Self-management has been shown to increase perceived control over both illness and nonillness aspects of life among people with chronic conditions but has not received significant research attention among persons with multiple sclerosis (MS). Based on relationships proposed in the illness intrusiveness and disability centrality models, this study explored the relationships between subjective and objective measures of MS impact, self-management, perceived control, and subjective quality of life (SQOL). A sample of 157 adults with MS participated in this research. The results suggest that self-management is strongly associated with perceived control and that both perceived control and self-management mediate the relationship between MS impact and SQOL. The rehabilitation counseling implications of these findings are discussed.
Affleck, G., Tennen, H., Pfeiffer, C., & Fifield, J. (1987). Appraisals of control and predictability in adapting to a chronic illness. Journal of Personality and Social Psychology , 53, 273-279.
2.
Andrews, F.M., & Robinson, J.P. (1991). Measures of subjective well-being. In J. P. Robinson, P. R. Shaver, & L. S. Wrightsman (Eds.), Measures of personality and social psychological attitudes (Vol. 1, pp. 61-114). San Diego: Academic Press.
3.
Andrews, F., & Withey, S. (1976). Developing measures of perceived life quality: Results from several national surveys. Social Indicators Research , 1, 1-26.
4.
Arbuckle, J.L., & Wothke, W. (1999). Amos 4.0 user's guide. Chicago : SmallWaters Corporation.
5.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman.
6.
Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations . Journal of Personality and Social Psychology, 51, 1173-1182.
7.
Bishop, M. (2005a). Quality of life and psychosocial adaptation to chronic illness and acquired disability: A conceptual and theoretical synthesis . Journal of Rehabilitation, 71(2), 5-13.
8.
Bishop, M. (2005b). Quality of life and psychosocial adaptation to chronic illness and acquired disability: Preliminary analysis of a conceptual and theoretical synthesis. Rehabilitation Counseling Bulletin , 48, 219-232.
9.
Bishop, M., & Allen, C.A. (2003). Epilepsy's impact on quality of life: A qualitative analysis. Epilepsy & Behavior, 4, 226-233.
10.
Bishop, M., & Frain, M. (2007). Development and initial analysis of the Multiple Sclerosis Self-Management Scale. International Journal of Multiple Sclerosis Care, 9, 35-42.
11.
Bishop, M., Stenhoff, D.M., & Shepard, L. (2007). Psychosocial adaptation and quality of life in multiple sclerosis: Assessment of the disability centrality model. Journal of Rehabilitation, 73(1), 3-12.
12.
Carver, C.S., Harris, S.D., Lehman, J.M., Durel, L.A., Antoni, M.H., Spencer, S.M. et al. (2000). How important is the perception of personal control? Studies of early stage breast cancer patients. Personality and Social Psychology Bulletin, 26, 139-150.
13.
Corbin, J., & Strauss, A. (1988). Unending work and care: Managing chronic illness . San Francisco: Jossey-Bass.
14.
Cronbach, L.J. (1987). Statistical tests for moderator variables: Flaws in analyses recently proposed. Psychological Bulletin, 102, 414-417.
15.
Devins, G.M. (1994). Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Advances in Renal Replacement Therapy, 1, 251-263.
16.
Devins, G.M., Blinik, Y.M., Hutchinson, T.A., Hollomby, D.J., Barre, P.E., & Guttmann, R.D. (1983). The emotional impact of end-stage renal disease: Importance of patients' perceptions of intrusiveness and control. International Journal of Psychiatry in Medicine , 13, 327-343.
17.
Devins, G.M., Mandin, H., Beanlands, H., & Paul, L.C. (1997). Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease. Health Psychology, 16, 529-538.
18.
Devins, G.M., Seland, T.P., Klein, G., Edworthy, S.M., & Saary, M.J. (1993). Stability and determinants of psychosocial well-being in multiple sclerosis. Rehabilitation Psychology, 38, 11-26.
19.
Devins, G.M., & Shnek, Z.M. (2000). Multiple sclerosis. In R. G. Frank & T. R. Elliott (Eds.), Handbook of rehabilitation psychology (pp. 163-184). Washington, DC: American Psychological Association .
20.
Dilorio, C., Faherty, B., & Manteuffel, B. (1992). Self-efficacy and social support in self-management of epilepsy. Western Journal of Nursing Research, 14(3), 292-303.
21.
Endler, N.S., Kocovski, N.L., & Macrodimitris, S.D. (2001). Coping, efficacy, and perceived control in acute versus chronic illness. Personal and Individual Differences, 30, 617-625.
22.
Frazier, P.A., Tix, A.P., & Barron, E.K. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51, 115-134.
23.
Hobart, J., Lamping, D., Fitzpatrick, R., Riazi, A., & Thompson, A. (2001). The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain, 124(5), 962-973.
24.
Hobart, J.C., Riazi, A., Lamping, D.L., Fitzpatrick, R., & Thompson, A.J. (2004). Improving the evaluation of therapeutic interventions in multiple sclerosis: Development of a patient-based measure of outcome. Health Technology Assessment, 8(9).
