title: Rural-urban analyses of health-related quality of life among people with multiple sclerosis.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels.
  
  
  OBJECTIVE
  To identify factors associated with HRQOL among people with multiple sclerosis (MS) utilizing the SF-8 Health Survey.
  
  
  METHODS
  Data presented in this study were collected in a survey of 1,518 people with MS living in all 50 states. The survey sample was randomly selected from the database of the National Multiple Sclerosis Society, using ZIP codes to recruit the survey sample. A multiple linear regression model was employed to analyze the survey data, with the Physical Component Summary and the Mental Component Summary of the SF-8 the dependent variables. Independent variables were demographic characteristics, MS-disease characteristics, and health services utilized.
  
  
  RESULTS
  People with MS in rural areas tended to report lower physically related HRQOL. Worsening MS symptoms were associated with reduced physical and mental dimensions of HRQOL. In addition, people with MS who received a diagnosis of depression tended to have reduced physical and mental dimensions of HRQOL. Receiving MS care at an MS clinic was associated with better physically related HRQOL, while having a neurologist as principal care physician was associated with better mental-related HRQOL.
  
  
  CONCLUSIONS
  The challenge is to increase the access that people living with MS in rural areas have to MS-focused specialty care.
authors.affiliation: Department of Political Science and Public Administration, Mississippi State University, Mississippi State, MS 39762, USA. rjb161@ps.msstate.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Buchanan
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Randolph
authors.initials: R
authors.lastname: Schiffer
authors.forename: Dagmar
authors.initials: D
authors.lastname: Radin
authors.forename: Wesley
authors.initials: W
authors.lastname: James
mesh_terms: D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life; D012424:Rural Population; D014481:United States; D014505:Urban Population