The Effects of Family Function and Disability on Perceived Self-Efficacy in Multiple Sclerosis: Self-Efficacy Function and Self-Efficacy Control

Background: Self-efficacy has been shown to be a strong predictor of both psychological and general well-being. Multiple sclerosis (MS) and its accompanying disability can strongly affect a patient’s feelings of self-efficacy. The construct of self-efficacy is a composite of a number of beliefs and emotions relating to self-perception and there are a number of ways in which an illness such as MS can affect self-perception. One distinction is that of self-efficacy function the belief in one’s ability to take care of daily needs and self-efficacy control the extent to which a patient feels in control of his or her life. It appears that MS differentially effects se-function more than se-control but the mechanisms for this differential effect are unknown.

Objectives: Compare the scores of MS patients on items of se-function and se-control and examine whether the factors of disability and family function may differentially affect the two scales.

Methods: 79 patients with confirmed MS were given measures of disease severity and self-esteem (the Multiple Sclerosis Self-Efficacy Scale [MSSE])¹  as well as a measure of MS disability. Both patients and their family members completed the McMaster Family Assessment Device (FAD)² a measure of perceived family function. The MMSE offers measurements on the two subscales of se-function and se-control. Pearson r correlations were run to determine the relationship of disability and family function to general self-efficacy as well as to the subscales of se-control and se-function.

Results: Self-efficacy function was more elevated (i.e. worse) than se-control in a manner consistent with other research in MS (se-function- Mean=658.1, SD=232.6; se-control- Mean=500.7, SD=182.4). Disability (r=-.724, p<.001), and family function (r=.354, p=.002) were both significantly correlated with overall MS self-efficacy. Disability was similarly correlated to both se-function (r= -.642, p<.001) and se-control (r= -.634, p<.001). Family function was also correlated with both se-function (r= -.324, p=.004) and se-control (r= -.313, p=.006).

Conclusions: MS has a deleterious effect on patient self-efficacy both in patient perception of functional ability (se-function) as well as in patient perception of personal locus of control (se-control). While both disability and family functioning are significantly related to self-efficacy neither would suggest an explanation for the difference between se-function and se-control in MS.