25.
Hobart, J.C., Riazi, A., Lamping, D.L., Fitzpatrick, R., & Thompson, A.J. (2005). How responsive is the Multiple Sclerosis Impact Scale (MSIS-29)? A comparison with some other self-report scales. Journal of Neurology, Neurosurgery, & Psychiatry , 76, 1539-1543.
26.
Holmbeck, G.N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology, 65, 599-610.
27.
Hoyle, R.H., & Smith, G.T. (1994). Formulating clinical research hypotheses as structural equation models: A conceptual overview. Journal of Consulting and Clinical Psychology, 62, 429-440.
28.
Jacelon, C.S. (2007). Theoretical perspectives of perceived control in older adults: A selective review of the literature. Journal of Advanced Nursing, 59(1), 1-10.
29.
Johnson, K.L., Amtmann, D., Yorkston, K., Klasner, E.R., & Kuehn, C.M. (2004). Medical, psychological, social, and programmatic barriers to employment for people with multiple sclerosis. Journal of Rehabilitation, 70, 38-49.
30.
Johnson, K.L., Kuehn, C.M., Yorkston, K.M., Kraft, G.H., Klasner, E., & Amtmann, D. (2006). Patient perspectives on disease-modifying therapy in multiple sclerosis. International Journal of MS Care, 8, 11-18.
31.
Kempen, G., Vansonderen, E., & Ormel, J. (1999). The impact of psychological attributes on changes in disability among low-functioning older persons. Journals of Gerontology: Psychological Sciences, 54B, 23-29.
32.
Kline, R.B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York : Guilford.
33.
Kralik, D., Koch, T., Price, K., & Howard, N. (2004). Chronic illness self-management: Taking action to create order. Journal of Clinical Nursing, 13, 259-267.
34.
Lorig, K. (1993). Self-management of chronic illness: A model for the future (self care and older adults). Generations, 17(3), 11-14.
35.
Lorig, K., Gonzalel, V., Laurent, D., Morgan, L., & Laris, B. (1998). Arthritis self-management program variations: Three studies. Arthritis Care and Research, 11, 448-454.
36.
McGuigan, C., & Hutchinson, M. (2004). The Multiple Sclerosis Impact Scale (MSIS-29) is a reliable and sensitive measure. Journal of Neurology, Neurosurgery, & Psychiatry, 75, 266-269.
37.
McNulty, K., Livneh, H., & Wilson, L.M. (2004). Perceived uncertainty, spiritual well-being, and psychosocial adaptation in individuals with multiple sclerosis. Rehabilitation Psychology, 49, 91-99.
38.
Mishel, M.H. (1988). Uncertainty in illness. Journal of Nursing Scholarship, 20, 225-232.
39.
Mullins, L.L., Cote, M.P., Fuemmeler, B.F., Jean, V.M., Beatty, W.W., & Paul, R.H. (2001). Illness intrusiveness, uncertainty, and distress in individuals with multiple sclerosis. Rehabilitation Psychology , 46, 139-153.
40.
Munschauer, F.E., & Weinstock-Guttman, B. (2005, July). Importance of adherence to and persistence with prescribed treatments in patients with multiple sclerosis . US Neurology Review, pp. 61-63.
41.
National Multiple Sclerosis Society. (2006 ). Multiple sclerosis information sourcebook. Retrieved January 15, 2007, from http://www.nationalmssociety.org
Rotter, J. (1954). Social learning and clinical psychology. New York: Prentice Hall.
44.
Stein, R.K., Gortmaker, S.L., Perrin, E.C., Perrin, J.M., Pless, I.B., & Walker, D.K. (1987). Severity of illness: Concepts and measurements . The Lancet, 340, 1506-1509.
45.
Stutely, S., Hewett, M., & Wheeler, P. (2004). Maintaining the momentum: Developing a self-management group for people with multiple sclerosis. Way Ahead, 8(3), 8-9.
46.
Tabachnick, B.G., & Fidell, L.S. (2001). Using multivariate statistics (4th ed.). New York: HarperCollins .
47.
Thompson, S. (2002). The role of personal control in adaptive functioning . In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 202-213). Oxford, UK: Oxford University Press.
48.
Wallhagen, M.I., & Brod, M. (1997). Perceived control and well-being in Parkinson's disease. Western Journal of Nursing Research, 19(1), 11-31.
49.
Wallston, K.A. (1989). Assessment of control in health care settings . In A. Steptoe & A. Appel (Eds.), Stress, personal control and health (pp. 85-105). Chichester, UK: Wiley.
50.
Wineman, N.M., O'Brien, R.A., Nealon, N.R., & Kaskel, B. (1993). Congruence in uncertainty between individuals with multiple sclerosis and their spouses. Journal of Neuroscience Nursing, 25, 356-361.
51.
Wineman, N.M., Schwetz, K.M., Goodkin, D.E., & Rudick, R.A. (1996). Relationships among illness uncertainty, stress, coping, and emotional well-being at entry into a clinical drug trial. Applied Nursing Research, 9, 53-60.
