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Clinical trial| Volume 38, 101481, February 2020

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
    Affiliations
    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
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  • C.R. Brown
    Affiliations
    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
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  • G.A. Jelinek
    Affiliations
    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
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  • S.L. Neate
    Affiliations
    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
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  • K.T. Taylor
    Affiliations
    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
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  • W. Bevens
    Affiliations
    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
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  • Author Footnotes
    # Equal contribution
    A.M. De Livera
    Footnotes
    # Equal contribution
    Affiliations
    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
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  • Author Footnotes
    # Equal contribution
    S. Simpson, Jr.
    Footnotes
    # Equal contribution
    Affiliations
    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
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  • Author Footnotes
    # Equal contribution
    T.J. Weiland
    Correspondence
    Corresponding author.
    Footnotes
    # Equal contribution
    Affiliations
    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
    Search for articles by this author
  • Author Footnotes
    # Equal contribution
Published:October 30, 2019DOI:https://doi.org/10.1016/j.msard.2019.101481

      Highlights

      • Mastery is associated with physical and mental HRQOL.
      • Dose dependency exists between mastery quartiles and both physical and mental HRQOL.
      • Mastery is associated with all subscores of both physical and mental HRQOL.
      • Health distress appears to be an important component of HRQOL related to mastery.

      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

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