) are often used in clinical
research, but little is known about their performance as longitudinal
outcomes. Methods: We used data from ASCEND, a large SPMS trial (n = 889), to
investigate changes on the Short Form Health Survey 36 (SF-36 v2) and the
Multiple Sclerosis Impact Scale (MSIS-29) over 2 years of follow-up. Results: PROM scores changed little over the 2 years of follow-up. In contrast to
physical disability measures, there was no consistent trend in PROM change:
significant worsening occurred about as often as improvement. Using a
6-month confirmation reduced the number of both worsening and improvement
events without altering their relative balance. There was no clear
difference in worsening events in groups based on population
characteristics, nor was there a noticeable effect using different
thresholds for clinically significant change. Conclusion: We found little consistent change in MSIS-29 and SF-36 over 2 years of
follow-up in people with SPMS. Our findings show a disconnect between
disability worsening and PROM change in this population. Our findings raise
caution about the use of these PROMs as primary outcome measures in SPMS
trials and call for a critical reappraisal of the longitudinal use of these
measures in SPMS trials.
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Affiliation(s)
- Eva Mm Strijbis
- Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Pavle Repovic
- Multiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, WA, USA
| | - Jop Mostert
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - James D Bowen
- Multiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, WA, USA
| | - Bernard Mj Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Gary Cutter
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcus W Koch
- Departments of Clinical Neurosciences and Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Effectiveness of Sexual Counseling Using BETTER Model to Promote Sexual Function and Satisfaction of Married Women with Multiple Sclerosis. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09746-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ibrahim M, Henry A, Khaled KJA, Bensa C, Moreau T, Montreuil M, Tourbah A. Health related quality of life and perceived social support in French and Lebanese MS patients: A comparative study. Mult Scler Relat Disord 2022; 61:103758. [PMID: 35378396 DOI: 10.1016/j.msard.2022.103758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 03/07/2022] [Accepted: 03/20/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND The perception of diagnosis announcement, the social support and the coping strategies seem to be determining factors for the quality of life of multiple sclerosis (MS) patients, with possible transcultural variations. This study explores these psychosocial dimensions in Lebanese and French MS patients. METHODS For this cross-sectional multi-center study, 8 questionnaires were used to assess quality of life, family support, coping strategies, mood, fatigue, stress, and hopelessness in MS patients. 7 were translated into Arabic and then back translated into French. These were administered to a group of Lebanese MS patients and compared to an MS sample from France. The data was collected for both populations and analyzed. RESULTS A total of 107 patients were included, 46 Lebanese and 61 French. The majority of MS patients were young females with a high level of education, relapsing remitting form of MS and a low level of disability. Both populations exhibited comparable quality of life and answers on the questionnaires regarding mood disorders, hopelessness, and perceived stress. However, the French patients had significantly more fatigue. Perceived social support given by family was considered greater in the French group compared to the Lebanese one. Also, maladaptive coping strategies (such as self-distraction, denial, behavioral disengagement, substance use, self-blame, venting) were used more frequently by the French population compared to the Lebanese, and this correlated with higher anxiety scores. Diagnosis communication was overall brief, informative, and satisfying in both populations. CONCLUSION This study highlighted transcultural differences between French and Lebanese MS patients mainly in social support and coping strategies.
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Affiliation(s)
- Michella Ibrahim
- Neurology, Hotel Dieu de France, Beirut, Lebanon; Université Saint Joseph, Beirut, Lebanon
| | - A Henry
- Université Reims-Champagne Ardenne, Laboratoire Cognition Santé, Société (C2S - EA 6291), Reims, France; Laboratoire de Psychopathologie et de Neuropsychologie, EA 2027, Paris, France
| | - K J Abou Khaled
- Neurology, Hotel Dieu de France, Beirut, Lebanon; Université Saint Joseph, Beirut, Lebanon
| | - C Bensa
- Neurology, Fondation Rothschild Hospital, Paris, France
| | - T Moreau
- Neurology, CHU de Dijon, Dijon, France
| | - M Montreuil
- Laboratoire de Psychopathologie et de Neuropsychologie, EA 2027, Paris, France
| | - A Tourbah
- Neurology, Hôpital Raymond Poincaré, Garches, APHP, France; UFR Simone Veil, UVSQ, Université Paris Saclay, France; INSERM U 1195 Université Paris Saclay, France.
