The Effectiveness of Self-care Program on the Life Quality of Patients with Multiple Sclerosis in 2015

Abstract

This study aimed to investigate the effectiveness of self-care plan on the life quality of patients with Multiple sclerosis (MS). The samples in this study included all the patients with MS under medical coverage of Iranian Association of supporting patients with MS in Tehran in 2015 who were studied as Convenience sampling and based on the inclusion and exclusion criteria. In this study, Dr. Madani's self-care program as an intervention and The World Health Organization Quality of Life (WHOQOL)-BREF for assessment of consequences were used. Spss software using Wilcoxon and ANOVA tests were used to analyze the data. Values are significant at P value less than 0.05. Before the intervention, the quality of life was 59.91 ± 13.39 and after the intervention, it was 69.37 ± 11.73 and there was a significant difference between them (P value < 0.001). Also, there was a significant difference between the items of life quality-including the physical, psychological and social relationships and living environment items-before and after the interventions. Self-care program has an effect on the quality of life and physical, psychological and social relationships and living environment items.

Introduction

Multiple sclerosis (MS) is a chronic, progressive and common disease of Demyelination in central nervous system in young adults. It's broken out at young ages and comes along with decreasing in individual and social function.1, 2 Almost 500,000 people in America have MS and every year, 8000 new cases are recognized. This disease occurs at the ages of 20–40 and is the third reason of inability in America.³

In Iran, according to the Association of MS, there are almost 50,000 patients with MS and it's broken out in Isfahan more than other cities (about 15–20 patients per 100,0000).⁴ The patients with MS face with problems relating to their disease and these problems restrict the presence of patients in health promotion activities and increase the side effects and limitations in independent life and finally have negative effects on their quality of life.⁵ In 1993, World Health Organization (WHO) defined quality of life as “The quality of life includes imaginations of people from their position in life regarding the cultural contents and value of system they live relating to aims, standards and their concerns”.⁶

The quality of life included four areas: physical health, psychological, social relationship, living environment and condition areas. Training patients the proper program and treatment method and the items they must consider, can cause the physical function, public health, emotional-mental and social condition to improve (WHOQOL-BREF). As chronic diseases, like Multiple sclerosis, effect on all of the economic, financial, social and emotional dimensions of the individual, family and society, so pharmaceutical treatment and controlling periods of diseases in these patients are only not enough.⁷ Lack of knowledge in patients with chronic disease about the self-care method is one of the reasons of their re-hospitalization in hospitals.⁸ So, the aim of training patients is helping them to get more responsibility for their self-care and to adapt them for changes in their physical and functional conditions which finally leads to improvement in their life quality.⁹

The self-care programs, means conscious, acquired and targeted actions and activities which the individual uses them for survival and health promotion of his family or him. Self-care is a part of daily life and includes the cares applied for children, family, friends, neighbors and local associations. In fact, self-care includes the activities which people do in order to be healthy, preserve their physical health, provide for their social and mental needs, prevent from diseases or events, modify the illness and chronic states and sustain their health following severe illness or discharging from hospital.¹⁰ A rising trend to increase MS patients makes consideration of treatment issues and problems in patients necessary.⁵ With regard to the fact that the necessity of recognizing and adopting measurements to control disabling problems of these patients and promote their quality of life by treatment team is felt and pharmaceutic treatments do not effect on physical dimensions of quality life in these patients,¹¹ inciting the self-care power in these patients and planning based on this potential power is important. There are a few studies about self-care in these patients and just the quality and quantity of self-care behaviors were investigated, while self-care power in these patients was not so considered.¹²

In this study, the researcher sought to determine the effectiveness of self-care programs on quality of life in four areas of quality of life (such as physical health, psychological area, social relationships, living environment and status) in patients with MS.