Skip to main content
Top
Gepubliceerd in:

05-11-2020

Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan

Auteurs: Stephanie L. Silveira, Katie L. J. Cederberg, Brenda Jeng, E. Morghen Sikes, Brian M. Sandroff, Catherine D. Jones, Robert W. Motl

Gepubliceerd in: Quality of Life Research | Uitgave 4/2021

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups.

Methods

This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20–39, 40–59, and 60–79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups.

Results

Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η2 = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η2 = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent.

Conclusions

Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.
Literatuur
8.
go back to reference Weiland, T. J., Jelinek, G. A., Marck, C. H., Hadgkiss, E. J., van der Meer, D. M., Pereira, N. G., & Taylor, K. L. (2015). Clinically significant fatigue: Prevalence and associated factors in an international sample of adults with multiple sclerosis recruited via the internet. PLoS One, 10(2), e0115541. CrossRef Weiland, T. J., Jelinek, G. A., Marck, C. H., Hadgkiss, E. J., van der Meer, D. M., Pereira, N. G., & Taylor, K. L. (2015). Clinically significant fatigue: Prevalence and associated factors in an international sample of adults with multiple sclerosis recruited via the internet. PLoS One, 10(2), e0115541. CrossRef
14.
go back to reference Dodd, M. J., Miaskowski, C., & Lee, K. A. (2004). Occurrence of symptom clusters. JNCI Monographs, 2004(32), 76–78.CrossRef Dodd, M. J., Miaskowski, C., & Lee, K. A. (2004). Occurrence of symptom clusters. JNCI Monographs, 2004(32), 76–78.CrossRef
16.
go back to reference Motl, R. W., & McAuley, E. (2010). Symptom cluster and quality of life: Preliminary evidence in multiple sclerosis. The Journal of Neuroscience Nursing, 42(4), 212.CrossRef Motl, R. W., & McAuley, E. (2010). Symptom cluster and quality of life: Preliminary evidence in multiple sclerosis. The Journal of Neuroscience Nursing, 42(4), 212.CrossRef
18.
go back to reference Motl, R. W., Weikert, M., Suh, Y., & Dlugonski, D. (2010). Symptom cluster and physical activity in relapsing-remitting multiple sclerosis. Research in Nursing & Health, 33(5), 398–412.CrossRef Motl, R. W., Weikert, M., Suh, Y., & Dlugonski, D. (2010). Symptom cluster and physical activity in relapsing-remitting multiple sclerosis. Research in Nursing & Health, 33(5), 398–412.CrossRef
19.
go back to reference Newland, P. K., Fearing, A., Riley, M., & Neath, A. (2012). Symptom clusters in women with relapsing-remitting multiple sclerosis. Journal of Neuroscience Nursing, 44(2), 66–71.CrossRef Newland, P. K., Fearing, A., Riley, M., & Neath, A. (2012). Symptom clusters in women with relapsing-remitting multiple sclerosis. Journal of Neuroscience Nursing, 44(2), 66–71.CrossRef
20.
go back to reference Shahrbanian, S., Duquette, P., Kuspinar, A., & Mayo, N. E. (2015). Contribution of symptom clusters to multiple sclerosis consequences. Quality of Life Research, 24(3), 617–629.CrossRef Shahrbanian, S., Duquette, P., Kuspinar, A., & Mayo, N. E. (2015). Contribution of symptom clusters to multiple sclerosis consequences. Quality of Life Research, 24(3), 617–629.CrossRef
25.
go back to reference Krupp, L. B., LaRocca, N. G., Muir-Nash, J., & Steinberg, A. D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121–1123.CrossRef Krupp, L. B., LaRocca, N. G., Muir-Nash, J., & Steinberg, A. D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121–1123.CrossRef
26.
go back to reference Andreasen, A., Stenager, E., & Dalgas, U. (2011). The effect of exercise therapy on fatigue in multiple sclerosis. Multiple Sclerosis Journal, 17(9), 1041–1054.CrossRef Andreasen, A., Stenager, E., & Dalgas, U. (2011). The effect of exercise therapy on fatigue in multiple sclerosis. Multiple Sclerosis Journal, 17(9), 1041–1054.CrossRef
27.
go back to reference Learmonth, Y., Dlugonski, D., Pilutti, L., Sandroff, B., Klaren, R., & Motl, R. W. (2013). Psychometric properties of the fatigue severity scale and the modified fatigue impact scale. Journal of Neurolgical Sciences, 331(1–2), 102–107.CrossRef Learmonth, Y., Dlugonski, D., Pilutti, L., Sandroff, B., Klaren, R., & Motl, R. W. (2013). Psychometric properties of the fatigue severity scale and the modified fatigue impact scale. Journal of Neurolgical Sciences, 331(1–2), 102–107.CrossRef
