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: 0.82). 08/2010; 42(4):212-6. DOI: 10.1097/JNN.0b013e3181e26c5f
Source: PubMed


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.

Download full-text


Available from: Edward Mcauley, Feb 16, 2015
  • Source
    • "Modifiable lifestyle factors, such as obesity, smoking, risky alcohol consumption and low levels of physical activity were found to have a negative correlation with health-related quality of life [8-10]. Furthermore, several studies concurrently report a negative association between depressive symptoms and chronic pain and SRH [11,12], respectively. In recent years, research has particularly focused on the relationship between different chronic diseases and health-related quality of life. "
    [Show abstract] [Hide abstract]
    ABSTRACT: With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients. Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses. Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson's disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors. In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH.Trial registration: MultiCare Cohort study registration: ISRCTN89818205.
    Full-text · Article · Jan 2014 · BMC Family Practice
    • "The sub-group with the lowest scores on all three symptoms had the highest QoL, whereas the sub-group with the highest scores on the symptoms had the worst QoL. This observation supports the concept of fatigue, pain and depression as a symptom cluster, which correlates with reduced QoL in patients with MS.[32] Another case-control study in women with relapsing-remitting multiple sclerosis (RRMS) found that pain and pain intensity were significantly more in the RRMS group as compared to controls. However, fatigue and depression intensity was not significantly different between the groups. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL). Prospective observational study in a University Tertiary Research Hospital in India. A total of 31 patients (25 females) with definite MS according to McDonald's criteria presented in out-patient/admitted in the Department of Neurology (between February 2010 and December 2011) were included in the study. Disease severity was evaluated using the Kurtzke's expanded disability status scale (EDSS). Fatigue was assessed using Krupp's fatigue severity scale (FSS). QoL was assessed by the World Health Organization QoL-BREF questionnaire. The mean age of patients was 30.1 ± 9.1 years. The mean age at first symptom was 25.23 ± 6.4 years. The mean number of relapses was 4.7 ± 3.6 in the patients. The mean duration of illness was 4.9 ± 4.4 years. The mean EDSS score was 3.5 ± 2.2. Mean fatigue score was 38.7 ± 18.5 (cut-off value 36 in FSS). The prevalence of fatigue in patients with MS was 58.1% (18/31). MS patients with fatigue were significantly more impaired (P < 0.05) on all QoL domains (i.e., physical, psychosocial, social, and environment) than MS patients without fatigue. Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.
    No preview · Article · Jul 2013
  • 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.
    Full-text · Article · May 2011 · Therapeutic Advances in Neurological Disorders
Show more