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Farran N, Safieddine BR, Bayram M, Abi Hanna T, Massouh J, AlKhawaja M, Tamim H, Darwish H. Factors affecting MS patients' health-related quality of life and measurement challenges in Lebanon and the MENA region. Mult Scler J Exp Transl Clin 2020; 6:2055217319848467. [PMID: 31976081 PMCID: PMC6956607 DOI: 10.1177/2055217319848467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 11/17/2022] Open
Abstract
Background In the Middle East and North Africa (MENA) region, few studies explored the quality of life of multiple sclerosis patients and the factors affecting it. Objective The objective of this study was to explore studies on multiple sclerosis quality of life in the MENA area through a comprehensive literature review. To validate the Multiple sclerosis international Quality of Life (MusiQoL) and Modified Fatigue Impact Scale (MFIS) in Arabic, and investigate the impact of sociodemographic and clinical variables of Lebanese multiple sclerosis patients on quality of life. Methods As part of an ongoing observational prospective research study, data from 663 stable multiple sclerosis patients were analysed. Results In Lebanese multiple sclerosis patients, the Arabic MusiQoL and MFIS seem to be accurate and valid tools with high reliability coefficients and confirmatory factor analytic indices. Variables such as age and disease type predicted multiple sclerosis quality of life, yet were significantly affected by psychosocial fatigue. The influence of sociodemographic and clinical variables on quality of life dimensions varied. Being a woman with multiple sclerosis, receiving medications and experiencing physical fatigue worsens the psychological wellbeing quality of life dimension. Conclusion Several sociodemographic and clinical variables predicted the health-related quality of life dimensions of multiple sclerosis patients in MENA. Further in-depth investigation to guide more targeted clinical management is recommended. We encourage using validated multidimensional tools to measure quality of life in MENA such as the Arabic MusiQoL.
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Affiliation(s)
| | | | - Mariam Bayram
- Hariri School of Nursing, American University of Beirut, Lebanon
| | | | - Joelle Massouh
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Lebanon
| | - Mona AlKhawaja
- Neurology Department, King Faisal Specialist Hospital and Research Center, Saudi Arabia
| | - Hani Tamim
- Clinical Research Institute, American University of Beirut Medical Center, Lebanon
| | - Hala Darwish
- Hariri School of Nursing, American University of Beirut, Lebanon
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Mahmudi L, Moslemirad M, Dabestani B, Shohani M, Azami M. Clinical and demographic features in Iranian multiple sclerosis patients: a systematic review and meta-analysis. FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2018-0025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: This study was conducted to determine the clinical and demographic features in Iranian multiple sclerosis (MS) patients including clinical courses, positive MS family history, disability and age of disease onset. Materials & methods: All stages of the study were reported according to the PRISMA guidelines. A systematic review of published literature in Persian and English journals with a comprehensive search was conducted on English international databases including Scopus, PubMed/Medline, Cochrane Library, Science Direct, Web of Science, Embase, PsycINFO, as well as the Google Scholar search engine and national databases. Results: The prevalence of clinical courses of relapsing remitting, primary progressive, secondary progressive and relapsing progressive in Iranian patients with MS was 77.1% (95% CI: 72.2–81.3), 6.2% (95% CI: 4.1–9.2), 9.5% (95% CI: 6.8–13.1) and 0.4% (95% CI: 0.2–0.8), respectively. Positive family history of MS in Iranian MS patients was 8.9% (95% CI: 6.9–11.4). The mean age of disease onset was 28.9 years (95% CI: 27.8–30.1). Conclusion: The results of this meta-analysis in an Iranian population can provide useful information for neurologists and healthcare.
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Affiliation(s)
- Leily Mahmudi
- School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Moslem Moslemirad
- School of Nursing & Midwifery, Yasuj University of Medical Science, Yasuj, Iran
| | - Bafrin Dabestani
- Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Shohani
- Department of Nursing, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Milad Azami
- School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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Relationship Between Anxiety and Depression with Disability Over Multiple Sclerosis Patients in Rafsanjan, Iran. ARCHIVES OF NEUROSCIENCE 2018. [DOI: 10.5812/archneurosci.63503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rosti-Otajärvi E, Hämäläinen P, Wiksten A, Hakkarainen T, Ruutiainen J. Validity and reliability of the Finnish version of the Multiple Sclerosis Impact Scale-29. Brain Behav 2017; 7:e00725. [PMID: 28729932 PMCID: PMC5516600 DOI: 10.1002/brb3.725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/29/2017] [Accepted: 04/06/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Multiple Sclerosis Impact Scale-29 (MSIS-29) has been increasingly used to evaluate the self-perceived impact of multiple sclerosis (MS) on a patient. OBJECTIVES The aim of this study was to evaluate the psychometric properties of the Finnish version of MSIS-29 in patients with MS. METHODS A total of 553 patients with MS completed the MSIS-29 and self-administered questionnaires capturing information on demographics, disease characteristics and severity, perceived quality of life (EuroQol 5D-3L instrument), and fatigue (Fatigue Severity Scale). RESULTS The data quality for MSIS-29 was excellent, with 99.5% computable scores for the MSIS-29 physical scale and 99.3% for the MSIS-29 psychological scale. Floor and ceiling effects were minimal. Excellent Cronbach's alpha values of 0.97 and 0.90 were seen for MSIS-29 physical and psychological subscales, respectively. The physical subscale showed highest correlations with measures of physical functioning, such as disease severity and the mobility domain of the quality of life. Similarly, the psychological subscale showed highest correlations with self-reported fatigue and the anxiety/depression domains of the quality of life. MSIS-29 physical scores related strongly to disease severity, whereas the MSIS-29 psychological scores increased in mild disease but declined in more severe disease forms. CONCLUSION The Finnish version of MSIS-29 has satisfactory psychometric properties. Consistent with the previous recommendations, the use of two MSIS-29 subscale scores instead of a total score was supported.
