Social participation, self-esteem and quality of life in people with multiple sclerosis

Abstract

Background The aim of this study is to explore whether self-esteem and social participation are associated with the physical and mental domains of quality of life in people with multiple sclerosis, and whether self-esteem can mediate the association between social participation and health-related quality of life. Methods We collected information from 118 consecutive MS patients (response rate: 76.1%, 72.2% women), who completed the Participation Scale, the Rosenberg Self-Esteem Scale and the Short-Form Health Survey for measuring the physical (PCS) and mental (MCS) components of quality of life. Multiple linear regressions and structural equation modeling were used for statistical analyses. Findings Age, gender, disease duration, functional status (EDSS) and participation were significant predictors of PCS, explaining 55.4% of the variance. No mediating effect of self-esteem was found between participation and PCS. Self-esteem mediated the association between social participation and MCS (Est./S.E.=-4.872; p<0.001), and along with EDSS it explained 48.3% of the variance in MCS. Discussion Self-esteem mediates the association between social participation and MCS, but not PCS, and can be used in intervention and educational programs for patients and their caregivers.