Document Type : Original Article
Authors
- Vahid Shaygannejad 1
- Omid Mirmosayyeb 1
- Aysa Shaygannejad 2
- Saeed Vaheb 2
- Sara Bagherieh 2
- Mozhdeh Askari 2
- Mahsa Ghajarzadeh 3
1 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), University of Tehran, Tehran, Iran
Abstract
Background: Social support and anxiety are essential for patients with chronic diseases such as multiple sclerosis (MS). During coronavirus disease 2019 (COVID-19) pandemic, the psychological well-being of subjects with MS was an important issue, and we designed this study to assess anxiety, resilience, and social support in these patients during COVID-19 pandemic stage.
Methods: We used convenience sampling for this study. Inclusion criteria were definite diagnosis of MS based on McDonald criteria and age more than 18 years. Two hundred patients with MS were enrolled. Subjects were asked to fill out valid and reliable Persian versions of Connor-Davidson Resilience Scale (CD-RISC), Beck Anxiety Inventory (BAI), and Perceived Social Support Scale. We also collected demographic data (age, sex, marital status, and occupation), disease duration, and disability level [Expanded Disability Status Scale (EDSS)]. Continuous variables were presented as mean ± standard deviation (SD) (except for EDSS, as its distribution was not normal), and categorical variables were presented as frequencies. Correlation coefficients were calculated. We did a subgroup analysis and compared patients with BAI less than 30 and more than 30 (severe anxiety). A P-value less than 0.05 was considered significant.
Results: Mean age and mean duration of the disease were 36.5 ± 9.3 and 6.2 ± 5.4 years, respectively.
Mean BAI, social support, and resilience scores were 33.8 ± 11.4, 65.7 ± 16.7, and 62.5 ± 19.4, respectively. There was a significant positive correlation between resilience and social support scales (r = 0.44, P < 0.001), and also a significant negative correlation between resilience and BAI (r = -0.31, P < 0.001). Patients with severe anxiety (BAI > 30) had lower social support scores and resilience (social support: 70.3 ± 13.1 vs. 61.5 ± 18.6, P < 0.001; resilience: 57.3 ± 17.0 vs. 68.2 ± 19.6, P < 0.001) compared to patients with BAI ≤ 30. By considering resilience score as the dependent variable and other variables as independent variables, we found that BAI and social support scores were independent predictors.
Conclusion: Social support and anxiety are independent predictors of resilience during COVID-19 pandemic in patients with MS.
Keywords
- Ghajarzadeh M, Bonavita S. Are patients with multiple sclerosis (MS) at higher risk of COVID-19 infection? Neurol Sci 2020; 41(9): 2315-6.
- Mirmosayyeb O, Shaygannejad V, Bagherieh S, Hosseinabadi AM, Ghajarzadeh M. Prevalence of multiple sclerosis (MS) in Iran: A systematic review and meta-analysis. Neurol Sci 2022; 43(1): 233-41.
- Moghadasi AN, Mirmosayyeb O, Barzegar M, Sahraian MA, Ghajarzadeh M. The prevalence of COVID-19 infection in patients with multiple sclerosis (MS): A systematic review and meta-analysis. Neurol Sci 2021; 42(8): 3093-9.
- Santangelo G, Sacco R, Siciliano M, Bisecco A, Muzzo G, Docimo R, et al. Anxiety in multiple sclerosis: Psychometric properties of the State-Trait Anxiety Inventory. Acta Neurol Scand 2016; 134(6): 458-66.
- Askari F, Ghajarzadeh M, Mohammadifar M, Azimi A, Sahraian MA, Owji M. Anxiety in patients with multiple sclerosis: Association with disability, depression, disease type and sex. Acta Med Iran 2014; 52(12): 889-92.
- Bonavita S, Sparaco M, Russo A, Borriello G, Lavorgna L. Perceived stress and social support in a large population of people with multiple sclerosis recruited online through the COVID-19 pandemic. Eur J Neurol 2021; 28(10): 3396-402.
- Shaygannejad V, Mirmosayyeb O, Nehzat N, Ghajarzadeh M. Fear of relapse, social support, and psychological well-being (depression, anxiety, and stress level) of patients with multiple sclerosis (MS) during the COVID-19 pandemic stage. Neurol Sci 2021; 42(7): 2615-8.
- Dennison L, Moss-Morris R, Chalder T. A review of psychological correlates of adjustment in patients with multiple sclerosis. Clin Psychol Rev 2009; 29(2): 141-53.
- Nishi D, Uehara R, Kondo M, Matsuoka Y. Reliability and validity of the Japanese version of the Resilience Scale and its short version. BMC Res Notes 2010; 3: 310.
- Luthar SS, Cicchetti D, Becker B. The construct of resilience: A critical evaluation and guidelines for future work. Child Dev 2000; 71(3): 543-62.
- Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17(2): 162-73.
- Connor KM, Davidson JR. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003; 18(2): 76-82.
- Bagherian-Sararoudi R, Hajian A, Ehsan HB, Sarafraz MR, Zimet GD. Psychometric properties of the Persian version of the Multidimensional Scale Of Perceived Social Support in Iran. Int J Prev Med 2013; 4(11): 1277-81.
- Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 2008; 66(2): 136-40. [In Persian].
- Harris TP, Zaeske LM, Ludwig R, Baker S, Lynch S, Thuringer A, et al. Social support predicts sleep quality in people with multiple sclerosis during the COVID-19 pandemic. Mult Scler Relat Disord 2022; 64: 103970.
- Taylor SE. Social support: A review. In: Friedman HS, editor. The Oxford handbook of health psychology. New York, NY: Oxford University Press; 2011. p. 189-214.
- Pearson JE. The definition and measurement of social support. J Couns Dev 1986; 64(6): 390-5.
- Graven LJ, Grant JS. Social support and self-care behaviors in individuals with heart failure: An integrative review. Int J Nurs Stud 2014; 51(2): 320-33.
- Stewart DE, Yuen T. A systematic review of resilience in the physically ill. Psychosomatics 2011; 52(3): 199-209.
- Min JA, Lee CU, Chae JH. Resilience moderates the risk of depression and anxiety symptoms on suicidal ideation in patients with depression and/or anxiety disorders. Compr Psychiatry 2015; 56: 103-11.
- Min JA, Lee NB, Lee CU, Lee C, Chae JH. Low trait anxiety, high resilience, and their interaction as possible predictors for treatment response in patients with depression. J Affect Disord 2012; 137(1-3): 61-9.
- Min JA, Yu JJ, Lee CU, Chae JH. Cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders. Compr Psychiatry 2013; 54(8): 1190-7.
- Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1993; 1(2): 165-78.
- Herrmann D, Scherg H, Verres R, von HC, Strowitzki T, Wischmann T. Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life. J Assist Reprod Genet 2011; 28(11): 1111-7.
- Naser MA. One Aspect of Coronavirus disease (COVID-19) Outbreak in Iran: High anxiety among MS patients. Mult Scler Relat Disord 2020; 41: 102138.
- Stojanov A, Malobabic M, Milosevic V, Stojanov J, Vojinovic S, Stanojevic G, et al. Psychological status of patients with relapsing-remitting multiple sclerosis during coronavirus disease-2019 outbreak. Mult Scler Relat Disord 2020; 45: 102407.
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