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Affiliation(s)
- Eija Rosti-Otajärvi
- Department of Neurosciences and Rehabilitation Tampere University Hospital Tampere Finland
| | | | | | | | - Juhani Ruutiainen
- Finnish Neuro Society Masku Finland.,University of Turku Turku Finland
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Ploughman M, Collins K, Wallack EM, Monks M, Mayo N. Women's and Men's Differing Experiences of Health, Lifestyle, and Aging with Multiple Sclerosis. Int J MS Care 2017; 19:165-171. [PMID: 28835740 DOI: 10.7224/1537-2073.2016-014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The growing population of older people with multiple sclerosis (MS) has led to more interest in understanding factors associated with healthy aging. We aimed to determine whether older women and men with MS have different health and lifestyle behaviors and whether there are sex differences in contributors to perceived health. METHODS Data were obtained from a postal survey involving 743 Canadians older than 55 years with MS for at least 20 years. Sex differences in health, lifestyle, mood, and socioeconomics were examined using analysis of variance. Multiple regression was used to build explanatory models of health perception. RESULTS Despite no differences in age, years with MS, disability, fatigue, or social support, older men (n = 166) experienced lower perceived health and lower resilience and participated less in life roles than older women (n = 577). Men experienced more depressive symptoms, and women reported more anxiety. Depression was the strongest predictor of health perception in both women and men (β = -2.40 and -5.19, respectively, for each 3-point increase in depressive symptoms). Other contributors included household participation, fatigue, resilience, and disability in women and physical activity, financial flexibility, and alcohol use in men. CONCLUSIONS Older men exhibit poorer adaptation to aging with MS than older women.
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Oliveira SR, Kallaur AP, Lopes J, Colado Simão AN, Reiche EM, de Almeida ERD, Morimoto HK, de Carvalho Jennings de Pereira WL, Alfieri DF, Flauzino T, de Meleck Proença C, Gomes AM, Kaimen-Maciel DR, Maes M. Insulin resistance, atherogenicity, and iron metabolism in multiple sclerosis with and without depression: Associations with inflammatory and oxidative stress biomarkers and uric acid. Psychiatry Res 2017; 250:113-120. [PMID: 28152396 DOI: 10.1016/j.psychres.2016.12.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/03/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022]
Abstract
Depression is accompanied by metabolic disorders in iron metabolism, lipoproteins, and insulin resistance. We measured plasma levels of ferritin, iron, lipids, insulin, and glucose and computed the homeostasis model assessment (HOMA2IR) and atherogenic index of plasma (AIP) in MS patients with and without depression and healthy controls. Explanatory variables were serum uric acid, interleukin (IL)-6, lipid hydroperoxides (CL-LOOH), albumin, and C-reactive protein (CRP). Depression was assessed using the Hospital Anxiety and Depression Scale (HADS), neurological disability using the Expanded Disability Status Scale (EDSS), and disease progression using ∆EDSS over five years earlier. HOMA2IR and insulin were predicted by diagnosis (increased in MS), age and body mass index (BMI); AIP by diagnosis, sex, BMI, CRP, and uric acid; triglycerides by diagnosis (higher in MS without depression), age, BMI and uric acid; ferritin by diagnosis (higher in MS), sex, CRP, and albumin; and iron by albumin. The HADS score was significantly predicted by ∆EDSS, gastro-intestinal symptoms, iron (inverse), and age. MS is characterized by significantly increased insulin resistance, which is determined by increased insulin levels; and increased ferritin, a biomarker of inflammation. Depression in MS is not associated with increased insulin resistance and atherogenicity but with lowered iron.
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Affiliation(s)
- Sayonara Rangel Oliveira
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Ana Paula Kallaur
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Josiane Lopes
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Andrea Name Colado Simão
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Edna Maria Reiche
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Elaine Regina Delicato de Almeida
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Helena Kaminami Morimoto
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Wildea Lice de Carvalho Jennings de Pereira
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil; Outpatient Clinic for Multiple Sclerosis, University Hospital, State University of Londrina, Londrina, Paraná, Brazil
| | - Daniela Frizon Alfieri
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Tamires Flauzino
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Caio de Meleck Proença
- Medicine School, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Anna Maria Gomes
- Outpatient Clinic for Multiple Sclerosis, University Hospital, State University of Londrina, Londrina, Paraná, Brazil; Department of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Damacio Ramón Kaimen-Maciel
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil
| | - Michael Maes
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Parana, Brazil; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand; Impact Strategic Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; Revitalis, Waalre, The Netherlands.
