Predictors of fatigue self-management behaviors in adults with multiple sclerosis

Abstract

BACKGROUND: Fatigue is one of the most common and disabling symptoms in people with multiple sclerosis (MS). Fatigue self-management behaviors may be effective in reducing the impact of fatigue in people with MS. However, few studies have examined the factors that influence engagement in fatigue self-management behaviors. OBJECTIVE: Identify factors that directly and indirectly influence fatigue self-management behaviors. METHODS: Participants with MS (n=287) completed online questionnaires at baseline and 6-weeks. Guided by the Self-and Family Management Framework, we examined the influence of health status, resources and environment, healthcare utilization, and self-management processes on fatigue self-management behaviors at 6-weeks. Multiple regression and path analyses were conducted. RESULTS: The final regression model variables accounted for 41.58% of the variance in fatigue self-management behaviors, which included outcome expectations (β=0.287), disability (β=0.265), environmental barriers (β=0.188), self-efficacy (β=0.153), symptom severity (β=0.113), living in an urban community (β=-0.108), and living alone (β=0.103). Path analysis indicated that outcome expectations may mediate the relationship between disability levels and fatigue self-management behavior. CONCLUSIONS: Health status (i.e., disability and symptom severity), environmental factors (e.g., living situation), and self-management processes (i.e., self-efficacy and outcome expectations) may play an important role in influencing engagement in fatigue self-management behaviors.