28.
go back to reference Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.CrossRef Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.CrossRef
30.
go back to reference Marrie, R. A., Zhang, L., Lix, L. M., Graff, L. A., Walker, J. R., Fisk, J. D., et al. (2018). The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. Multiple Sclerosis and Related Disorders, 20, 9–15.CrossRef Marrie, R. A., Zhang, L., Lix, L. M., Graff, L. A., Walker, J. R., Fisk, J. D., et al. (2018). The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. Multiple Sclerosis and Related Disorders, 20, 9–15.CrossRef
31.
go back to reference Buysse, D. J., Reynolds, C. F., 3rd., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.CrossRef Buysse, D. J., Reynolds, C. F., 3rd., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213.CrossRef
32.
go back to reference Carpenter, J. S., & Andrykowski, M. A. (1998). Psychometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research, 45(1), 5–13.CrossRef Carpenter, J. S., & Andrykowski, M. A. (1998). Psychometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research, 45(1), 5–13.CrossRef
33.
go back to reference Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483. CrossRef Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483. CrossRef
34.
go back to reference Vickrey, B., Hays, R. D., Harooni, R., Myers, L. W., & Ellison, G. W. (1995). A health-related quality of life measure for multiple sclerosis. Quality of Life Research, 4(3), 187–206.CrossRef Vickrey, B., Hays, R. D., Harooni, R., Myers, L. W., & Ellison, G. W. (1995). A health-related quality of life measure for multiple sclerosis. Quality of Life Research, 4(3), 187–206.CrossRef
35.
go back to reference Hohol, M., Orav, E., & Weiner, H. (1995). Disease steps in multiple sclerosis: A simple approach to evaluate disease progression. Neurology, 45(2), 251–255.CrossRef Hohol, M., Orav, E., & Weiner, H. (1995). Disease steps in multiple sclerosis: A simple approach to evaluate disease progression. Neurology, 45(2), 251–255.CrossRef
36.
go back to reference Learmonth, Y. C., Motl, R. W., Sandroff, B. M., Pula, J. H., & Cadavid, D. (2013). Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurology, 13(1), 37.CrossRef Learmonth, Y. C., Motl, R. W., Sandroff, B. M., Pula, J. H., & Cadavid, D. (2013). Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis. BMC Neurology, 13(1), 37.CrossRef
37.
go back to reference Motl, R. W., & McAuley, E. (2009). Symptom cluster as a predictor of physical activity in multiple sclerosis: Preliminary evidence. Journal of Pain Symptom Management, 38(2), 270–280.CrossRef Motl, R. W., & McAuley, E. (2009). Symptom cluster as a predictor of physical activity in multiple sclerosis: Preliminary evidence. Journal of Pain Symptom Management, 38(2), 270–280.CrossRef
38.
go back to reference Sarstedt, M., & Mooi, E. (2014). Cluster analysis. In B. R. Wainrib (Ed.), A concise guide to market research. The process, data, and methods using IBM SPSS statistics (pp. 274–324). New York: Springer. Sarstedt, M., & Mooi, E. (2014). Cluster analysis. In B. R. Wainrib (Ed.), A concise guide to market research. The process, data, and methods using IBM SPSS statistics (pp. 274–324). New York: Springer.
40.
go back to reference Barsevick, A. M., Whitmer, K., Nail, L. M., Beck, S. L., & Dudley, W. N. (2006). Symptom cluster research: Conceptual, design, measurement, and analysis issues. Journal of Pain Symptom Management, 31(1), 85–95.CrossRef Barsevick, A. M., Whitmer, K., Nail, L. M., Beck, S. L., & Dudley, W. N. (2006). Symptom cluster research: Conceptual, design, measurement, and analysis issues. Journal of Pain Symptom Management, 31(1), 85–95.CrossRef
41.
go back to reference Ghaem, H., & Haghighi, A. B. (2008). The impact of disability, fatigue and sleep quality on the quality of life in multiple sclerosis. Annals of Indian Academy of Neurology, 11(4), 236.CrossRef Ghaem, H., & Haghighi, A. B. (2008). The impact of disability, fatigue and sleep quality on the quality of life in multiple sclerosis. Annals of Indian Academy of Neurology, 11(4), 236.CrossRef
