A TEST OF TWO MODELS DEPICTING THE PROCESS OF ADAPTATION IN PEOPLE WITH MULTIPLE SCLEROSIS.
Contributors: University of Rochester.
Published: 1988
Number of pages: 292
Subjects: Health Sciences, Nursing.; Social Work.; Psychology, Clinical.; Health Sciences, Mental Health.
Description: Two theoretical models, each depicting the process of adaptation in people with multiple sclerosis (MS) were tested in the present research. The more parsimonious model included only demographic, illness-related, and coping variables to explain adaptation, whereas the more complex model incorporated these variables along with intolerance of ambiguity, perceived uncertainty, and cognitive appraisal. Hypotheses were posed within each model based upon the direct and indirect pathways.

Thirty eight men and 80 women with a mean age of 41.4 years were sampled from the outpatient neurology clinics at the University of Rochester Medical Center. Fifty-one subjects now had relapsing-remitting MS, and 67 had had onset of MS as relapsing-remitting, but it was now progressive.

The following instruments were administered during a semi-structured interview: the Intolerance of Ambiguity Scale, the Mishel Uncertainty in Illness Scale, the Appraisal Questionnaire, the Ways of Coping Checklist (revised), the Purpose-in-Life Test, the Incapacity Scale, the Beck Depression Inventory, and the Social Support Questionnaire. All but four interviews were conducted within six weeks of the clinic visit. Eighty-two percent of the interviews were done in subjects' homes; the remaining 18% were done in various other settings.

Results of the two models indicated that the parsimonious model was a satisfactory fit for the data. This model was subsequently modified and found to be a better fit for the data for women alone, rather than for both sexes. The more complex model, which included constructs related to the unpredictable nature of MS, did not fit the data well. Additional analyses focused on examination of the independent variables that explained the variance in the different types of coping behaviors using multiple regression analysis. In general, a positive-cognitive appraisal of one's situation with MS explained the largest portion of the variance in active forms of coping, whereas a negative-cognitive appraisal accounted for the largest portion of the variance in passive-cognitive coping behaviors. Social support characteristics within the sample were also explored. The implications of the findings for future theory development, research, and clinical practice were advanced.
Notes: Source: Dissertation Abstracts International, Volume: 49-07, Section: B, page: 2572.

Thesis (PH.D.)--THE UNIVERSITY OF ROCHESTER, 1988.

School code: 0188.