The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study

Clin Rehabil. 2018 Apr;32(4):536-545. doi: 10.1177/0269215517730670. Epub 2017 Sep 12.

Abstract

Objective: To examine the impact of perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients.

Design: Cross-sectional survey.

Setting: Department of Neurology, University Medical Center Groningen, the Netherlands.

Subjects: Multiple sclerosis patients.

Main measures: World Health Organization Quality of Life - abbreviated version, Stigma Scale for Chronic Illness, Sense of Coherence Scale, background and disease-related questions.

Results: In total, 185 patients (61% response rate) participated in the study with moderate to severe limitations. Stigma was highly prevalent but low in severity. Patients with a higher sense of coherence experienced a lower level of limitations ( B = -0.063, P < 0.01) and less stigma (enacted stigma B = -0.030, P < 0.01; self-stigma B = -0.037, P < 0.01). Patients with a higher level of limitations experienced more stigma (enacted stigma B = 0.044, P < 0.05; self-stigma B = 0.063, P < 0.01). Patients with a higher sense of coherence experienced better quality of life (physical health B = 0.059, P < 0.01; psychological health B = 0.062, P < 0.01; social relationships B = 0.052, P < 0.01; environmental aspects B = 0.030, P < 0.01). Patients with a higher level of limitations experienced poorer quality of life (physical health B = -0.364, P < 0.01; psychological health B = -0.089, P < 0.05) and patients with more stigma also experienced poorer quality of life (self-stigma: physical health B = -0.073, P < 0.01; psychological health B = -0.089, P < 0.01; social relationships B = -0.124, P < 0.01; environmental aspects B = -0.052, P < 0.01, and enacted stigma: physical health B = -0.085, P < 0.10).

Conclusion: Patients with less perceived limitations and stigma and a higher level of sense of coherence experienced better quality of life. Patients with a higher sense of coherence experienced a lower level of limitations and less stigma.

Keywords: Sense of coherence; multiple sclerosis; quality of life; stigma.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mobility Limitation
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / psychology*
  • Multiple Sclerosis / therapy
  • Netherlands
  • Quality of Life*
  • Risk Assessment
  • Self Concept*
  • Sense of Coherence / physiology*
  • Sex Factors
  • Social Stigma*