Skip to main content Accessibility help

Determinants of Independent Living Optimism among Adults with Multiple Sclerosis

  • Jian Li (a1), Hannah Wilson (a1), Shawn M. Fitzgerald (a2), Malachy Bishop (a3) and Phillip D. Rumrill (a4)...


This study investigated the relationship between cognitive, psychological and physical symptoms of multiple sclerosis (MS) and independent living optimism among a sample of 5,082 adults with MS (females = 77.8%; Whites = 96.1%, age range 20 to 91 years). Data on physical, cognitive and psychological function were collected utilising standardised clinical measures including the Multiple Sclerosis Impact Scale-29, Perceived Deficits Questionnaire-5-Item version, and the Independent Living Optimism scale. Multiple regression analysis indicated that specific physical, psychological and cognitive factors contributed to the overall prediction model. The combined variables explained approximately 33% of the variance in independent living optimism. This study enables a specific, item-level understanding of the relationship between MS-related symptoms and independent living optimism, and provides important information for the development of targeted rehabilitation interventions.


Corresponding author

Correspondence author: Jian Li, School of Foundation, Leadership and Administration, 316 White Hall, PO Box 5190, Kent State University, Kent, Ohio, 44242. Email:


Hide All
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84 (2), 191215.
Beatty, W., Blanco, C., Wilbanks, S., Paul, R., & Hames, K. (1995). Demographic, clinical, and cognitive characteristics of multiple sclerosis patients who continue to work. Journal of Neurological Rehabilitation, 9, 167193.
Bishop, M., Roessler, R., Rumrill, P., Sheppard-Jones, K., Frain, M., Waletich, B., & Umeasiegbu, V. (2013). The relationship between housing accessibility variables and employment status among adults with multiple sclerosis. Journal of Rehabilitation, 79 (4), 414.
Centers for Disease Control and Prevention. (2014). Disability and Health. Retrieved on November 25, 2014, from
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Davis, P., & Tyry, T. (2008). NARCOMS report-2007 registry update. Multiple Sclerosis Quarterly Report, 26 (4). Retrieved May 10, 2012, from:
DeLuca, J., & Nocentini, U. (2011). Neurological, medical, and rehabilitative management in persons with multiple sclerosis. Neuro Rehabilitation, 29, 197219.
Denney, D.R., Gallagher, K.A., & Lynch, S.G. (2011). Deficits in processing speed in patients with multiple sclerosis: Evidence from explicitly-timed and covertly-timed measures. Archives of Clinical Neuropsychology, 26, 110119.
Denney, D.R., Hughes, A.J., Owens, E.M., & Lynch, S.G. (2012). Deficits in planning time but not performance in patients with multiple sclerosis. Archives of Clinical Neuropsychology, 27, 148158.
Denney, D.R., Lynch, S.G., Parmenter, B.A., & Horne, N. (2004). Cognitive impairment in relapsing and primary progressive multiple sclerosis: Mostly a matter of speed. Journal of the International Neuropsychological Society, 10, 948956.
Dillman, D. A., Smyth, J. D., & Melani Christian, L. (2009). Internet, Mail, and Mixed-Mode Surveys: The Tailored Design Method (3rd ed.). Hoboken, NJ: Wiley.
Einarsson, U., Gottberg, K., Fredrikson, S., von Koch, L., & Holmqvist, L.W. (2006). Activities of daily living and social activities in people with multiple sclerosis in Stockholm County. Clinical Rehabilitation, 20 (6), 543551.
Finlayson, M. (2004). Concerns about the future among older adults with multiple sclerosis. American Journal of Occupational Therapy, 58 (1), 5463.
Finlayson, M., & Van Denend, T. (2003). Experiencing the loss of mobility: Perspectives of older adults with MS. Disability and Rehabilitation, 25 (20), 11681180.
Fraser, R., Clemmons, D., & Bennett, F. (2002). Multiple Sclerosis: Psychosocial and Interventions. New York: Demos.
Fraser, R.T., Kraft, G.H., Ehde, D.M., & Johnson, K.L. (2006). The MS Workbook: Living Fully with Multiple Sclerosis. Oakland, CA: New Harbinger Publications, Inc.
Gmeindl, L., & Courtney, S.M. (2012). Deconstructing spatial working memory and attention deficits in multiple sclerosis. Neuropsychology, 26 (1), 5770.
Gulick, E. (1997). Correlates of quality of life among persons with multiple sclerosis. Nursing Research, 46, 305311.
Gray, O.M., McDonnell, G.V., & Hawkins, S.A. (2009). Tried and tested: The psychometric properties of the multiple sclerosis impact scale (MSIS-29) in a population-based study. Multiple Sclerosis, 15, 7580.
Iezzoni, L., & Ngo, L. (2007). Health, disability, and life insurance experiences of working-age persons with multiple sclerosis. Multiple Sclerosis, 13, 534546.
Herndon, R. (2000). Pathology and pathophysiology. In Burks, J. & Johnson, K. (eds.). Multiple Sclerosis: Diagnosis, Medical Management, and Rehabilitation (pp. 3545). New York, NY: Demos Medical Publishing, Inc.
