title: Psychosocial difficulties of individuals with multiple sclerosis: the PARADISE-24 questionnaire.
abstract: The aim of this study is to identify the most relevant psychosocial difficulties (PSDs) experienced by persons with multiple sclerosis (PwMS); to evaluate the relation between an overall level of PSDs measured with the PARADISE-24 and other variables; to assess which factors may predict PARADISE-24 overall score. Adults PwMS were consecutively enrolled and completed a battery of eight self-reported instruments (i.e. SCQ, EUROHIS-QOL 8, BRS, BFI-10, JSPE, OSS-3, WHODAS-12, PARADISE-24). A clinical evaluation was performed for each patient and the Expanded Disability Status Scale (EDSS) score was determined by neurologists. A total of 80 PwMS, mean age 41.0, 65% women, 62% married, and 76.3% working, 86.3% relapsing-remitting MS, with an EDSS median score of 1.5, took part in the study. The mean disease duration was 7.7 years. The most frequently reported PSDs involved motor and emotional functioning. Free of charge access to medicines; health treatments and family, friends and health professionals' assistance represented the most important facilitators. WHODAS-12 and EUROHIS-QOL 8 were excluded from regression because of their strong correlation with PARADISE-24. EDSS, BRS, OSS-3, and neuroticism were the main predictors of the PARADISE-24 score. Despite MS heterogeneity, a common pattern of PSDs can be observed among PwMS. The level of physical impairment and personal resilience were the main predictors of the overall level of PSDs in PwMS, with a lower but significant additional role played by social support and personality traits. Attention to PSDs and their predictors, using PARADISE-24, can help clinicians to plan tailored and personalized rehabilitation programs.
authors.affiliation: Departments of aNeuroimmunology and Neuromuscular Diseases bNeurosurgery, Radiotherapy Unit cNeurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy.
authors.forename: Ambra M
authors.initials: AM
authors.lastname: Giovannetti
authors.forename: Silvia
authors.initials: S
authors.lastname: Schiavolin
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.forename: Rui
authors.initials: R
authors.lastname: Quintas
authors.forename: Milda
authors.initials: M
authors.lastname: Cerniauskaite
authors.forename: Paolo
authors.initials: P
authors.lastname: Confalonieri
authors.forename: Renato
authors.initials: R
authors.lastname: Mantegazza
authors.forename: Valentina
authors.initials: V
authors.lastname: Torri Clerici
authors.forename: Carlo
authors.initials: C
authors.lastname: Antozzi
authors.forename: Greta
authors.initials: G
authors.lastname: Brenna
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
mesh_terms: D000328:Adult; D001008:Anxiety Disorders; D004185:Disability Evaluation; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology / Q000534:rehabilitation; D000075384:Neuroticism; D011594:Psychometrics / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D057566:Self Report; D012917:Social Adjustment; D012944:Social Support; D011795:Surveys and Questionnaires