Health related quality of life in people with multiple sclerosis: the role of coping, social participation and self-esteem

Multiple sclerosis (MS) is the most common neurological disease with disabling consequences that occurs in young adults. Symptoms of MS are responsible for high levels of stress and low levels of overall health-related quality of life (HRQoL). In this dissertation we aimed at gaining insight into the associations between physical and psychosocial factors and HRQoL in order to identify areas that could benefit from intervention. We found that problem-focused coping, emotion-focused coping and coping focused on stopping unpleasant emotions and thoughts were all predictors of the mental component (MCS) of health-related quality of life and that all three coping strategies mediated the associations between fatigue and MCS and also between type D personality and MCS. We also found that self-esteem is a predictor of MCS and mediated the association between social participation and MCS. Social participation by itself, on the other hand, was associated only with the physical component (PCS) of health-related quality of life. Coping, social participation and self-esteem may thus play an important role in HRQoL outcomes in patients with multiple sclerosis. Our findings could be used in a series of education seminars supplemented by role-play model situations, social games and introspective sessions in order to create a full-fleshed unit on how to improve some aspects of HRQoL, which could be beneficial not only for patients but also for caretakers, physicians and other medical workers involved in the treatment of MS