Physical activity as a mediator in the relationship between health locus of control and health-related quality of life in multiple sclerosis patients with different disease duration.

BACKGROUND: The importance of undertaking physical activity for functioning of patients with multiple sclerosis (MS) has been repeatedly highlighted. However, the research on the role of physical activity in shaping the quality of life of patients with different disease duration is scarce. OBJECTIVE: The aim of this study was to identify the mediating role of physical activity in the relationship between health locus of control (HLoC) and health-related quality of life in MS patients with varying disease duration. METHODS: The study included 339 patients with MS from rehabilitation centers. The Multiple Sclerosis Impact Scale (MSIS-29) was used to measure health-related quality of life, physical activity was assessed by the Godin Leisure Time Exercise Questionnaire (GLTEQ) and the Health Locus of Control Questionnaire was used to measure HLoC. RESULTS: Physical activity has been shown to be a mediator in the relationship between intrinsic HLoC and health-related quality of life particularly in patients with longer disease duration. Intrinsic HLoC was positively associated with engaging in physical activity, which in turn was positively associated with the physical component of quality of life in patients with longer (indirect effect: ß = -0.077, p < 0.05) and moderate (ß = -0.040, p < 0.05) duration of illness. CONCLUSION: The results highlight the importance of psychological resources for undertaking quality-of-life-related physical activity by MS patients with long disease duration. Particularly important here is the internal HLoC, which promotes physical activity that increases the chance of a high quality of life.

Coping profiles in multiple sclerosis: Comparison of personal resources.

BACKGROUND: Identifying the profiles of multiple sclerosis (MS) patients who employ similar patterns of coping may improve the understanding of how coping is associated with psychological adjustment. The purpose of this study was to identify the groups of MS patients using different coping strategies and compare the levels of psychological resources across the groups. METHODS: In this cross-sectional study 382 patients with MS completed a battery of self-report measures that assessed their use of different coping strategies, optimism, self-efficacy, health locus of control (HLC), and perception of disease. The groups with different coping profiles were selected by performing a cluster analysis. RESULTS: Five different coping profiles were highlighted and were defined as follows: "Emotional," "Temperate," "Active," "Passive," and "Problem copers." Significant differences were detected between the groups in the levels of optimism, self-efficacy, HLC, and perception of disease. CONCLUSION: Patients with MS use a varied repertoire of coping strategies, which allowed distinguishing coping profiles. Groups representing particular profiles differ in terms of psychological resources. This study contributed to increasing the interest in investigating coping profiles. Identifying subgroups of individuals based on their coping profiles and recognizing the differences is important for providing psychological support.

Perception of Multiple Sclerosis Impact and Treatment Efficacy Beliefs: Mediating Effect of Patient's Illness and Self-Appraisals.

CONTEXT: Patients with multiple sclerosis (MS) experience many negative, seriously aggravating disease symptoms, and hence, research studies are utmost required to improve their coping with symptoms. Our research is an attempt to show ways to increase participation of patients with MS in the treatment and treatment planning process, as well as in managing the symptoms of the disease. OBJECTIVES: To examine the relationship between perception of MS impact and treatment efficacy beliefs in patients with MS and the extent to which self and illness appraisals can be regarded as mediator variables in this relationship. METHODS: The cross-sectional study included 278 MS patients who completed the Treatment Beliefs Scale, Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Brief Illness Perception Questionnaire. Demographic and clinical characteristics of the participants were collected with a self-report survey. RESULTS: Illness perception and general self-efficacy mediated the relationship between perception of MS impact and treatment efficacy beliefs under the control of age and time from diagnosis. The standardized indirect effects for illness perception and general self-efficacy were -0.131 95% CI [-0.2029, -0.0739] and -0.086 95% CI [-0.1663, -0.0165], respectively. CONCLUSION: Our results indicate that worse perception of physical condition in patients with MS is associated with more negative treatment efficacy beliefs, and that this association is mediated by self-efficacy and illness perception. To inhibit the increase of negative treatment efficacy beliefs, health care specialists can work on improving self-efficacy and illness appraisals.

Work locus of control and burnout in Polish physiotherapists: The mediating effect of coping styles.

OBJECTIVES: The aim of this study was to explain the relationship between work locus of control and burnout in Polish physiotherapists through the mediation of coping styles. In particular, we hypothesized that external work locus of control may have a positive direct relationship with burnout symptoms via positive relationship with emotion-focused and avoidant coping styles, and a negative relationship with problem-focused style. MATERIAL AND METHODS: We tested the mediational hypothesis using structural equation modeling of self-report data from 155 Polish physiotherapists. RESULTS: The relationship between external work locus of control and physiotherapists' burnout was shown to be mediated by a positive relationship with emotion-focused coping and an inverse relationship with problem-focused coping. The variables included in the model explained about 15% of the variance of emotional exhaustion, 14% of depersonalization, and 14% of personal accomplishment. CONCLUSIONS: Physiotherapists perceiving the situation as difficult to control, feel more burned out when they use more emotion-focused strategies, and less problem-focused strategies. This indicates the importance of including both, problem-focused coping training and increasing the perception of the situation controllability in preventing physiotherapists' burnout programs.