Effect of Educational Intervention Based on Health-Promoting Self-Care Behaviors Model on Quality of Life, Resilience, and Sense of Coherence in Patients with Multiple Sclerosis: A Randomized Controlled Trial

Background: Multiple sclerosis (MS) is a progressive central nervous system disease that has an enormous effect on a patient's quality of life due to physical complications and psychological problems. Objectives: The purpose of this study is to investigate the effect of self-care education program based on Health-Promoting Self-Care Behaviors System Model on quality of life, resilience, and sense of coherence in patients with MS. Methods: In this randomized controlled clinical trial, 80 patients with MS referred to hospitals for special diseases in Kerman were enrolled using systematic sampling method and then randomly assigned to the intervention and control groups. The main research instruments, including demographic information checklist, Multiple Sclerosis Quality of Life (MSQOL-54), Connor-Davidson scale, Resilience Scale and Sense of Coherence Scale were completed by subjects in both intervention and control groups. The intervention group participated in 18 training sessions that addressed the needs of patients. The two groups completed the questionnaires one week and two months after intervention again. Generalized Estimating Equations (GEE) (GEE) test was used for data analysis. Results: Pre-intervention results revealed that intervention and control groups were not significantly different in the mean scores of most dimensions of quality of life and sense of coherence (P > 0.05). However, intervention and control groups were significantly different in mean scores of all dimensions of quality of life, resilience and sense of coherence one week and (P < 0.05) and two months (P < 0.05) after the intervention. The results of GEE test also reflected a meaningful difference in the intervention group in terms of increased mean scores in all dimensions of quality of life (P < 0.05), resilience (69.60 +/- 6.62) (P < 0.05) and sense of coherence (74.50 +/- 3.52) (P < 0.05) one week and two months after the intervention compared to the baseline. However, this improvement was not observed in the controls (P> 0.05). Conclusions: Teaching health-promoting self-care behaviors system model improves the quality of life, resilience, and sense of coherence in patients with MS. Therefore, it is recommended to plan and implement self-care training interventions in accordance with this model for all patients with MS.