Improved self-efficacy in persons with relapsing remitting multiple sclerosis after an intensive social cognitive wellness program with participation of support partners: a 6-months observational study

Health and Quality of Life Outcomes

Leo H Visser²  Rogier Donders¹  Wim Lemmens¹  Maarten van Droffelaar⁵  Hanne Wolper⁶  Joyce Valkenburg-Vissers³  Anneke van der Zande⁵  Lotte Duyverman⁶  Astrid Hussaarts⁵  Marco Heerings⁵  Rob Ruimschotel⁶  Peter Joseph Jongen⁴ 

[1] Department for Health Evidence, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands;University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD Utrecht, The Netherlands;Body-Care Verbeek, Ekkersrijt 4206, 5692 DE Son, The Netherlands;MS4 Research Institute, Ubbergseweg 34, 6522 KJ Nijmegen, The Netherlands;National Multiple Sclerosis Foundation, Wagenstraat 25, 3142 CR, Maassluis, The Netherlands;Medical Psychiatric Centre PsyToBe, Metroweg 50, 3083 BB Rotterdam, The Netherlands

关键词: Fatigue;    Anxiety;    Depression;    Progressive;    Relapsing remitting;    Quality of life;    Participation;    Autonomy;    Multiple sclerosis;    Self-efficacy;   

Others  :  815056
DOI  :  10.1186/1477-7525-12-40

 received in 2014-02-22, accepted in 2014-03-10,  发布年份 2014

【 摘 要 】

Background

For persons with multiple sclerosis (MS) it is important to preserve their autonomy, in spite of increasing disability. A major factor mediating autonomy is self-efficacy. According to the social cognitive theory stressors are crucial determinants of self-efficacy, as well as the interaction with partners.

Methods

In an explorative observational study we assessed in 47 persons with MS (PwMS) the effect of an intense, multidisciplinary, 3-day, social cognitive wellness program with the participation of support partners, after 1, 3 and 6 months. Primary outcomes: self-efficacy-control and -function (Multiple Sclerosis Self-Efficacy Scale [MSSES]),limitations to and problems with participation and autonomy (Impact on Participation and Autonomy [IPA] scale). Secondary outcomes: health-related quality of life (HRQoL) (MS Quality of Life-54 Items [MSQoL-54] questionnaire), anxiety, depression (Hospital Anxiety and Depression Scale [HADS]), and fatigue (Modified Fatigue Impact Scale-5 Items [MFIS-5]). Disability was measured with the Expanded Disability Status Scale (EDSS). Percentage changes from baseline were tested with T-tests, level of significance 0.05.

Results

In the whole group the MSQoL-54 Mental score was increased at 1, 3 and 6 months (+16.0%, +13.2%, +12.2%), and the MSQoL-54 Physical (+10.2%) at 6 months, with no changes in other outcomes. The relapsing remitting (RR) subgroup (n = 20) had at 6 months an increase in the MSSES-Control score (+24.8%) and in the MSQoL54 Mental and Physical scores (+22.3%, +17.6%). Progressive patients (n = 22) only showed an increase in the MSQoL-54 Mental score (+11.5%) at 1 month. In the low-disability (EDSS < 4.0) subgroup the MSSES-Control score was increased (+23.8%) at 6 months, and the IPA-Limitations and -Problems scores decreased at 3 months (−6.1%, −8.8%); the MSQoL-54 Mental score had increased at 1, 3 and 6 months (+19.3%, +21.5%, +19.3%). In the high-disability (EDSS > =4.0) subgroup no significant changes occurred.

Conclusions

Results from this observational study suggest that 6 months after an intense, 3-day, multidisciplinary, social cognitive wellness program with support partners, PwMS with a RR course or low disability may experience an improved self-efficacy-control and HRQoL.