42.
go back to reference Marrie, R. A., Reider, N., Cohen, J., Trojano, M., Sorensen, P. S., Cutter, G., et al. (2015). A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis. Multiple Sclerosis Journal, 21(3), 342–349.CrossRef Marrie, R. A., Reider, N., Cohen, J., Trojano, M., Sorensen, P. S., Cutter, G., et al. (2015). A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis. Multiple Sclerosis Journal, 21(3), 342–349.CrossRef
43.
go back to reference Tabrizi, F. M., & Radfar, M. (2015). Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis. International Journal of MS Care, 17(6), 268–274.CrossRef Tabrizi, F. M., & Radfar, M. (2015). Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis. International Journal of MS Care, 17(6), 268–274.CrossRef
44.
go back to reference Landry, G. J., Best, J. R., & Liu-Ambrose, T. (2015). Measuring sleep quality in older adults: A comparison using subjective and objective methods. Frontiers in Aging Neuroscience, 7, 166.PubMedPubMedCentral Landry, G. J., Best, J. R., & Liu-Ambrose, T. (2015). Measuring sleep quality in older adults: A comparison using subjective and objective methods. Frontiers in Aging Neuroscience, 7, 166.PubMedPubMedCentral
45.
go back to reference Espiritu, J. R. D. (2008). Aging-related sleep changes. Clinics in Geriatric Medicine, 24(1), 1–14.CrossRef Espiritu, J. R. D. (2008). Aging-related sleep changes. Clinics in Geriatric Medicine, 24(1), 1–14.CrossRef
46.
go back to reference Benedict, R. H., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., et al. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231(1–2), 29–34.CrossRef Benedict, R. H., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., et al. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231(1–2), 29–34.CrossRef
47.
go back to reference Merlino, G., Fratticci, L., Lenchig, C., Valente, M., Cargnelutti, D., Picello, M., et al. (2009). Prevalence of ‘poor sleep’ among patients with multiple sclerosis: An independent predictor of mental and physical status. Sleep Medicine, 10(1), 26–34.CrossRef Merlino, G., Fratticci, L., Lenchig, C., Valente, M., Cargnelutti, D., Picello, M., et al. (2009). Prevalence of ‘poor sleep’ among patients with multiple sclerosis: An independent predictor of mental and physical status. Sleep Medicine, 10(1), 26–34.CrossRef
48.
go back to reference Fernández, O., Baumstarck-Barrau, K., Simeoni, M.-C., Auquier, P., & MusiQoL study group. (2011). Patient characteristics and determinants of quality of life in an international population with multiple sclerosis: Assessment using the MusiQoL and SF-36 questionnaires. Multiple Sclerosis Journal, 17(10), 1238–1249.CrossRef Fernández, O., Baumstarck-Barrau, K., Simeoni, M.-C., Auquier, P., & MusiQoL study group. (2011). Patient characteristics and determinants of quality of life in an international population with multiple sclerosis: Assessment using the MusiQoL and SF-36 questionnaires. Multiple Sclerosis Journal, 17(10), 1238–1249.CrossRef
49.
go back to reference Motl, R. W., McAuley, E., Snook, E. M., & Gliottoni, R. C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health & Medicine, 14(1), 111–124.CrossRef Motl, R. W., McAuley, E., Snook, E. M., & Gliottoni, R. C. (2009). Physical activity and quality of life in multiple sclerosis: Intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health & Medicine, 14(1), 111–124.CrossRef
50.
go back to reference Motl, R. W., & Sandroff, B. M. (2015). Benefits of exercise training in multiple sclerosis. Current Neurology and Neuroscience Reports, 15(9), 62.CrossRef Motl, R. W., & Sandroff, B. M. (2015). Benefits of exercise training in multiple sclerosis. Current Neurology and Neuroscience Reports, 15(9), 62.CrossRef
Metagegevens
Titel
Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan
Auteurs
Stephanie L. Silveira
Katie L. J. Cederberg
Brenda Jeng
E. Morghen Sikes
Brian M. Sandroff
Catherine D. Jones
Robert W. Motl
Publicatiedatum
05-11-2020
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 4/2021
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02689-x