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Rezapour A, Almasian Kia A, Goodarzi S, Hasoumi M, Nouraei Motlagh S, Vahedi S. The impact of disease characteristics on multiple sclerosis patients' quality of life. Epidemiol Health 2017; 39:e2017008. [PMID: 28231687 PMCID: PMC5434226 DOI: 10.4178/epih.e2017008] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/19/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the quality of life (QoL) of patients with multiple sclerosis (MS), and to investigate the effects of characteristics of MS such as disease course, severity, and relapses on patients' QoL. METHODS This was a cross-sectional study, in which 171 patients were enrolled. Health-related QoL was assessed using the Persian version of the Multiple Sclerosis Quality of Life-54 questionnaire. To measure patients' disability status, we used the Expanded Disability Status Scale. Other variables included in the study were disease course and relapses of the disease. RESULTS The average scores for patients' physical and mental QoL were 60.9±22.3 and 59.5±21.4, respectively. In a bivariate analysis, disease course, severity of the disease, and relapses were significantly associated with the physical and mental health composite scores. In a hierarchal regression analysis, disease course, severity of the disease, and relapses were responsible for 38 and 16% of the variance in physical and mental QoL, respectively. It was also observed that relapses were a strong predictor of both physical and mental QoL. CONCLUSIONS Our results showed that disease characteristics significantly affected both dimensions of QoL. It is therefore suggested that health care providers should be aware of these characteristics of MS to more successfully improve MS patients' QoL.
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Affiliation(s)
- Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abdollah Almasian Kia
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Goodarzi
- Department of Health Economics, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Hasoumi
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Soraya Nouraei Motlagh
- Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Sajad Vahedi
- Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran
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Mehrabi Z, Nazari F, Mehrabi T, Shaygannejad V. The Effect of Emotional Intelligence Training on Self-efficacy in Women with Multiple Sclerosis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:421-426. [PMID: 29184578 PMCID: PMC5684787 DOI: 10.4103/ijnmr.ijnmr_145_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background: Multiple sclerosis (MS), a chronic disease of the central nervous system (CNS), causing progressive nerve damage, has disabling symptoms, and undermines self-efficacy beliefs. Due to the importance of self-efficacy modified in adaptation and coping with stress, this study was conducted with the aim to investigate the effect of emotional intelligence training on self-efficacy in women with MS. Materials and Methods: This randomized clinical trial was conducted on 70 women referring to the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran. The participants were randomly assigned to two groups through minimization method. In the experimental group, emotional intelligence training was performed within 8 weeks, once a week for 90 minutes, in groups of 8–9 individuals. Data were collected using the Multiple Sclerosis Self-efficacy Scale (MSSS) before, immediately after, and 3 months after the intervention in both groups. Data were analyzed using independent t-test and repeated measures ANOVA in SPSS. Results: The results of independent t-test showed no significant difference between the groups in terms of mean self-efficacy scores before the intervention (p > 0.05). However, there was a significant difference between the groups in this regard immediately after and 3 months after the intervention (p < 0.05). Repeated measures ANOVA showed a significant difference in the mean score of self-efficacy and its components between the groups at different times (p < 0.05). Conclusions: It seems that emotional intelligence training is effective on the improvement of self-efficacy of women with MS. Hence, this method can be recommended as an effective and affordable technique.
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Affiliation(s)
- Zahra Mehrabi
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nazari
- Isfahan Neurosciences Research Center, Department of Adult Health Nursing, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tayebe Mehrabi
- Department of Psychological Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Isfahan Neurosciences Research Centre, Neurology Department, School of Medicine, University of Medical Sciences, Isfahan, Iran
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Personality characteristics in MS patients: The role of avoidant personality. Clin Neurol Neurosurg 2016; 144:23-7. [PMID: 26963086 DOI: 10.1016/j.clineuro.2016.02.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 02/17/2016] [Accepted: 02/26/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Quality of life (QOL) is markedly affected by multiple sclerosis (MS). Particular personality characteristics (PC) of MS patients can affect their QOL. We designed the present study to determine the role of various PCs on QOL in MS patients accounting for other clinical factors. METHODS QOL, PC, physical disability, and mental status were recorded in 83 MS patients referred to two academic hospitals of Tehran University of Medical Sciences in 2011-2012. RESULTS The mean age of enrolled patients was 31.54±7.38 (range: 14-50) years and 74 (89.2%) were female. Mean disease duration was 4.55±4.70 years. Seventy-seven patients (92.8%) had relapsing-remitting disease, five (6%) had primary progressive, and one showed a secondary progressive course. Correlation between total QOL scores in MS patients and disease duration, cognitive impairment, and physical disability was significant (all p<0.001). Obsessive-compulsive personality was the most frequent PC (43.4%) in our patients. Only avoidant personality had a significant negative correlation with all components of QOL (Beta: 0.33, p<0.00). In addition, avoidant personality, physical disability, and mental status were found to be three predictors of QOL with all its components. CONCLUSION Avoidant personality appears to be an important predictor of poor QOL in MS patients. In addition, avoidant coping strategies appear to be associated with adverse response to stressful events in these patients. These findings suggest the need for psychological intervention for improving the coping strategies and QOL in MS patients.
