Perception of Multiple Sclerosis Impact and Treatment Efficacy Beliefs: Mediating Effect of Patient's Illness and Self-Appraisals

Abstract

Context. Patients with multiple sclerosis (MS) experience many negative, seriously aggravating disease symptoms, and hence, research studies are utmost required to improve their coping with symptoms. Our research is an attempt to show ways to increase participation of patients with MS in the treatment and treatment planning process, as well as in managing the symptoms of the disease.Objectives. To examine the relationship between perception of MS impact and treatment efficacy beliefs in patients with MS and the extent to which self and illness appraisals can be regarded as mediator variables in this relationship.Methods. The cross-sectional study included 278 MS patients who completed the Treatment Beliefs Scale, Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Brief Illness Perception Questionnaire. Demographic and clinical characteristics of the participants were collected with a self-report survey.Results. Illness perception and general self-efficacy mediated the relationship between perception of MS impact and treatment efficacy beliefs under the control of age and time from diagnosis. The standardized indirect effects for illness perception and general self-efficacy were À0.131 95% CI [À0.2029, À0.0739] and À0.086 95% CI [À0.1663, À0.0165], respectively. Conclusion.Our results indicate that worse perception of physical condition in patients with MS is associated with more negative treatment efficacy beliefs, and that this association is mediated by self-efficacy and illness perception. To inhibit the increase of negative treatment efficacy beliefs, health care specialists can work on improving self-efficacy and illness appraisals.

Effectiveness of film as a health communication tool to improve perceptions and attitudes in multiple sclerosis

“…MS patients have been reported to have negative perceptions in treatment control among other domains. [17][18][19][20] Nevertheless, in our study those perceptions turned positive with exposure to film. While not explored in this study, these perceptions have previously been reported to correlate with poor quality of life and disengagement.…”

Autopercepción de la Esclerosis Múltiple: La persona frente a sus ocupaciones

“…Con este hallazgo puede establecerse un paralelismo con el dato arrojado por parte de los profesionales, que afirmaron con 41,8% que la intervención en Salud Mental debía ser el primer abordaje realizado desde TO en esta población. En consonancia con esa respuesta, existen estudios que destacan que es sumamente importante considerar la influencia de la situación psicoemocional en el transcurso de la EM (Strober, 2018;Wilski, Kocur, Górny, Koper, Nadolska & Chmielewski, 2019). Además, se percibe la figura del terapeuta ocupacional como imprescindible para explorar y analizar cómo los problemas derivados de la salud mental afectan a la vida diaria de las personas y a su calidad de vida (Mesa, Anderson, Askey-Jones, Gray, & Silber, 2012).…”

Therapeutic status quo in patients with relapsing-remitting multiple sclerosis: A sign of poor self-perception of their clinical status?

“…Given the increasing amount of treatments available, patients play a more important role in shared decisions (either treatment initiation or escalation) with their neurologist (Arroyo et al, 2017). Individual thoughts or negative perceptions towards some agents may not always be openly shared with healthcare professionals, impacting on therapeutic decisions and adherence (Colligan et al, 2017;Wilski et al, 2019). Other studies has reported on the relevance of the development of patients' awareness and self-regulation about their MS trajectory and the role of the treating physician in communicating the prognosis (Colligan et al, 2017).…”

“…Internal factors include depression, subjective disability perception or having higher risk-seeking personality (Saposnik and Montalban, 2018). Wilski et al showed that a worse selfperception of physical condition and illness in MS patients was associated with beliefs of negative treatment efficacy (Wilski et al, 2019). Depression also emerged as one of the cardinal symptoms that correlated with poor self-rated health, but not vision impairment (Green et al, 2017).…”

“…Our study is in line with our previous research on therapeutic inertia among treating neurologists suggesting a general knowledge-to-action gap affecting both sides of the physician-patient relationship (Saposnik et al, 2017a). Indeed, this relationship in patients could be affected by cognitive (e.g., pessimistic beliefs about symptom relief and preventing disability progression), emotional (e.g., increased depression/lower mood, fear of side effects) and motivational (e.g., increased apathy/reduced goal directed action) components, with each leading to knowledge-to-action gaps (Eskyte et al, 2019;Wilski et al, 2019;Yalachkov et al, 2019). We may speculate that patients´negative perception of their own clinical status (and perhaps a sense of helplessness toward the future) is one of the factors that may lead to the SQ bias (Joiner et al, 2001).…”