Self-management in multiple sclerosis patients and evaluation of the factors affecting self-management

Multiple sclerosis is a chronic, inflammatory, autoimmune and neurodegenerative disease that progresses with demyelination and axonal damage in the central nervous system. There is a large spectrum of clinical symptomatology including motor, sensational, visual, cognitive, genitourinary and neuropsychiatric aspects. The cognitive reserve has a protecting role on cognitive functions, furthermore positive effects on the global and focal brain atrophy processes. It can be defined as coping with the consequences of the demiyelinating pathology or capability of using cognitive strategies. Self-management which is one of the most prominent strategies during chronic illness period, involves orientation to clinical symptoms, therapy, physical and psychosocial outcomes. The aim of our study is to assess the relationships between self management, disability, cognition, cognitive reserve, fatique and quality of life. Participants consist of 79 patients that have been followed up in our demiyelinating clinic recruited through inclusion criteria in our cross-sectional designed study. Sociodemographic and Clinical Data, Beck Depression Inventory, Modified Fatique Impact Scale, Multiple Sclerosis Self-Management Scale, EuroQol Quality of Life Inventory, The Brief Repeatable Battery of Neuropsychological Test were applied and EDSS, Timed 25-Foot Walk, 9-Hole Peg Test scores were calculated. While 92.4% of our patients have normal cognition according to BRB-N, 7.6% have cognitive deficit whose ages were detected higher at diagnosis. Although the subtests of BRB-N do not have statistical significance, SDMT was found to have positive correlation. Multiple Sclerosis Self-Management Scale scores have negative relationship with EDSS, Modified Fatique Impact Scale, Beck Depression Inventory and disease duration, on the other hand positive correlation with EuroQol. In order to improve evidence based methods related to self-management in multiple sclerosis patients, multicenter studies that investigate cognitive, physical, psychosocial and demographic parameters would be worthwhile. Keywords: Multiple sclerosis, self management, cognition, cognitive reserve, quality of life