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17
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Tabrizi FM, Radfar M. Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis. Int J MS Care 2015; 17:268-74. [PMID: 26664332 DOI: 10.7224/1537-2073.2014-046] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Quality of life (QOL) is impaired in multiple sclerosis (MS) in part due to physical disability. MS-associated fatigue and poor sleep are common and treatable features of MS that affect QOL. We assessed the association between fatigue, sleep quality, and QOL in people with MS. METHODS Cross-sectional data were collected from 217 patients with MS. Health-related QOL (MS Quality of Life-54), fatigue (Fatigue Severity Scale [FSS]), and sleep quality (Pittsburgh Sleep Quality Inventory [PSQI]) were assessed. Expanded Disability Status Scale scores were also provided by a qualified neurologist. RESULTS The mean ± SD age of the 217 patients was 32.6 ± 8.6 years, and 79% were female. One hundred fifty-two patients (70.0%) were classified as poor sleepers based on PSQI scores; 122 (56.2%) had significant fatigue based on FSS results. The mean ± SE physical (PCS) and mental (MCS) health composite scores of the MSQOL-54 were 40.12 ± 1.27 and 43.81 ± 1.61, respectively. There was a strong statistically significant positive correlation between PCS scores and MCS (r = 0.58), FSS (r = 0.49), and PSQI (r = 0.52) scores. MCS scores were strongly correlated with FSS (r = 0.53) and PSQI (r = 0.35) scores. Age exhibited statistically significant negative correlations with PCS (r = -0.21) and MCS (r = -0.58) scores, and was statistically significantly correlated with FSS (r = 0.23) and PSQI (r = 0.21) scores. Expanded Disability Status Scale scores were strongly correlated with FSS scores. CONCLUSIONS These findings support screening of fatigue severity and sleep quality and their effects on QOL.
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Affiliation(s)
- Fatemeh Moghaddam Tabrizi
- Nursing and Midwifery Department, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Moloud Radfar
- Nursing and Midwifery Department, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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18
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Kallaur AP, Lopes J, Oliveira SR, Simão ANC, Reiche EMV, de Almeida ERD, Morimoto HK, de Pereira WLCJ, Alfieri DF, Borelli SD, Kaimen-Maciel DR, Maes M. Immune-Inflammatory and Oxidative and Nitrosative Stress Biomarkers of Depression Symptoms in Subjects with Multiple Sclerosis: Increased Peripheral Inflammation but Less Acute Neuroinflammation. Mol Neurobiol 2015; 53:5191-202. [DOI: 10.1007/s12035-015-9443-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/11/2015] [Indexed: 01/02/2023]
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19
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Mohammadi K, Rahnama P, Montazeri A. Prevalence and risk factors for depression in women with multiple sclerosis: a study from Iran. Ann Gen Psychiatry 2015; 14:29. [PMID: 26401158 PMCID: PMC4580126 DOI: 10.1186/s12991-015-0069-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 09/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple sclerosis is increasingly becoming a major health problem among women worldwide. The aim of the present study was to estimate prevalence of depression in women with multiple sclerosis and also to identify risk factors contributing to its development. METHODS This was a cross-sectional study of depression in a sample of 226 women with multiple sclerosis. The sample was recruited from an outpatient clinic in Tehran, Iran. Depression was assessed using the Beck Depression Inventory-II (BDI-II). Univariate and multiple logistic regression analyses were performed to examine the association between depression and independent variables. RESULTS Overall, 91 women (40.2 %) had moderate to severe depression. The mean age of participants was 35.7 years (SD = 8.07). The results obtained from multiple logistic regression analysis showed that the disease course (OR for relapsing-remitting MS = 2.36, % 95 CI = 1.14-5.53, P = 0.46), the expanded disability status scale (OR for score of 5-8 = 4.88, % 95 CI = 2.51-11.06, P < 0.001) and employment status (OR for housewife = 4.75, % 95 CI = 1.55-14.58, P = 0.006) were significant contributing factors to depression in patients with multiple sclerosis. CONCLUSIONS The findings suggest that depression in patients with multiple sclerosis is multi-factorial and very much dependent to physical and social conditions of patients. The recognition of such conditions might help clinicians to manage patients more effectively.
