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Health problems and health-related quality of life in people with multiple sclerosis

Alison While

Lucia Mathes

Peter Griffiths

Primary and Intermediate Care Section, The Florence Nightingale School of Nursing & Midwifery, King's College London, UK

Objective: To explore the interrelationship between a number of common multiple sclerosis-related problems and health-related quality of life independent of the effect of physical disease impact.

Design: A cross-sectional postal survey.

Setting: The study was conducted in seven treatment centres within England.

Subjects: Nine hundred and twenty-nine people with multiple sclerosis.

Measures: The severity of the multiple sclerosis problems (fatigue, pain, urinary incontinence, bowel, depression, pressure ulcers, sexual and employment problems) was assessed using 5-point self-report ordinal scales. Disease impact was measured using the Multiple Sclerosis Impact Scale-29. Health-related quality of life was measured using the 36-Item Short Form Health Survey, version 2 (SF-36). The relationship between the problems, disease impact and health-related quality of life was determined using multivariate analysis of covariance.

Results: Seventy four per cent of the sample experienced four or more of the selected problems. The extent and severity of problems increased with the level of disease impact (P B=0.001). Fatigue, pain, employment, depression and relationship problems were all found to have negative effect on the SF-36 scales independent to the effect of disease impact. SF-36 scores were most compromised in patients experiencing multiple problems. The data suggest an interdependent relationship between depression, fatigue and pain.

Conclusion: The data suggest that many multiple sclerosis complications negatively affect health-related quality of life, independent of the effect of overall disease impact.

Clinical Rehabilitation, Vol. 20, No. 1, 67-78 (2006)
DOI: 10.1191/0269215506cr880oa


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