Article

Symptom cluster and quality of life: Preliminary evidence in multiple sclerosis

Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, USA.
Journal of Neuroscience Nursing (Impact Factor: 0.91). 08/2010; 42(4):212-6. DOI: 10.1097/JNN.0b013e3181e26c5f
Source: PubMed

ABSTRACT This study examined the symptom cluster of fatigue, pain, and depression as a correlate of reduced quality of life (QOL) in individuals with multiple sclerosis (MS). The sample included 291 individuals with a definite diagnosis of MS who were enrolled in a 6-month longitudinal study of physical activity and QOL. The participants completed baseline measures of fatigue, depression, and pain and follow-up measures of QOL. Cluster analysis initially identified three subgroups differing in experiences of fatigue, depression, and pain, and analysis of variance then indicated that the three subgroups differed in QOL. The subgroup with lowest scores on all three symptoms had the highest QOL, whereas the subgroup with the highest scores on the symptoms had the worst QOL. Such findings provide preliminary support for fatigue, pain, and depression as a symptom cluster that correlates with reduced QOL in persons with MS.

0 Followers
 · 
92 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: As more investigations into factors affecting the quality of life of patients with multiple sclerosis (MS) are undertaken, it is becoming increasingly apparent that certain comorbidities and associated symptoms commonly found in these patients differ in incidence, pathophysiology and other factors compared with the general population. Many of these MS-related symptoms are frequently ignored in assessments of disease status and are often not considered to be associated with the disease. Research into how such comorbidities and symptoms can be diagnosed and treated within the MS population is lacking. This information gap adds further complexity to disease management and represents an unmet need in MS, particularly as early recognition and treatment of these conditions can improve patient outcomes. In this manuscript, we sought to review the literature on the comorbidities and symptoms of MS and to summarize the evidence for treatments that have been or may be used to alleviate them.
    Therapeutic Advances in Neurological Disorders 05/2011; 4(3):139-68. DOI:10.1177/1756285611403646
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND AND PURPOSE: Predictive factors of long-term disability in patients with relapsing-remitting multiple sclerosis (RR-MS) are well known, but the weight of these factors does not explain the entire change of disability. Few studies have examined the predictive value of quality of life (QoL). OBJECTIVES: To determine the value of the initial level of QoL to predict changes in the disability status of patients with MS and to determine if specific-MS questionnaires predict more accuracy in these changes than generic questionnaires. METHODS: Design: multicenter, multi-regional, and longitudinal study. Main inclusion criteria: patients with RR-MS subtype and an Expanded Disability Status Scale (EDSS) score lower than 7.0. Sociodemographic and clinical data were recorded at baseline. Every 6 months up to month 24, QoL (MusiQoL and SF-36) was recorded. At 24 months, individuals were defined into two 'disability change' groups: the worsened and not worsened patients. RESULTS: Five-hundred and twenty-six patients were enrolled: 386 (83.7%) not worsened and 75 (16.3%) worsened patients at 24 months. The activity of daily living and the relationship with healthcare workers dimensions of MusiQoL questionnaire were independent predictors of change in the EDSS score after 24 months. The physical-functioning dimension of the SF-36 questionnaire predicted independently disability change after 24 months. CONCLUSIONS: Patient-reported baseline QoL levels provide additional prognostic information on MS disability beyond traditional clinical or sociodemographic factors. These findings reinforce the importance of incorporating a patient's evaluation of their own QoL level during patient monitoring and the assessment of treatment effects.
    European Journal of Neurology 01/2013; 20(6). DOI:10.1111/ene.12087
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: To conduct a systematic review of evidence surrounding the effects of exercise training on physical fitness, mobility, fatigue and health-related quality of life in adults with MS. Data Sources: The databases included: EMBASE 1980 to 2011 Week 12; Ovid MEDLINE(R) and Ovid OLDMEDLINE(R) 1947 to March Week 3 2011; PsycINFO 1967 to March Week 4 2011; CINAHL all-inclusive; SportDiscus all-inclusive; Cochrane Library all-inclusive; PEDro all-inclusive. STUDY SELECTION: The review was limited to English language studies (published prior to December 2011) of people with MS that evaluated the effects of exercise training on outcomes of physical fitness, mobility, fatigue, and/or health related quality of life. DATA EXTRACTION: One research assistant extracted data and rated study quality. A second research assistant verified the extraction and quality assessment. DATA SYNTHESIS: From the 4362 studies identified, 54 studies were included in the review. The extracted data were analyzed using a descriptive approach. There was strong evidence that exercise performed 2 times per week at a moderate intensity increases aerobic capacity and muscular strength. The evidence was not consistent regarding the effects of exercise training on other outcomes. CONCLUSIONS: Among those with mild to moderate disability from MS, there is sufficient evidence that exercise training is effective for improving both aerobic capacity and muscular strength. Exercise may improve mobility, fatigue, and health related quality of life.
    Archives of physical medicine and rehabilitation 05/2013; 94(9). DOI:10.1016/j.apmr.2013.04.020
Show more