Relationship of Leisure Time Activities With Fatigue and Mental Health Problems in People With Multiple Sclerosi

 One of the essential aspects of life in patients with Multiple Sclerosis (MS) is leisure time activities. One of the duties of occupational therapists is the evaluation and implementation of therapeutic interventions in the field of leisure for patients with neurological disorders such as MS. However, before presenting any intervention for increasing the ability of MS patients to spend their leisure time, it is necessary to study the concept of this field scientifically and systematically and identify and evaluate the factors affecting it. Many symptoms of MS, such as fatigue and mental health problems, may affect leisure activities. This study examines the relationship of leisure time activities with fatigue and mental health problems (stress, anxiety, and depression) in MS patients.

 This research is a cross-sectional study. The study population consisted of all MS patients referred to Imam Khomeini Clinic, Mobasher Kashani Hospital, and MS Association in Hamadan City, Iran, in 2019. Of them, 99 (70 women, 29 men) with a Mean±SD age of 32.28±8.26 years were selected by using a convenience sampling method and based on the inclusion and exclusion criteria. For data collection, we used the MS leisure questionnaire, Fatigue Severity Scale (FSS), Visual Analog Fatigue Scale (VAFS), Expanded Disability Status Scale (EDSS), and Depression-Anxiety-Stress Scale (DASS). After obtaining written informed consent from the patients, the study questionnaires were completed by them. The collected data were analyzed in SPSS v. 16. The Spearman correlation test was used to examine the relationship of leisure time activities with fatigue and mental health problems. 

 There was a significant relationship between leisure activities and fatigue tests of VAFS (P=0.003) and FSS (P=0.001). Fatigue showed a high negative correlation with all leisure domains (r=0.350, P=0.001) of difficult, social, spiritual/religious, out-of-home physical, and art/cultural activities and reduced them. The overall score of DASS was significantly correlated with leisure time spiritual/religious activity (r= -0.263), out-of-home physical activity (r= -0.213) and art/cultural activity (r= -0.205). Regarding its subscales, anxiety showed a significant correlation only with leisure time social activities (r= -0.259), stress with spiritual/religious activities (r= -0.212), and depression with all domains of leisure time activities except for difficult activities (P≤0.005)

 Leisure time activities are associated with fatigue and mental health problems (stress, anxiety, and depression) in MS patients. Stress and anxiety only affect their leisure time social activities. Fatigue or mental health problems can reduce the amount of leisure time.