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STUDY: The role of positive coping & hopefulness in predicting quality of life in MS
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The role of positive coping and hopefulness in predicting quality of life in multiple sclerosis
C.A. Young1,2, A. Tennant3, TONiC Group
1Walton Centre NHS Trust, 2University of Liverpool, Liverpool, United Kingdom, 3Swiss Paraplegic Research, Nottwil, Switzerland
Background: Hope facilitates coping with the unpredictable nature of multiple sclerosis (MS) and improves mood. Coping mechanisms can improve the patients´ quality of life (QoL). How does either construct impact upon QoL?
Methods: The TONiC study is an ongoing, multi-centre, UK study to investigate the trajectories of outcomes in MS. It incorporates many Patient Reported Outcome Measures, including measures of hopefulness (MS-Hope-12) and positive coping (MS-Cope-12). Both have a score range of 0-36 (Rasch transformed), which can be divided into tertials, giving rise to low-medium-high groups. The Leeds MS QoL scale can be divided using the lower tertial range to indicate a good quality of life. Logistic regression was used to examine the odds ratios for the effect of high positive coping and hopefulness on quality of life, adjusted for disease type.
Results: Of 722 people with MS analysed, 71.9% were female. 66.4% reported relapsing-remitting MS; 23.3% secondary progressive MS; and 10.3% primary progressive MS. Almost three- fifths (58%) reported a strong hopeful perspective (upper tertial); whereas just less than one-quarter (24.3%) reported a strong positive coping style. Just over one third (34.2%) reported a good QoL. 15% displayed low levels of positive coping, and there appeared to be no specific association with levels of hopefulness. There was no association between the type of MS and the level of coping, but those with progressive MS were more likely to have low levels of hopefulness, and less likely to display high levels than those with the relapsing remitting type (Chi-Square 25.9; P < 0.001).Both coping and hopefulness were shown to be predictive of QOL, with the increased odds of good QoL for high coping group being 4.3 (CI: 2.1-8.8) and 4.1 for the high hope group (CI:1.5-11.3). The odds were adjusted for each other and for disease type, also shown to be a significant predictor of QoL (p=0.024) (Nagelkerke R Square 0.213; Hosmer & Lemeshow Test 0.866; correct classification 72.1%).
Conclusion: Both positive coping skills and hopefulness have been shown to be indicative of good quality of life in MS, adjusted for MS type. While high levels of coping and hopefulness appear to go together, this is not the case for low levels of coping skills. The results suggest that helping patients to improve positive coping, and achieve a sense of hopefulness, will also improve their quality of life.
The role of positive coping and hopefulness in predicting quality of life in multiple sclerosis
C.A. Young1,2, A. Tennant3, TONiC Group
1Walton Centre NHS Trust, 2University of Liverpool, Liverpool, United Kingdom, 3Swiss Paraplegic Research, Nottwil, Switzerland
Background: Hope facilitates coping with the unpredictable nature of multiple sclerosis (MS) and improves mood. Coping mechanisms can improve the patients´ quality of life (QoL). How does either construct impact upon QoL?
Methods: The TONiC study is an ongoing, multi-centre, UK study to investigate the trajectories of outcomes in MS. It incorporates many Patient Reported Outcome Measures, including measures of hopefulness (MS-Hope-12) and positive coping (MS-Cope-12). Both have a score range of 0-36 (Rasch transformed), which can be divided into tertials, giving rise to low-medium-high groups. The Leeds MS QoL scale can be divided using the lower tertial range to indicate a good quality of life. Logistic regression was used to examine the odds ratios for the effect of high positive coping and hopefulness on quality of life, adjusted for disease type.
Results: Of 722 people with MS analysed, 71.9% were female. 66.4% reported relapsing-remitting MS; 23.3% secondary progressive MS; and 10.3% primary progressive MS. Almost three- fifths (58%) reported a strong hopeful perspective (upper tertial); whereas just less than one-quarter (24.3%) reported a strong positive coping style. Just over one third (34.2%) reported a good QoL. 15% displayed low levels of positive coping, and there appeared to be no specific association with levels of hopefulness. There was no association between the type of MS and the level of coping, but those with progressive MS were more likely to have low levels of hopefulness, and less likely to display high levels than those with the relapsing remitting type (Chi-Square 25.9; P < 0.001).Both coping and hopefulness were shown to be predictive of QOL, with the increased odds of good QoL for high coping group being 4.3 (CI: 2.1-8.8) and 4.1 for the high hope group (CI:1.5-11.3). The odds were adjusted for each other and for disease type, also shown to be a significant predictor of QoL (p=0.024) (Nagelkerke R Square 0.213; Hosmer & Lemeshow Test 0.866; correct classification 72.1%).
Conclusion: Both positive coping skills and hopefulness have been shown to be indicative of good quality of life in MS, adjusted for MS type. While high levels of coping and hopefulness appear to go together, this is not the case for low levels of coping skills. The results suggest that helping patients to improve positive coping, and achieve a sense of hopefulness, will also improve their quality of life.