【 授权许可】

   
2014 Jongen et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Bandura A: Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977, 84:191-215.
• [2]Bandura A: Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs: Prentice-Hall; 1986.
• [3]Amtmann D, Bamer AM, Cook KF, Askew RL, Noonan VK, Brockway JA: UW-SES: a new self-efficacy scale for people with disabilities. Arch Phys Med Rehabil 2012, 93:1757-1765.
• [4]Stuifbergen AK, Becker H, Blozis S, Timmerman G, Kullberg V: A randomized clinical trial of a wellness intervention for women with multiple sclerosis. Arch Phys Med Rehabil 2003, 84:467-476.
• [5]Motl RW, Snook EM: Physical activity, self-efficacy, and quality of life in multiple sclerosis. Ann Behav Med 2008, 35:111-115.
• [6]Barnwell AM, Kavanagh DJ: Prediction of psychological adjustment to multiple sclerosis. Soc Sci Med 1997, 45:411-418.
• [7]Watt D, Verma S, Flynn L: Wellness programs: a review of the evidence. CMAJ 1998, 158:224-230.
• [8]Ng A, Kennedy P, Hutchinson B, Ingram A, Vondrell S, Goodman T, Miller D: Self-efficacy and health status improve after a wellness program in persons with multiple sclerosis. Disabil Rehabil 2013, 35:1039-1044.
• [9]Schwartz CE, Coulthard-Morris L, Zeng Q, Retzlaff P: Measuring self-efficacy in people with multiple sclerosis: a validation study. Arch Phys Med Rehabil 1996, 77:394-398.
• [10]Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ: Psychometric properties of the impact on participation and autonomy questionnaire. Arch Phys Med Rehabil 2001, 82:210-216.
• [11]Cardol M, Beelen A, van den Bos GA, de Jong BA, de Groot IJ, de Haan RJ: Responsiveness of the impact on participation and autonomy questionnaire. Arch Phys Med Rehabil 2002, 83:1524-1529.
• [12]Franchignoni F, Ferriero G, Giordano A, Guglielmi V, Picco D: Rasch psychometric validation of the impact on participation and autonomy questionnaire in people with Parkinson’s disease. Eura Medicophys 2007, 43:451-461.
• [13]Vickrey BG, Hays RD, Harooni R, Myers LW, Ellison GW: A health-related quality of life measure for multiple sclerosis. Qual Life Res 1995, 4:187-206.
• [14]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67:361-370.
• [15]Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF: Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 1994, 18(Suppl 1):S79-S83.
• [16]Lechner-Scott J, Kappos L, Hofman M, Polman CH, Ronner H, Montalban X, Tintore M, Frontoni M, Buttinelli C, Amato MP, Bartolozzi ML, Versavel M, Dahlke F, Kapp J-F, Gibberd R: Can the expanded disability status scale be assessed by telephone? Mult Scler 2003, 9:154-159.
• [17]Kurtzke JF: Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983, 33:1444-1452.
• [18]Rigby SA, Domenech C, Thornton EW, Tedman S, Young CA: Development and validation of a self-efficacy measure for people with multiple sclerosis: the multiple sclerosis self-efficacy scale. Mult Scler 2003, 9:73-81.
• [19]Marks R, Allegrante JP, Lorig K: A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II). Health Promot Pract 2005, 6:148-156.
• [20]Stuifbergen AK, Morris M, Jung JH, Pierini D, Morgan S: Benefits of wellness interventions for persons with chronic and disabling conditions: a review of the evidence. Disabil Health J 2010, 3:133-145.
• [21]Stuifbergen AK: Building health promotion interventions for persons with chronic disabling conditions. Fam Community Health 2006, 29:28S-34S.
• [22]Garfield AC, Lincoln NB: Factors affecting anxiety in multiple sclerosis. Disabil Rehabil 2012, 34:2047-2052.
• [23]Dunn J: Impact of mobility impairment on the burden of caregiving in individuals with multiple sclerosis. Expert Rev Pharmacoecon Outcomes Res 2010, 10:433-440.
• [24]Aronson KJ, Cleghorn G, Goldenberg E: Assistance arrangements and use of services among persons with multiple sclerosis and their caregivers. Disabil Rehabil 1996, 18:354-361.