[Home ] [Archive]   [ فارسی ]  
:: ::
:: Volume 14, Issue 11 (January 2021) ::
Qom Univ Med Sci J 2021, 14(11): 38-47 Back to browse issues page
Mediating Role of Sense of Coherence in the Relationship of Perceived Stress with Fatigue and Pain in Multiple Sclerosis Patients
Samira Zarrabi-Ajami1 , Hadi Zamanian 2, Adis Kraskian Mujembari1 , Sara Pashang1
1- Department of Psychology, School of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.
2- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran. , zamanian@alumnus.tums.ac.ir
Abstract:   (2008 Views)
Background and Objectives: Fatigue and pain are the common complications in patients suffering from multiple sclerosis (MS), which is influenced by the patients’ psychological status as well as stress. The current study aimed at investigating the protective mediating role of sense of coherence in the relationship of perceived stress with fatigue and pain in Iranian MS patients.
Methods: This cross-sectional study was carried out in 2019. The study population consisted of patients who were members of the Iranian MS association in Tehran, Karaj, and Qom, Iran. The sampling was performed via the convenience sampling method using a multi-center design in MS centers in Tehran, Karaj, and Qom, Iran. In total, 452 patients with a mean age of 38.45±9.36 years were included in the study. The data were collected using the Orientation to Life Questionnaire (OLQ-13, Antonovsky, 1978), Perceived Stress Scale (PSS, Cohen et al., 1983), and Visual Analogue Scale for fatigue and pain (VAS-F and VAS-P, Hayes and Patterson, 1921). The mediation analysis was carried out via PROCESS macro in SPSS software. A p-value less than 0.05 was considered statistically significant.
Results: Pain and fatigue showed significant positive and negative relationships with perceived stress and sense of coherence, respectively (P<.001). Furthermore, the sense of coherence could reduce 25% of the total effect of perceived stress on fatigue and pain; however, the results remained significant in the presence of gender, education level, employment status, and illness duration only for fatigue (indirect effect = -0.07, [0.01, 0.14]).
Conclusion: Sense of coherence reduces the effect of perceived stress on fatigue in MS patients. However, it does not affect the relationship between perceived stress and pain among these patients.
Keywords: Fatigue, multiple sclerosis, pain, sense of coherence
Full-Text [PDF 813 kb]   (676 Downloads)    
Type of Study: Original Article | Subject: روانشناسی
Received: 2021/01/27 | Accepted: 2021/02/14 | Published: 2021/01/29
1. 1. Miller A. Handbook of relapsing-remitting multiple sclerosis. Berlin, Germany: Springer; 2017. Link [DOI:10.1007/978-3-319-40628-2]
2. Azami M, YektaKooshali MH, Shohani M, Khorshidi A, Mahmudi L. Epidemiology of multiple sclerosis in Iran: a systematic review and meta-analysis. PLoS One 2019;14(4):e0214738. DOI: 10.1371/journal.pone.0214738 [DOI:10.1371/journal.pone.0214738]
3. Mahdizadeh A, Lokzadeh S, Riyahi A, Hosseini SA, Jalili N. The Investigation of factors affecting the gait of the patients suffering from multiple sclerosis. Arch Rehabil 2019;20(1):64-73. (In Persian) Link [DOI:10.32598/rj.20.1.64]
4. Yilmazer C, Lamers I, Solaro C, Feys P. Clinical perspective on pain in multiple sclerosis. Mult Scler 2020;3:1352458520952015. DOI: 10.1177/1352458520952015 [DOI:10.1177/1352458520952015]
5. Barzegar M, Badihian S, Mirmosayyeb O, Ashtari F, Jamadi M, Emami S, et al. Comparative study of quality of life, anxiety, depression, and fatigue among patients with neuromyelitis optica spectrum disorder and multiple sclerosis: the first report from Iran. Mult Scler Relat Disord 2018;22:161-5. DOI: 10.1016/j.msard.2018.04.009 [DOI:10.1016/j.msard.2018.04.009]
6. Schreurs KM, de Ridder DT, Bensing JM. Fatigue in multiple sclerosis: reciprocal relationships with physical disabilities and depression. J Psychosom Res 2002;53(3):775-81. DOI: 10.1016/s0022-3999(02)00326-4 [DOI:10.1016/S0022-3999(02)00326-4]
7. Van Kessel K, Moss-Morris R. Understanding multiple sclerosis fatigue: a synthesis of biological and psychological factors. J Psychosom Res 2006;61(5):583-5. DOI: 10.1016/j.jpsychores.2006.03.006 [DOI:10.1016/j.jpsychores.2006.03.006]
8. Trojan DA, Arnold D, Collet JP, Shapiro S, Bar-Or A, Robinson A, et al. Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors. Mult Scler 2007;13(8):985-95. DOI: 10.1177/1352458507077175 [DOI:10.1177/1352458507077175]
9. Nwoke MB, Onuigbo EN, Odo VO. Social support, self-efficacy and gender as predictors of reported stress among inpatient caregivers. Soc Sci J 2017;54(2):115-9. DOI: 10.1016/j.soscij.2016.08.001 [DOI:10.1016/j.soscij.2016.08.001]
10. Turner AP, Alschuler KN. Anxiety is more important than depression in MS - No. Mult Scler 2018;24(4):442-4. DOI: 10.1177/1352458517748477 [DOI:10.1177/1352458517748477]
11. Kale N, Agaoglu J, Tanik O. Neuropsychiatric manifestations in multiple sclerosis: correlation of fatigue and depression with disease progression. Neurol Res 2010;32(2):221-3. DOI: 10.1179/174313209X455664 [DOI:10.1179/174313209X455664]
