Shifting to the Positive: Findings from the "Resilience Questionnaire in MS"
The concept of resilience is emerging in clinical circles and research literature as an important aspect in the well-being of those living with a chronic illness. Resilience is generally defined as a dynamic process of positive adaptation in the face of adversity, or in other words, the ability to navigate through adversities towards well-being. Although attention has been paid to studying some of the resources (like good coping skills) and vulnerabilities (like depression) that may influence the degree of resilience persons with MS experience, we know little about the broader construct of resilience as it applies to MS.
The aim of this cross-sectional study was to assess resilience amongst persons with MS.
A “Resilience Questionnaire in MS” was created containing a validated, reliable measure of resilience, the Connor-Davidson Resilience Scale (CD-RISC). This widely used scale contains 25 questions for a score ranging from 0 to 100, with higher scores reflecting greater resilience. The questionnaire included several other measures to assess MS disease characteristics, such as the Patient Determined Disease Steps (disability level); clinical aspects, such as the Self-report Comorbidity Questionnaire for MS and Daily Fatigue Impact Scale; as well as psychosocial aspects, such as the Health Utilities Index Mark 3 (health-related quality of life) and Hospital Anxiety and Depression Scale. MS participants were invited to fill out the questionnaire (both online and paper versions were available) via advertisements at 4 MS Clinics in Western Canada, and MS Society of Canada's print and e-newsletters.
302 out of 477 persons with MS (63%) who began the questionnaire completed it in its entirety. The majority were female (79%), married (75%), and had some type of post-secondary schooling (63%). Average age was 48.2 years. The average score on the CD-RISC was 77.7 (range 44.8-100.0), a score higher than some published results for primary care (71.8), psychiatric (68.0), general anxiety (62.4), and post-traumatic stress disorder patient populations (52.8), as well as general populations (71.3). Interestingly, the score was lower than many published results for spinal cord injury (82.2) and diabetes populations (83.1).
Research has clearly demonstrated the prevalence and impact of depression, anxiety, stress, poor coping and lack of social support network on the lives of those with MS. Research now needs to shift to the positive – the prevalence and impact of resilience on the lives of those with MS and how MS researchers and clinicians can strengthen resilience characteristics and capacities. The factors that were found to be associated with resilience in this study will be outlined, and the implications for patient care elucidated.