Mastery is associated with greater physical and mental health-related quality of life in two international cohorts of people with multiple sclerosis

E L O'Kearney; C R Brown; G A Jelinek; S L Neate; K T Taylor; W Bevens; A M De Livera; S Simpson Jr; T J Weiland

doi:10.1016/j.msard.2019.101481

Mastery is associated with greater physical and mental health-related quality of life in two international cohorts of people with multiple sclerosis

Mult Scler Relat Disord. 2020 Feb:38:101481. doi: 10.1016/j.msard.2019.101481. Epub 2019 Oct 31.

Authors

E L O'Kearney¹, C R Brown¹, G A Jelinek¹, S L Neate¹, K T Taylor², W Bevens¹, A M De Livera¹, S Simpson Jr³, T J Weiland⁴

Affiliations

¹ Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3 bldg 379, 207 Bouverie Street, 3010 Carlton Victoria, Australia.
² Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3 bldg 379, 207 Bouverie Street, 3010 Carlton Victoria, Australia; Department of Psychiatry and Psychosocial Cancer Care, St Vincent's Hospital, Melbourne, Australia.
³ Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3 bldg 379, 207 Bouverie Street, 3010 Carlton Victoria, Australia; Menzies Institute for Medical Research, University of Tasmania, Australia.
⁴ Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Level 3 bldg 379, 207 Bouverie Street, 3010 Carlton Victoria, Australia. Electronic address: tweiland@unimelb.edu.au.

PMID: 31756608
DOI: 10.1016/j.msard.2019.101481

Abstract

Background: Mastery is the sense of being in control of one's life and improvement in mastery may help to enhance quality of life. Little research has explored mastery in people with multiple sclerosis (MS), including its association with quality of life.

Objective: To explore the association between mastery and health-related quality of life (HRQOL) in people with MS.

Method: Two cross-sectional cohorts of adults with MS (n = 1401 and n = 573), recruited through convenience sampling, completed an online survey which measured mastery using the Pearlin Mastery Scale, physical and mental HRQOL via physical and mental health composite scores of MSQOL-54, along with other covariates, including demographics, clinical characteristics and lifestyle factors. Linear regression assessed associations between mastery and physical HRQOL adjusting for age, sex, education, disability and depression, and between mastery and mental HRQOL adjusting for age, sex, education, disability and clinically significant fatigue.

Results: Greater mastery score was associated with higher physical and mental HRQOL in both cohorts, such that a one-point increase in the PMS was associated with an increase of 2.9 (95% Confidence Interval (CI): 2.6, 3.1) and 2.8 points (95% CI: 2.4, 3.2) in the means of physical HRQOL score in the first and second cohorts respectively, and a 2.9-point (95% CI: 2.7, 3.1) and 3.1-point (95% CI: 2.7, 3.4) increase in the means of mental HRQOL score. A dose-dependent relationship was demonstrated between a quartile categorical mastery variable and both physical and mental HRQOL in both cohorts. Mastery was associated with all subscores of both physical and mental HRQOL.

Conclusions: Greater mastery is associated with better physical and mental quality of life. Efforts to improve the sense of self control and agency of people with MS may have benefits for their quality of life, even despite clinical features of the illness.

Keywords: Disability; Epidemiology; Mastery; Multiple sclerosis; Quality of life.

MeSH terms

Adult
Cross-Sectional Studies
Disabled Persons
Female
Humans
Male
Middle Aged
Multiple Sclerosis / psychology*
Quality of Life / psychology*
Self Efficacy*
Severity of Illness Index