Variables associated with communicative participation in persons with multiple sclerosis.

TitleVariables associated with communicative participation in persons with multiple sclerosis.
Publication TypeJournal Article
AuthorsBaylor CR, Britton D, Yorkston KM, Bamer AM, Amtmann D
JournalInternational Journal of MS Care

Purpose: The term “communicative participation” refers to involvement in everyday life situations that require communication. Communication disorders, such as cognitive communication disorders and dysarthria associated with multiple sclerosis (MS), may interfere with communicative participation, resulting in negative consequences, including loss of employment, social isolation, and difficulty negotiating community services and activities. From a theoretical perspective, communicative participation may be influenced by variables other than, or in addition to, impaired speech, language, or cognition, such as other health symptoms, the physical or social environment, and personal characteristics. Understanding the influences on communicative participation has important ramifications for intervention approaches to help individuals maximize their participation. The purpose of this study was to explore variables associated with self-reported communicative participation in a sample (n = 498) of community-dwelling adults with MS. Methods: A battery of questionnaires was administered online or on paper according to participant preference. Data were analyzed using multiple linear regression with backward stepwise regression. The dependent variable was an item response theory score of communicative participation measured by a subset of the Communicative Participation Item Bank that asked respondents to rate the extent to which their health condition interferes with participation in real-life speech-communication situations. Thirteen independent variables were included in the model as self-reported symptoms: problems with thinking, slurred speech, vision loss, pain, mobility, depression, fatigue, perceived social support, age, education level, employment status, gender, and MS duration. Results: Fatigue, slurred speech, depression, problems with thinking, employment status, and social support were significantly associated with communicative participation, accounting for 48.7% of the variance. Conclusions: Communicative participation is significantly associated with multiple variables, only some of which reflect communication disorders. Interventions aimed at improving communicative participation may need to extend beyond traditional speech pathology boundaries to include other health symptoms as well as personal, social, and physical environments.

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