title: Improved self-efficacy in persons with relapsing remitting multiple sclerosis after an intensive social cognitive wellness program with participation of support partners: a 6-months observational study.
abstract: BACKGROUND
  For persons with multiple sclerosis (MS) it is important to preserve their autonomy, in spite of increasing disability. A major factor mediating autonomy is self-efficacy. According to the social cognitive theory stressors are crucial determinants of self-efficacy, as well as the interaction with partners.
  
  
  METHODS
  In an explorative observational study we assessed in 47 persons with MS (PwMS) the effect of an intense, multidisciplinary, 3-day, social cognitive wellness program with the participation of support partners, after 1, 3 and 6 months.
  
  
  METHODS
  self-efficacy-control and -function (Multiple Sclerosis Self-Efficacy Scale [MSSES]),limitations to and problems with participation and autonomy (Impact on Participation and Autonomy [IPA] scale).
  
  
  RESULTS
  health-related quality of life (HRQoL) (MS Quality of Life-54 Items [MSQoL-54] questionnaire), anxiety, depression (Hospital Anxiety and Depression Scale [HADS]), and fatigue (Modified Fatigue Impact Scale-5 Items [MFIS-5]). Disability was measured with the Expanded Disability Status Scale (EDSS). Percentage changes from baseline were tested with T-tests, level of significance 0.05.
  
  
  RESULTS
  In the whole group the MSQoL-54 Mental score was increased at 1, 3 and 6 months (+16.0%, +13.2%, +12.2%), and the MSQoL-54 Physical (+10.2%) at 6 months, with no changes in other outcomes. The relapsing remitting (RR) subgroup (n = 20) had at 6 months an increase in the MSSES-Control score (+24.8%) and in the MSQoL54 Mental and Physical scores (+22.3%, +17.6%). Progressive patients (n = 22) only showed an increase in the MSQoL-54 Mental score (+11.5%) at 1 month. In the low-disability (EDSS < 4.0) subgroup the MSSES-Control score was increased (+23.8%) at 6 months, and the IPA-Limitations and -Problems scores decreased at 3 months (-6.1%, -8.8%); the MSQoL-54 Mental score had increased at 1, 3 and 6 months (+19.3%, +21.5%, +19.3%). In the high-disability (EDSS > =4.0) subgroup no significant changes occurred.
  
  
  CONCLUSIONS
  Results from this observational study suggest that 6 months after an intense, 3-day, multidisciplinary, social cognitive wellness program with support partners, PwMS with a RR course or low disability may experience an improved self-efficacy-control and HRQoL.
authors.affiliation: MS4 Research Institute, Ubbergseweg 34, 6522 KJ Nijmegen, The Netherlands. ms4ri@kpnmail.nl.
authors.forename: Peter Joseph
authors.initials: PJ
authors.lastname: Jongen
authors.forename: Rob
authors.initials: R
authors.lastname: Ruimschotel
authors.forename: Marco
authors.initials: M
authors.lastname: Heerings
authors.forename: Astrid
authors.initials: A
authors.lastname: Hussaarts
authors.forename: Lotte
authors.initials: L
authors.lastname: Duyverman
authors.forename: Anneke
authors.initials: A
authors.lastname: van der Zande
authors.forename: Joyce
authors.initials: J
authors.lastname: Valkenburg-Vissers
authors.forename: Hanne
authors.initials: H
authors.lastname: Wolper
authors.forename: Maarten
authors.initials: M
authors.lastname: van Droffelaar
authors.forename: Wim
authors.initials: W
authors.lastname: Lemmens
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.forename: Leo H
authors.initials: LH
authors.lastname: Visser
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis; D003866:Depressive Disorder / Q000175:diagnosis; D004185:Disability Evaluation; D005260:Female; D006293:Health Promotion / Q000592:standards*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology*; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D020377:Self Efficacy; D012917:Social Adjustment; D012944:Social Support; D011795:Surveys and Questionnaires