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

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Abstract
To examine the impact of perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients. Cross-sectional survey. Department of Neurology, University Medical Center Groningen, the Netherlands. Multiple sclerosis patients. World Health Organization Quality of Life – abbreviated version, Stigma Scale for Chronic Illness, Sense of Coherence Scale, background and disease-related questions. In total, 185 patients (61% response rate) participated in the study with moderate to severe limitations. Stigma was highly prevalent but low in severity. Patients with a higher sense of coherence experienced a lower level of limitations (B = −0.063, P < 0.01) and less stigma (enacted stigma B = −0.030, P < 0.01; self-stigma B = −0.037, P < 0.01). Patients with a higher level of limitations experienced more stigma (enacted stigma B = 0.044, P < 0.05; self-stigma B = 0.063, P < 0.01). Patients with a higher sense of coherence experienced better quality of life (physical health B = 0.059, P < 0.01; psychological health B = 0.062, P < 0.01; social relationships B = 0.052, P < 0.01; environmental aspects B = 0.030, P < 0.01). Patients with a higher level of limitations experienced poorer quality of life (physical health B= −0.364, P < 0.01; psychological health B = −0.089, P< 0.05) and patients with more stigma also experienced poorer quality of life (self-stigma: physical health B = −0.073, P < 0.01; psychological health B = −0.089, P < 0.01; social relationships B = −0.124, P < 0.01; environmental aspects B = −0.052, P < 0.01, and enacted stigma: physical health B = −0.085, P < 0.10). Patients with less perceived limitations and stigma and a higher level of sense of coherence experienced better quality of life. Patients with a higher sense of coherence experienced a lower level of limitations and less stigma.

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