Personal Autonomy as Quality of Life Predictor for Multiple Sclerosis Patients.

Rodica Padureanu,Mihaela Simona Subtirelu,Ionica Pirici,Razvan Aurelian Turcu-Stiolica,Adina Turcu-Stiolica,Carmen Valeria Albu,Vlad Padureanu,Harri Sintonen,Radu Razvan Mititelu

doi:10.3390/jcm9051349

Abstract

Multiple sclerosis (MS) is a chronic, severe disease, characterized by a progressive alteration in neuronal transmission, which decreases personal independence and quality of life (QoL). This study aimed to investigate the relationship between QoL and personal autonomy in patients with MS, as well as its correlation with age, educational level, and diseases severity. Twenty-six MS patients were followed-up for six months. All patients completed the 15D questionnaire two times: at T0, when they started a new treatment, and at T1 after six months of treatment. At the end point, all patients completed the Personal Autonomy Questionnaire. The average patient age was 43 years (SD = 10), and 89% of them were female. The mean severity and duration of MS were 3.5 (SD = 1.75) and 9.5 (SD = 5.1), respectively. The average QoL of MS patients at T0 was 0.66 (SD = 0.18), and that at T1 was 0.71 (SD = 0.16). The scores of patients with different types of MS, i.e., relapsing–remitting MS (RRMS) or secondary progressive MS (SPMS), were compared. SPMS patients were older than RRMS patients (mean age 47.5 vs. 39.7 years; p = 0.032), and more RRMS patients were working (0.014). SPMS patients described the same QoL and personal autonomy as RRMS patients. Results from bivariate correlation analyses showed a significant relationship between QoL and age, education, and severity of MS. Also, the analysis showed no significant correlation between QoL and personal autonomy.

Highlights

Multiple sclerosis (MS) is a chronic, severe disease, affecting the central nervous system, often debilitating and leading to a progressive alteration of neuronal transmission [1] associated with a great variety of symptoms
We observed that a higher proportion of patients with relapsing–remitting MS (RRMS) were female compared to those with secondary progressive MS (SPMS) (50% with RRMS vs. 38% with SPMS), but the difference was not statistically significant
Our study showed that quality of life (QoL) is not correlated with patient autonomy: some patients insisted on their autonomy, while others did not, but all patients reported an increase in their QoL

Summary

Introduction

Multiple sclerosis (MS) is a chronic, severe disease, affecting the central nervous system, often debilitating and leading to a progressive alteration of neuronal transmission [1] associated with a great variety of symptoms. Fatigue can appear in all stages of the disease and can affect patients’ quality of life (QoL), emphasize anxiety and depression, and affect sleep patterns and the motor function [9,10,11]. In MS patients, because of cognitive impairments (lack of concentration, memory loss, deficits in information processing, and impaired reasoning skills), critical thinking and judgment ability are significantly affected. Another problem for these patients is to accept their condition, which greatly influences the desire to seek (additional) medical support and/or to adhere to chronic treatment plans [12]. Several studies show that women with MS are significantly more anxious [18], and high levels of anxiety are associated with higher levels of disability [19]; low education is related to high levels of anxiety [20,21]

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