The role of wisdom and self-management skills for coping with fear of progression among patients with multiple sclerosis with moderate disability: Results from a cross-sectional study

Background: Multiple sclerosis (MS) is a chronic neurological disease with an uncertain course. Wisdom and self-management are skills that can be used to cope with uncertainty and unpredictable life stresses. The present study aims to identify relevant wisdom and self-management skills for coping with fear of progression (FoP), a widely underdiagnosed real-life fear in response to uncertainty and a risk factor for depression and anxiety in patients with MS (PwMS). Methods: Ninety-two German inpatients aged 24–64 years with predominantly relapsing–remitting MS (72,8%) were included in this study. Correlation analyses and blockwise regression analyses were conducted to evaluate the relationship between wisdom skills (Self-Assessed Wisdom Scale, SAWS) and self-management skills (Questionnaire to Assess Resources and Self-management Skills, FERUS) with FoP (Fear of Progression-Questionnaire, FoP-Q), while controlling for demographic and disease-related variables. Results: Blockwise regression analyses (BRA) revealed the following significant unique predictions for each FoP-Q subscale: age (R change = 0.043), emotional regulation (0.028), and self-efficacy (0.029) on affective reaction; age (0.087) on partnership/family; age (0.055) and self-observation (0.043) on occupation; age (0.040), fatigue (0.057), and self-observation (0.039) on loss of autonomy. Limitations: The cross-sectional design, lack of comparison groups, and exclusive use of self-reports limit the generalizability of this study. Conclusions: Age is the strongest predictor for FoP-Q. Emotional regulation (as wisdom skills), self-observation and self-efficacy (as self-management skills), and fatigue are critical factors in dealing with specific aspects of FoP for PwMS. Larger, prospective, and longitudinal designed studies are needed to specify and replicate the results.