Self-management and its Associations with Function and Health Related Quality of Life among People with Multiple Sclerosis

Background: Multiple Sclerosis is an incurable, chronic, and progressive disease that affects an individual's function and health-related quality of life (HR-QoL). Self-management refers to activities the individual performs in order to reduce the impact of illness on his function and HR-QoL, and includes aspects such as medical management (treatment by health care professionals) and lifestyle (regular exercise). A subjective aspect of patient activation is also part of the broader approach, and refers to the knowledge, skills, and confidence individuals have to manage their health. Although this approach has been studied in people with Multiple Sclerosis, there is limited data about its associations with activation level, function, and HR-QoL. Objectives: 1. To describe self-management and the level of patient activation among people with Multiple Sclerosis. 2. To examine the correlation between self-management and patient activation and between function, mobility and HR-QoL. Method: A digital survey was conducted and included self-report questionnaires to assess self-management, activation levels, function, mobility and HR-QoL. Results: The survey was completed by 79 people. Self-management and levels of activation were high. Most participants did not receive health-profession treatment. Regression analysis showed that visits to the neurologist and receiving treatments from the health professions contribute to mobility (R2 = 0.05, R2 = 0.16 respectively). Exercise was found to be related to mobility status (r = -0.23, p <0.05) and the level of activation was found to be related to HR-QoL (r = -0.24, p <0.05) but both were not found to be significant in the regression model. Discussion and conclusions: In people with Multiple Sclerosis, self-management, including physical activity, but mainly visits to the neurologist and treatments by health professions, is related to mobility and HR-QoL. However, the relationships found are complex and differ from those seen for other chronic diseases, and this may be due to the fluctuating nature of the disease.