Hobart, J.C., Lamping, D.L., Fitzpatrick, R., Riazi, A., & Thompson, A.J. (2001). The Multiple Sclerosis Impact Scale (MSIS-29): A new patient-based outcome measure. Brain, 124, 962973.
Hobart, J.C., Riazi, A., Lamping, D.L., Fitzpatrick, R., & Thompson, A.J. (2004). Improving the evaluation of therapeutic interventions in multiple sclerosis: Development of a patient-based measure of outcome. Health Technology Assessment, 8 (9), 148.
Hobart, J.C., Riazi, A., Lamping, D.L., Fitzpatrick, R., & Thompson, A.J. (2005). How responsive is the Multiple Sclerosis Impact Scale (MSIS-29)? A comparison with some other self-report scales. Journal of Neurology, Neurosurgery and Psychiatry, 76, 15391543.
Johansson, S., Ytterberg, C., Claesson, al. (2007). High concurrent presence of disability in multiple sclerosis. Associations with perceived health. Journal of Neurology, 254, 767773.
Jonides, J., Lewis, R.L., Nee, D.E., Lustig, C.A., Berman, M.G., & Moore, K.S. (2008). The mind and brain of short-term memory. Annual Review of Psychology, 59, 193224. doi:10.1146/annurev.psych.59.103006.093615
Kalb, R. (2012). Multiple Sclerosis: The Questions You Have, the Answers You Need. New York, NY: Demos Medical Publishing, Inc.
Kierkegaard, M., Einarsson, U., Gottberg, al. (2012). The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis. Multiple Sclerosis, 18, 639646.
Klingbeil, H., Baer, H.R., & Wilson, P.E. (2004). Aging with a disability. Archives of Physical and Medical Rehabilitation, 85, S68–S73.
Lemelle, J.L., Guillemin, F., Aubert, D., Guys, J.M., Lottmann, H., Lortat-Jacob, S., Mouriquand, P., Ruffion, A., Moscovici, J., & Schmitt, M. (2006). Quality of life and continence in patients with spina bifida. Quality of Life Research, 15, 14811492.
Lomax, R.G., & Hahs-Vaughn, D. (2012). An Introduction to Statistical Concepts (3rd ed.). New York, NY: Taylor & Francis Group.
Michalski, D., Liebig, S., Thomae, E., Singer, S., Hinz, al. (2010). Anxiety, depression and impaired health-related quality of life are therapeutic challenges in patients with multiple sclerosis. Mental Illness, 2:e5.
Newland, P.K., Flick, L.H., Thomas, F.P., & Shannon, W.D. (2014). Identifying symptom co-occurrence in persons with Multiple Sclerosis. Clinical Nursing Research, 23 (5), 529543.
Pedhazur, J. (1997). Multiple Regression in Behavioral Research. Belmont, CA: Wadsworth.
Polman, C., Thompson, A., Murray, T., Bowling, A., & Noseworthy, J. (2006). Multiple Sclerosis: The Guide to Treatment and Management. New York, NY: Demos Medical Publishing, Inc.
Riazi, A., Thompson, A.J., & Hobart, J.C. (2004). Self-efficacy predicts self-reported health status in multiple sclerosis. Multiple Sclerosis, 10 (1), 6166.
Ritvo, P.G., Fischer, J.S., Miller, D.M., Andrews, H., Paty, D.W., & LaRocca, N.G. (1997). Multiple Sclerosis Quality of Life Inventory: A User's Manual. New York: National Multiple Sclerosis Society.
Roessler, R., & Gitchel, D. (2013). Severity, employment, and gender: Factors influencing independence for adults with multiple sclerosis. Journal of Rehabilitation, 79, 3345.
Roessler, R.T., Gitchel, W.D., & Bishop, M. (2013). Housing satisfaction: An additive predictor of QOL for adults with MS? Journal of Vocational Rehabilitation, 39, 101109.
Roessler, R., Rumrill, P., & Fitzgerald, S. (2004). Predictors of employment status for people with multiple sclerosis. Rehabilitation Counseling Bulletin, 47 (2), 97103.
Rumrill, P., Fraser, R., & Johnson, K. (2013). Employment and workplace accommodation outcomes among participants in a vocational consultation service for people with multiple sclerosis. Journal of Vocational Rehabilitation, 39, 8590.
Schapiro, R.T. (2003). Managing the Symptoms Of Multiple Sclerosis (4th ed.). New York, NY: Demos Medical Publishing, Inc.
Sheppard-Jones, K., Bishop, M., Kinyanjui, B., Roessler, R.T., Rumrill, P.D., Waletich, B., & Umeasiegbu, V. (2013). Specialized housing policies, resources, and services for Americans with multiple sclerosis: Priorities for a national agenda. Journal of Rehabilitation, 79 (4), 1522.
Smith, C. & Schapiro, R. (2004). Neurology. In Kalb, R. (3rd ed.), Multiple Sclerosis: The Questions You Have the Answers You Need (pp. 742). New York, NY: Demos Medical Publishing, Inc.
Snook, E.M., & Motl, R.W. (2008). Physical activity behavior in individuals with multiple sclerosis: roles of overall and specific symptoms, and self-efficacy. Journal of Pain Symptom Manage, 36 (1), 4653.
Sullivan, M.J., Edgley, K., & Dehoux, E. (1990). A survey of multiple sclerosis. Part I: Perceived cognitive problems and compensatory strategies use. Canadian Journal of Rehabilitation, 4, 99105.
Tyry, T. (2009). NARCOMS Report: Registry Status in Spring 2009. Retrieved May 1, 2012, from:
Ytterberg, C., Johansson, S., Andersson, M., et al. (2008). Variations in functioning and disability in multiple sclerosis: A two-year prospective study. Journal of Neurology, 255, 967973.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed