Examining psychosocial factors affecting the coping strategies of MS patients in Hamedan

Dissertation to receive a master's degree in the field of social sciences - sociology

Abstract:

Multiple sclerosis is a chronic and progressive neurological disease that occurs as a result of a combination of environmental factors (such as mental pressure or stress) or genetics. The age of the disease is about 20 to 40 years, but it can develop at any age. Amas usually has periods of relapse and remission, and a high percentage of people with this disease suffer from this condition. In general, the occurrence of symptoms is unpredictable and its causes are unknown, so it is necessary for these patients to cope with their disease and adapt. Coping is defined as active or passive behavioral and cognitive efforts in response to stressful situations and in order to master the challenges resulting from the disease and also reduce its negative effects. Therefore, in this research, the effect of various psychosocial factors on coping strategies in MS patients is examined. Materials and methods: The present study is a descriptive-analytical study and the research population includes all women and men suffering from emas and members of the emas association of Hamedan city. In this research, the sampling method was done by available method and 252 people participated in this study. In order to collect data, Lazarus and Folkman's standard coping strategies questionnaire, Khodapanahi's social support questionnaire, Scherer et al.'s self-efficacy questionnaire, as well as the social relationship network and disease perception questionnaire adapted from Rezai Dadgar's research were used. Data analysis was done using SPSS software. Kruskal-Wallis statistical tests, Mann-Whitney test and Spearman's correlation coefficient test were used to determine the relationship between the research variables due to the non-normality of the data distribution. Findings: The results of the Kruskal-Wallis test showed that there is a significant relationship between the socio-economic base and coping strategies, so that patients with a high and medium socioeconomic base use the problem-oriented coping style, but patients with a low socioeconomic base use the emotion-oriented coping strategy. And the results of the Spearman correlation coefficient test indicated a significant positive relationship between the network of social relationships, social support, self-efficacy, and disease perception with problem-oriented coping strategies and an inverse relationship with emotion-oriented coping strategies. Key words: multiple sclerosis, social support, social relationship network, self-efficacy, disease perception, coping strategies. Introduction: Medical and health sociology are branches of sociology and It is one of the newest specialized fields, in which issues such as health, illness and medical care are analyzed from a sociological point of view. Researching the effect of diseases on human groups and how to defend against it is an interesting topic for sociology. The distribution of diseases among humans is different, and knowledge and awareness of the disease takes place within the framework of cultural patterns. Due to the intervention of social factors and conditions in the path and flow of treatment, social sciences are involved with medicine and healthcare and the emergence of the field of medical sociology becomes necessary (Mohsani, 1368: 1-2). Illness, transformation and performance of health care institutions and the development of social policies affect (Masoudnia, 2009: 28). Every disease does not only involve the medical institution, but also affects several social levels such as family or professions. The historical course of diseases, the evolution of medical science, the study of health conditions and its social determinants, cultural and social interpretations of health and disease, doctor-patient relationships, and the study of hospital conditions are among the topics studied in medical sociology (Philip [3]; Claudine [4]; Katabi, 1385: 3).

Chronic diseases affect all periods of life, so that they affect not only the elderly but also very young and middle-aged people. Although some of these diseases have little effect on the quality of life, most of them often cause significant effects on the quality of life of people due to the disabilities they leave behind (Smeltzer [5] et al., 2002; quoted by Hazrati et al., 2014).Chronic diseases such as MS are a threat to the social network of affected people. MS relapses challenge the coping mechanisms of the patient and his family. The effects of these returns affect people's family members, friends, the world of work and education, and the larger society. Family members and people in the patient's social or professional networks may feel guilt, anxiety, and other negative emotions in response to these relapses. Stigma is sometimes associated with chronic illness, and disability is a constant stressor for patients and their families. Also, this disease may threaten the long-term plans, hope for the future and overall security of the person (Halper [6], 2007).

As chronic diseases have no definitive treatment and have a relatively long period, it is necessary for patients to live with the limitations imposed by their conditions. The study on coping with chronic diseases and social support for chronic patients, which has increased greatly during the last 15 years, shows that in many cases, stressful factors are associated with chronic diseases and make patients dependent on getting support from their social environment. In addition to these studies, they have shown that both coping and social support have an independent effect on the health of chronic patients (Kerlin[7] et al., 1997).

Multiple Sclerosis[8] (MS) was first described in 1868 by Jicherkote[9], a professor at the University of Paris, who is called the father of neurology[10] (Cherkote, 1868; quoted by Ahmadzadeh Raji and colleagues, 1390). After him, Eugen Deus[11] (1858-1930), Joseph Ballou[12] (1895-1979) and Paul Ferdinand Schilder[13] (1886-1940) also described cases of the disease. This disease was named multiple sclerosis in 1995 (Compston[14], 2008; cited in the same). Despite numerous treatments, this disease is one of the most debilitating diseases that affects various aspects of a person's life, especially the quality of life related to health in patients with moderate and advanced form is generally low and this causes a lot of depression in them (Kesselring [15]; 2000; quoted by Hossein Madani et al., 2014). It seems that coping methods are effective in coping with multiple sclerosis and especially problem-oriented coping methods have a great positive effect on coping with the disease (O'Brien[16], 1993; quoted by Madani et al., 2014). In this way, in this research, some psycho-social factors affecting the coping strategies of these patients are examined.

This research is compiled in five chapters, the first chapter is related to generalities (introduction, statement of the problem, the importance and necessity of the research, and the questions and objectives of the research), the second chapter includes the background of the research and the theoretical literature of the research. In the third chapter, we talk about the research method and how to analyze the data, in the fourth chapter, the data is analyzed, and in the fifth chapter, the results and suggestions are presented. Health is a necessary condition for fulfilling social roles and people can be fully active if they feel healthy and society considers them healthy (Mohsani, 1368).

One of the debilitating neurological disorders is Multiple Sclerosis [17] (MS), which, in addition to neuro-motor disorders, presents with symptoms such as anxiety, weakness, and reduced problem-solving ability, and causes numerous physical and mental disorders. Amas is a chronic and debilitating disease of the nervous system, in which the myelin of the central nervous system (brain and spinal cord) is destroyed, and after that, the muscle part of the body gradually loses its ability. Amas lesions after trauma are the second most common cause of neurological disability in early and middle adulthood, and its manifestations vary from a benign disease to a rapidly progressive and debilitating disease (Harrison[18]; cited by Maybodi, 2014). This disease occurs as a result of a combination of environmental factors (such as emotional or stressful), genetic and autoimmune factors. The age of onset of this disease is around 18-35 years old, but it can develop at any age (McKown[19] et al., 2003; quoted by Bastani et al., 2017).