12. Beier M, Amtmann D, Ehde DM. Beyond depression: predictors of self-reported cognitive function in adults living with MS. Rehabil Psychol 2015;60(3):254-62. DOI: 10.1037/rep0000045 [DOI:10.1037/rep0000045]
13. Eriksson M. The sense of coherence in the salutogenic model of health. In: Mittelmark MB, Sagy S, Eriksson M, Bauer GF, Pelikan JM, Lindstrom B, et al, editors. The handbook of salutogenesis. Berlin, Germany: Springer; 2017. P. 91-6. Link
14. Mittelmark M, Sagy S, Eriksson M, Bauer G, Pelikan J, Lindstrom B, et al. The sense of coherence and its measurement. In: Mittelmark MB, Sagy S, Eriksson M, Bauer GF, Pelikan JM, Lindstrom B, et al, editors. The handbook of salutogenesis. Berlin, Germany: Springer; 2017. P. 97-106. Link [DOI:10.1007/978-3-319-04600-6]
15. Jakovljevic M. Empathy, sense of coherence and resilience: bridging personal, public and global mental health and conceptual synthesis. Psychiatr Danub 2018;30(4):380-4. DOI: 10.24869/psyd.2018.380 [DOI:10.24869/psyd.2018.380]
16. Ytterberg C, Johansson S, Holmqvist LW, von Koch L. Longitudinal variations and predictors of increased perceived impact of multiple sclerosis, a two-year study. J Neurol Sci 2008;270(1-2):53-9. DOI: 10.1016/j.jns.2008.01.014 [DOI:10.1016/j.jns.2008.01.014]
17. Schaefer LM, Poettgen J, Fischer A, Gold S, Stellmann JP, Heesen C. Impairment and restrictions in possibly benign multiple sclerosis. Brain Behav 2019;9(4):e01259. DOI: 10.1002/brb3.1259 [DOI:10.1002/brb3.1259]
18. Broersma F, Oeseburg B, Dijkstra J, Wynia K. The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study. Clin Rehabil 2018;32(4):536-45. DOI: 10.1177/0269215517730670 [DOI:10.1177/0269215517730670]
19. Johansson S, Ytterberg C, Hillert J, Widén Holmqvist L, von Koch L. A longitudinal study of variations in and predictors of fatigue in multiple sclerosis. J Neurol Neurosurg Psychiatry 2008;79(4):454-7. DOI: 10.1136/jnnp.2007.121129 [DOI:10.1136/jnnp.2007.121129]
20. Hyphantis TN, Tsifetaki N, Siafaka V, Voulgari PV, Pappa C, Bai M, et al. The impact of psychological functioning upon systemic sclerosis patients' quality of life. Semin Arthritis Rheum 2007;37(2):81-92. DOI: 10.1016/j.semarthrit.2007.03.008 [DOI:10.1016/j.semarthrit.2007.03.008]
21. Koenig HG, Cohen HJ. Psychological stress and autoimmune disease. The link between religion and health: psychoneuroimmunology and the faith factor. Oxford, England: Oxford University Press; 2010. Link
22. Schönbrodt FD, Perugini M. At what sample size do correlations stabilize? J Res Pers 2013;47(5):609-12. DOI: 10.1016/j.jrp.2013.05.009 [DOI:10.1016/j.jrp.2013.05.009]
23. Antonovsky A. The structure and properties of the sense of coherence scale. Soc Sci Med 1993;36(6):725-33. DOI: 10.1016/0277-9536(93)90033-z [DOI:10.1016/0277-9536(93)90033-Z]
24. Rohani C, Khanjari S, Abedi HA, Oskouie F, Langius-Eklöf A. Health index, sense of coherence scale, brief religious coping scale and spiritual perspective scale: psychometric properties. J Adv Nurs 2010;66(12):2796-806. DOI: 10.1111/j.1365-2648.2010.05409.x [DOI:10.1111/j.1365-2648.2010.05409.x]
25. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24(4):385-96. Link [DOI:10.2307/2136404]
26. Ghorbani N, Watson PJ, Bing MN, Davison HK, LeBreton D. Two facets of self-knowledge: cross-cultural development of measures in Iran and the United States. Genet Soc Gen Psychol Monogr 2003;129(3):238-68. Link
27. Cohen S. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health: claremont symposium on applied social psychology. Newbury Park, CA: Sage Publications, Inc.; 1998. P. 31-67. Link
28. Lee EH. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res (Korean Soc Nurs Sci) 2012;6(4):121-7. DOI: 10.1016/j.anr.2012.08.004 [DOI:10.1016/j.anr.2012.08.004]
29. Sung YT, Wu JS. The visual analogue scale for rating, ranking and paired-comparison (VAS-RRP): a new technique for psychological measurement. Behav Res Methods 2018;50(4):1694-715. DOI: 10.3758/s13428-018-1041-8 [DOI:10.3758/s13428-018-1041-8]
30. Kim HY. Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis. Restor Dent Endod 2013;38(1):52-4. DOI: 10.5395/rde.2013.38.1.52 [DOI:10.5395/rde.2013.38.1.52]
31. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. 2nd ed. New York: Guilford Publications; 2017. Link
Send email to the article author

Add your comments about this article
Your username or Email:


XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Zarrabi-Ajami S, Zamanian H, Kraskian Mujembari A, Pashang S. Mediating Role of Sense of Coherence in the Relationship of Perceived Stress with Fatigue and Pain in Multiple Sclerosis Patients. Qom Univ Med Sci J 2021; 14 (11) :38-47
URL: http://journal.muq.ac.ir/article-1-3046-en.html

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 14, Issue 11 (January 2021) Back to browse issues page
مجله دانشگاه علوم پزشکی قم Qom University of Medical Sciences Journal
Persian site map - English site map - Created in 0.07 seconds with 30 queries by YEKTAWEB 4547