The Effects of Family Functioning on Patient Self-Efficacy in Multiple Sclerosis

Background: Perceived self-efficacy has been shown to be a strong predictor of both psychological and general well-being. It is understood that chronic disabling illness such as multiple sclerosis (MS) can potentially impact a patient’s feelings of self-efficacy. It is also understood that family and social support play a crucial role in support of healthy self-efficacy and this is especially so in individuals with considerable disease burden. Little is known regarding the relationship of family function and self-efficacy in MS.

Objectives: To evaluate the effects of family function on the MS patient’s perceived self-efficacy while controlling for disease severity and disability.

Methods: 79 patients with confirmed MS were given measures of disease severity and self-efficacy (the Multiple Sclerosis Self-Efficacy Scale [MSSE])¹ while both patients and their family members completed the McMaster Family Assessment Device (FAD)²as a measure of perceived family function. Hierarchical linear regression analysis was used to determine the effect of family function on perceived self-efficacy while controlling for demographic factors (age, education and income) and disability status.

Results: None of the demographic variables included in the analysis were significant in predicting self-efficacy. Disability status was the largest predictor of MS self-efficacy (beta= -.657, p<.001). Family function was also a significant as a predictor of patient self-efficacy (beta= -.27, p=.002). After entering demographic variables and disability in step 1, the model accounted for 54% of total variance (R²=.536). Model 2 which added family function accounted for an additional 7% (R²Δ= .070).

Conclusions: The variable in MS that most strongly predicts self-efficacy is MS related disability. However, disability alone accounts for only half of the variance in patient self-efficacy pointing to psychological factors as most likely to play an additional role in determining self-efficacy. Family function is one such psychological factor. It is importance therefore for healthcare providers to emphasize family involvement and education in comprehensive treatment for MS patients.