Effectively managing all the symptoms associated with multiple sclerosis (MS) can be a challenge. One approach is self-management, which helps persons with chronic health conditions become more actively involved in their care. While there is evidence that self-management can be beneficial for persons with MS, little is known on the role that cognitive and psychological functioning play in self-management behaviors.
To examine whether aspects of cognitive and psychological functioning are predictive of self-management behaviors, as measured by the MS Self-Management Scale-Revised (MSSM-R).
Participants (n = 111) were persons with MS who completed a brief neuropsychological battery, including demographics and measures of objective (performance-based) and subjective (self-reported) cognition, personality, emotional symptomatology, determinants of quality of life, and resiliency to MS-related challenges. Variables with a p-value of <.10 in the bivariate analyses were entered into logistic regressions, with the MSSM-R’s five subscales (Healthcare Provider Relationships and Communication, Treatment Adherence/Barriers, Social/Family Support, MS Knowledge and Information, and Health Maintenance Behavior) as individual outcomes.
Self-reported cognition was a significant predictor in several models, with subjective prospective memory predicting Healthcare Provider Relationships and Communication (b = -.19) and Treatment Adherence/Barriers (b = -.41), attention predicting Social/Family Support (b = -.08), and planning/organization predicting Health Maintenance Behavior (b = -.28). Objective prospective memory, on the other hand, was a predictor of MS Knowledge and Information (b = .02). Certain personality traits emerged as predictors: high levels of conscientiousness were associated with Treatment Adherence/Barriers (b = 1.62), as were high levels of openness (b = 1.15) and agreeableness (b = 1.24) with MS Knowledge and Information. Components of resiliency and quality of life were also significant in certain models.
Cognitive functioning plays a significant role in self-reported self-management behaviors, with patients’ subjective report contributing more frequently in the models than their objective performance. Coupled with the involvement of certain personality traits and determinants of resiliency and quality of life in the models, these findings highlight the importance of cognitive and psychological functioning in persons with MS’ self-management abilities.