Self-efficacy in multiple sclerosis.

TitleSelf-efficacy in multiple sclerosis.
Publication TypeJournal Article
AuthorsAmtmann D, Bamer AM, Brockway J A, Cook KF, Johnson KL
JournalInternational Journal of MS Care
Quality of Life in MS

Background: Multiple sclerosis (MS) is a complex disease. Health management in the context of MS presents a considerable challenge, especially in combination with the complexity of the US health-care system. People with MS who develop confidence in their ability to manage the disease often have better health outcomes and quality of life. Objectives: The objective of our study was to examine self-efficacy and its impact on emotional well-being and quality of life using two self-efficacy scales. The Disability Management Self Efficacy Scale (DMSES) is a new scale developed with and validated for people with MS. The Stanford Self-efficacy (SSE) scale was developed for general self-management in chronic disease and has not been validated in people with MS. Methods: Short versions of both scales consist of six items. The DMSES was developed using Item Response Theory scoring, with the range from 0 to 100. The summary score on the SSE scale ranges from 0 to 10. Data were collected via surveys of community-dwelling individuals with MS (N = 473) enrolled in an ongoing longitudinal survey study. Results: The average age of the sample was 52.3 years, the mean duration of MS was 14.9 years, and the sample was 82.7% female. On the DMSES the sample had a mean (SD) of 50.1 (9.3), and on the SSE scale a mean (SD) of 7.1 (2.0). Published studies on the SSE scale for other populations reported a mean (SD) of 5.53 (2.2) based on 175 participants with arthritis and a mean (SD) of 6.87 (1.76) based on the sample of 186 people with diabetes. Both scales were most highly correlated with scores from the Modified Fatigue Impact Scale (MFIS) (DMSES r = –0.72, SSE r = –0.69), followed by the Perceived Stress Scale (DMSES r = –0.67, SSE r = –0.65). In the regression model, self-efficacy measured by either scale was most predictive of MFIS scores 8 months later (DMSES r2 = 0.46, SSE r2 = 0.43). Conclusion: Self-efficacy in this MS sample appears higher than that in other populations with chronic diseases. People with MS with higher self-efficacy scores reported better overall health as well as less pain interference, fatigue, depression, perceived stress, and interference with participation in valued activities.

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