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Affiliation(s)
- Khadijeh Mohammadi
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Parvin Rahnama
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran ; Faculty of Humanity Sciences, University of Science and Culture, ACECR, Tehran, Iran
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20
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Abnormalities of motor imagery and relationship with depressive symptoms in mildly disabling relapsing-remitting multiple sclerosis. J Neurol Phys Ther 2014; 38:111-8. [PMID: 24531344 DOI: 10.1097/npt.0000000000000033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The effectiveness of motor imagery (MI) as an adjunct to physical rehabilitation has previously been shown. Motor imagery ability can be affected by neurologic disorders that affect motor and cognitive function. This study was designed to assess MI ability in persons with mildly disabling relapsing-remitting multiple sclerosis (RRMS) based on the functional and cognitive dysfunctions. METHODS Twenty-two participants with RRMS and 23 age-, gender-, and education-matched comparison subjects were evaluated by a battery of MI tasks, including a kinesthetic and visual imagery questionnaire, a mental hand rotation task, and a visual guided pointing task. RESULTS There was no significant difference in MI vividness between the participants with MS and the comparison group, but the accuracy and temporal correspondence of MI in the participants with MS differed significantly from those in the comparison group. Depression scores were significantly higher in participants with MS (P < 0.001), and depression was significantly correlated with disability (r = 0.4; P < 0.05). The correlation between accuracy of MI in the participants with MS and their cognitive ability was significant (r = 0.57; P < 0.05). The MI duration of participants with MS was significantly correlated with their disability (r = 0.59; P < 0.05) and their cognitive ability (r = -0.38; P = 0.009). DISCUSSION The preservation of MI ability was observed in participants with RRMS; however, abnormalities in accuracy and temporal aspects of MI were observed even in the participants with mild disease. Abnormalities in temporal aspects and accuracy of MI were related to disability and cognitive ability, respectively. In participants with MS, depression should be considered as a confounding factor for the MI task results. CONCLUSIONS Our finding could be considered in the application of MI during the rehabilitation of persons with MS.
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Al Tahan AM, Alsharoqi I, Bohlega SA, Dahdaleh M, Daif A, Deleu D, Esmat K, Giampaolo D, Freedman MS, Gwilt M, Hosny H, Inshasi JS, Aljumah M, Khalifa A, Pakdaman H, Szólics M, Yamout BI, Sahraian MA, Zakaria MF. Characteristics of multiple sclerosis in the Middle East with special reference to the applicability of international guidelines to the region. Int J Neurosci 2013; 124:635-41. [DOI: 10.3109/00207454.2013.865620] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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22
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Factores psicosociales predictores de la calidad de vida en personas en situación de discapacidad física. ACTA COLOMBIANA DE PSICOLOGIA 2013. [DOI: 10.14718/acp.2013.16.2.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
El presente estudio correlacional descriptivo se propuso evaluar los factores que determinan la calidad de vida (CV) relacionada con la salud en 78 personas con discapacidad física que vivían en Bogotá, y hacían parte de un proyecto de inclusión laboral dirigido por una ONG. Se evaluó la calidad de vida relacionada con la salud (Cuestionario de Salud SF36 y visita domiciliaria), al igual que las condiciones asociadas a la discapacidad y algunos factores psicológicos (Escala de Autoeficacia Generalizada, Prueba de Imagen Corporal, Inventario de Estilos de Afrontamiento, Prueba de optimismo disposicional, Inventario de Depresión de Beck y Escala de Ansiedad de Zung). Se utilizó un modelo de ecuaciones estructurales para encontrar el poder predictivo de las variables en la calidad de vida. El modelo obtenido predecía un 39% de la varianza, incluyendo en orden de peso relativo aportando variables como condiciones de enfermedad, depresión, afrontamiento centrado en la fantasía, trascendencia, pesimismo, ansiedad y autoeficacia. Se discuten los hallazgos y las limitaciones del estudio.
