Article

OBJECTIVE: To examine the relative association between daily change in pain,
fatigue, depressed mood, and cognitive function and 4 outcomes-positive affect
and well-being, ability to participate in social roles and activities, upper
extremity (UE) functioning, and lower extremity (LE) functioning. DESIGN: Data
analysis, multilevel mixed modeling. SETTING: General community. PARTICIPANTS:
Ambulatory adults (N=102) with multiple sclerosis. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Customized short-forms of the Quality of Life in
Neurological Disorders positive affect and well-being, UE functioning, and LE
functioning item banks and the Patient-Reported Outcomes Measurement Information
System ability to participate in social roles and activities item bank adapted
for daily use and administered as end-of-day diaries. RESULTS: Above and beyond
the effects of demographic and clinical covariates, daily pain was associated
with 3 of the 4 outcomes; days of higher than usual pain were related to lower
same-day social participation (unstandardized beta, B=-1.00; P=.002), UE
functioning (B=-1.04; P=.01), and LE functioning (B=-.71; P=.04). Daily fatigue
and depressed mood were independently related to daily positive affect and
well-being; days of worse fatigue (B=-.54; P=.006) and depressed mood (B=-1.17;
P<.0001) were related to lower same-day well-being. CONCLUSIONS: The results
indicate the role of fluctuations in symptoms in daily functioning and quality of
life of individuals with multiple sclerosis. Daily increases in pain intensity
are related to social and physical functioning, whereas increases in fatigue and
depressed mood are related to lower daily well-being. Findings implicate a
person-centered approach to monitoring and treating symptoms.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS