Determinants of self-management in Multiple Sclerosis: Insights from a Tunisian cross-sectional study

People living with Multiple Sclerosis (MS) face numerous challenges in their daily lives. To cope with these difficulties and maintain an optimal quality of life, several strategies are employed, including self-management. This study aimed to assess self-management among Tunisian people with MS and identify associated factors.

A descriptive cross-sectional study on people with MS was conducted in the department of Neurology -Razi University Hospital-Tunisia. Self-management was assessed using the Multiple Sclerosis Self-Management Scale-Revised (MSSM-R), with scores ranging from 24 to 120, where higher scores indicate better self-management capabilities. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS), personality traits were evaluated using the Big Five Inventory with 10 items (BFI-10), and stigma was assessed with the Stigma Scale for Chronic Illness with 8 items (SSCI-8). A multiple linear regression model was used to identify independent associated variables of the total MSSM-R score.

The study included 100 MS patients: 72 women and 28 men with a mean age=34.23years ± 10.29. The mean MSSM-R score was 96.62 ± 9.83. Depression (β =-0.867, p = 0.023), anxiety (β= -0.743, p = 0.04), agreeableness(β = 1.385, p = 0.031), neuroticism(β = -0.634, p = 0.042), and second-line treatment(β = 1.295, p = 0.049) were significantly associated with self-management in the multivariate analysis. No significant association was found with stigma (r =-0.129, p = 0.2).

The level of self-management among Tunisian people with MS was high. The type of disease-modifying therapy may affect self-management abilities, potentially by shaping patients' perception of their illness.Psychological well-being and personality traits represent important targets for interventions aimed at improving MS self-management.