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Chen K, Fan Y, Hu R, Yang T, Li K. Impact of depression, fatigue and disability on quality of life in Chinese patients with multiple sclerosis. Stress Health 2013; 29:108-12. [PMID: 22566371 DOI: 10.1002/smi.2432] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/20/2012] [Accepted: 03/30/2012] [Indexed: 11/11/2022]
Abstract
The aim of this work is to investigate and analyze the main factors that influence the quality of life (QOL) of multiple sclerosis (MS) patients. The QOL (multiple sclerosis impact scale), disability (expanded disability status scale), fatigue (modified fatigue impact scale) and depression (Beck Depression Inventory) were assessed in 100 MS patients. Correlation analysis shows that QOL is positively correlated with disability status, fatigue and depression, i.e., the more severe the disability, fatigue and depression, the worse the QOL. Multiple linear regression analysis indicated that Expanded Disability Status Scale grade and fatigue have important predictive value on the somatic QOL of MS patients. On the other hand, depression and fatigue have important predictive value on the mental QOL of MS patients. The QOL of MS patients is influenced by various factors, nursing care that focuses on patient disability, fatigue and depression should be strengthened.
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Affiliation(s)
- Kelong Chen
- Department of Traditional Chinese Medicine, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China
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Kargarfard M, Eetemadifar M, Mehrabi M, Maghzi AH, Hayatbakhsh MR. Fatigue, depression, and health-related quality of life in patients with multiple sclerosis in Isfahan, Iran. Eur J Neurol 2011; 19:431-7. [PMID: 21967324 DOI: 10.1111/j.1468-1331.2011.03535.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Quality of life (QoL) of patients with multiple sclerosis (MS) is worse than that of other chronic diseases. There is a need to examine the impact of fatigue and depression on the QoL independent of level of physical disability in MS. The aim of this study is to explore physical, psychological, and social aspects of health-related QoL (HRQoL) of MS patients in association with physical disability, fatigue, and depression. METHODS In a cross-sectional study, 281 (63.4% women, 36.6% men) patients with MS participated in the study. The HRQoL was assessed by the Persian version of the multiple sclerosis quality of life (MSQoL-54) questionnaires. Other covariates included in the study were disease type, physical disability, fatigue, disease impact, and depression. RESULTS In univariate analysis disease type, physical disability, fatigue, disease impact, and depression were significantly associated with both physical and mental health composite summaries of MSQoL-54. In multivariate regression analysis, patients' physical disability remained significantly associated with both components of MSQoL-54, whilst fatigue and depression were associated with physical and mental composite summaries, respectively. CONCLUSIONS Our findings suggest that MS-related physical disability, fatigue, and depression affect the HRQoL of MS patients, independently of each other and other potential confounding factors. Effective interventions that target fatigue and depression may help improve the QoL of patients, regardless of their disease type and level of disability.
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Affiliation(s)
- M Kargarfard
- Faculty of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran.
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25
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Quality of Life in Patients With Multiple Sclerosis in Turkey: Relationship to Depression and Fatigue. J Neurosci Nurs 2010. [DOI: 10.1097/jnn.0b013e3181ecb019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Twork S, Wiesmeth S, Spindler M, Wirtz M, Schipper S, Pöhlau D, Klewer J, Kugler J. Disability status and quality of life in multiple sclerosis: non-linearity of the Expanded Disability Status Scale (EDSS). Health Qual Life Outcomes 2010; 8:55. [PMID: 20529265 PMCID: PMC2890700 DOI: 10.1186/1477-7525-8-55] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 06/07/2010] [Indexed: 11/10/2022] Open
Abstract
Background Progression in disability as measured by increase in the Expanded Disability Status Scale (EDSS) is commonly used as outcome variable in clinical trials concerning multiple sclerosis (MS). In this study, we addressed the question, whether there is a linear relationship between disability status and health related quality of life (HRQOL) in MS. Methods 7305 MS patients were sent a questionnaire containing a German version of the "Multiple Sclerosis Quality of Life (MSQOL)-54" and an assessment of self-reported disability status analogous to the EDSS. 3157 patients participated in the study. Patients were allocated to three groups according to disability status. Results Regarding the physical health composite and the mental health composite as well as most MSQOL-54 subscales, the differences between EDSS 4.5-6.5 and EDSS >= 7 were clearly smaller than the differences between EDSS <= 4 and EDSS 4.5-6.5. Conclusion These results indicate a non-linear relationship between disability status and HRQOL in MS. The EDSS does not seem to be interval scaled as is commonly assumed. Consequently, absolute increase in EDSS does not seem to be a suitable outcome variable in MS studies.
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Affiliation(s)
- Sabine Twork
- Faculty of Medicine at the University of Technology-Dresden, Department Health Sciences/Public Health, Dresden, Germany
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Füvesi J, Bencsik K, Losonczi E, Fricska-Nagy Z, Mátyás K, Mészáros E, Benedek K, Rajda C, Lencsés G, Vécsei L. Factors influencing the health-related quality of life in Hungarian multiple sclerosis patients. J Neurol Sci 2010; 293:59-64. [DOI: 10.1016/j.jns.2010.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 02/09/2010] [Accepted: 03/11/2010] [Indexed: 11/16/2022]
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Ramp M, Khan F, Misajon RA, Pallant JF. Rasch analysis of the Multiple Sclerosis Impact Scale MSIS-29. Health Qual Life Outcomes 2009; 7:58. [PMID: 19545445 PMCID: PMC2706812 DOI: 10.1186/1477-7525-7-58] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2008] [Accepted: 06/22/2009] [Indexed: 11/18/2022] Open
Abstract
Background Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality. Methods Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29. Results Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score. Conclusion In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings.
