Mediating Role of Sense of Coherence in the Relationship of Perceived Stress with Fatigue and Pain in Multiple Sclerosis Patients

Abstract

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