Variation in the Perception of Family Function in MS and Its Relationship with Patient Self-Efficacy

Background: Family and social support play a crucial role in helping patients with multiple sclerosis (MS) manage the significant practical and psychological burden of living with and caring for their MS. In this way, healthy family function is crucial to MS patients but ironically, MS itself places a great strain on families. It is difficult to measure the effect of MS on patient families and little is known about this important relationship.

Objectives: To measure both patient and family assessment of family function and consider the possible differences in perception and the role of this perception in patient self-efficacy.   

Methods: 79 patients with confirmed MS were given measures of disease severity and self-esteem (the Multiple Sclerosis Self-Efficacy Scale [MSSE])¹ while both patients and their family members completed the McMaster Family Assessment Device (FAD)² as a measure of perceived family function. Pearson r correlations were run to determine the relationship of patient perception and family perception in assessing family function as well as the effects of both of these perceptions on patient perceived self-efficacy.

Results: The cohorts of MS patients and MS family members showed no significant difference in perceived family function; patient Mean=1.916, family Mean=1.922 (on a scale of 1-4 where lower scores imply better function). However, in comparing the ratings of individual MS patients with ratings of their own family members, scores of family members differed from those of patients by a mean of 0.40 (SD in this population is 0.58). Patient and family perceptions of family function were significantly, but only moderately, correlated (r= .54, p<.001). In predicting patient self-efficacy, patient perceived family function was significant (r=-.354, p=.002), while family member’s perception of functioning was only trending significance as a predictor of patient self-efficacy (r= -.202, p=.08)  

Conclusions: Moderate discrepancy between patient perception of family function and family perception is likely. Of the two it is patient perception that is more likely to correlate with poorer self-efficacy outcomes. Thus when considering the role of family and disease burden in MS it is important to distinguish between the experience and perception of patients and that of their families. It is important that healthcare providers be aware of the effects of MS on families both for MS patients as well as for their families.