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Affiliation(s)
- Melina Ramp
- Department of General Practice, University of Melbourne, Carlton 3053, Victoria, Australia.
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Ytterberg C, Johansson S, Holmqvist LW, Koch LV. Longitudinal variations and predictors of increased perceived impact of multiple sclerosis, a two-year study. J Neurol Sci 2008; 270:53-9. [DOI: 10.1016/j.jns.2008.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 01/23/2008] [Accepted: 01/24/2008] [Indexed: 11/16/2022]
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Alshubaili AF, Ohaeri JU, Awadalla AW, Mabrouk AA. Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experience. Acta Neurol Scand 2008; 117:384-92. [PMID: 18028242 DOI: 10.1111/j.1600-0404.2007.00960.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We compared the quality of life (QOL) self-ratings of relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS) patients with those of the general population; and assessed the association of demographic, clinical, and caregiver variables with patients' QOL. METHODS Consecutive clinic attendees were assessed with MSQOL-54, Beck's Depression Inventory, and Expanded Disability Status Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. RESULTS Of 170 patients (35.5% M, 64.5% F), 85.3% had RRMS and 14.7% PMS. RRMS had higher QOL domain scores (P < 0.001). Patients had lower QOL than controls (P < 0.001). Depression was the commonest significant covariate of QOL domains. After controlling for depression and disability, differences between the MS groups were less significant. Predictors of overall QOL were caregiver impression of patient's QOL, depression, and treatment side effects. CONCLUSION Programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education should enhance QOL outcomes.
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Affiliation(s)
- A F Alshubaili
- Department of Neurology, Ibn Sina Hospital, Safat, Kuwait
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Alshubaili AF, Awadalla AW, Ohaeri JU, Mabrouk AA. Relationship of depression, disability, and family caregiver attitudes to the quality of life of Kuwaiti persons with multiple sclerosis: a controlled study. BMC Neurol 2007; 7:31. [PMID: 17877820 PMCID: PMC2041952 DOI: 10.1186/1471-2377-7-31] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Accepted: 09/18/2007] [Indexed: 11/26/2022] Open
Abstract
Background Assessment of subjective quality of life (QOL) of persons with multiple sclerosis (MS) could facilitate the detection of psychosocial aspects of disease that may otherwise go unrecognized. The objectives of the study were to (i) compare the QOL ratings of relapsing remitting (RRMS) and progressive (PMS) types of MS with those of a general population group and the impression of their family caregivers; and (ii) assess the association of demographic, clinical, treatment, depression, and caregiver variables with patients' QOL. Methods Consecutive clinic attendees at the national neurology hospital were assessed with the 26 -item WHOQOL Instrument, Beck's Depression Inventory and Expanded Disability Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. Results The 170 patients (60 m, 109 f) consisted of 145(85.3%) with RRMS and 25 with PMS, aged 32.4(SD 8.8), age at onset 27.1(7.7), EDSS score 2.9 (1.8), and 76% were employed. The patients were predominantly dissatisfied with their life circumstances. The RRMS group had higher QOL domain scores (P < 0.001), and lower depression(P > 0.05) and disability (P < 0.0001) scores than the PMS group. Patients had significantly lower QOL scores than the control group (P < 0.001). Caregiver impression was significantly correlated with patients' ratings. Depression was the commonest significant covariate of QOL domains. When we controlled for depression and disability scores, differences between the two MS groups became significant for only one (out of 6) QOL domains. Patients who were younger, better educated, employed, felt less sick and with lesser side effects, had higher QOL. The predictors of patients' overall QOL were disability score, caregiver impression of patients' QOL, and caregiver fear of having MS. Conclusion Our data indicate that MS patients in stable condition and with social support can hope to have better QOL, if clinicians pay attention to depression, disability, the impact of side effects of treatment and family caregiver anxieties about the illness. The findings call for a regular program of psychosocial intervention in the clinical setting, to address these issues and provide caregiver education and supports, in order to enhance the quality of care.
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Affiliation(s)
| | - Abdel W Awadalla
- Department of Psychiatry, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait
| | - Jude U Ohaeri
- Department of Psychiatry, Psychological Medicine Hospital, Gamal Abdul Naser Road, PO Box 4081, Safat, 13041, Kuwait
| | - Asser A Mabrouk
- Department of Neurology, Ibn Sina Hospital, PO Box 2547, Safat, 13115, Kuwait
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