The Mediating Role of Sense of Coherence in the Relationship between Perceived Stress with Fatigue and Pain in Multiple Sclerosis Patients

Fatigue and pain are the common complications in multiple sclerosis patients, which is influenced by the patients’ psychology as well as stress. The current study aimed at investigating protective mediating role of sense of coherence in the relationship between perceived stress and fatigue/pain in Iranian MS patients.

This cross-sectional study was carried out in 2019. The study population consisted of patients registered in Iranian MS association of Tehran, Karaj, and Qom cities. The sample was recruited via convenience sampling method in multi-center fashion form MS centers in Tehran, Karaj, and Qom cities. In total, 452 patients with a mean age of 38.45 (9.36) engaged in the study. Orientation to Life Questionnaire (OLQ-13, Antonovsky, 1978), Perceived Stress Scale (PSS, Cohen et al., 1983), and Visual Analogue Scale for fatigue and pain (VAS-F and VAS-P, Hayes and Patterson, 1921) were investigated. The mediation analysis was carried out via PROCESS macro for SPSS software application in 95% confidence interval.

Pain and fatigue showed significant positive and negative relationships, respectively, with perceived stress and sense of coherence (P < .001). Sense of coherence could reduce a quarter of the total effect of perceived stress on fatigue and pain; however, the results remained significant in the presence of gender, education, employment status, and illness duration only for fatigue (indirect effect = -0.07, [0.01, 0.14]).

Sense of coherence reduces the effect of perceived stress on fatigue, while it does not affect the relationship between perceived stress and pain in MS patients.