Adaptive tasks in multiple sclerosis: Development of an instrument to identify the focus of patients' coping efforts

Objective: Adaptive tasks, referring to the subjective evaluation of disease-related stressors in relation to personal concerns, have been neglected in the extensive literature on coping with chronic disease. In this study, the development of an instrument for measuring adaptive tasks is described: the Questionnaire Adaptive Tasks in Multiple Sclerosis (QuAT-MS). Method. The QuAT-MS is based on a bottom-up categorization of patients' statements on the losses, threats, and challenges brought about by their disease, and employs 10 scales to measure the importance attached to particular disease-related stressors. Validity and reliability of this bottom-up categorization were established in a sample of MS patients (N = 259) by examining their associations with related concepts relevant in adaptation to disease, such as coping (CISS), coping resources (LOT, self-efficacy), and quality of life (SIP). We also investigated whether patients' backgrounds and disease characteristics were related to adaptive tasks. Results: Adaptive tasks are more closely related with concepts relevant for adaptation (coping and coping resources) than with physical functioning (SIP) and disease-related characteristics (illness duration). Adaptive tasks are also associated with gender and level of education. Conclusion: It is concluded that adaptive tasks can be distinguished from related concepts like coping and quality of life. Furthermore, the QuAT-MS offers a reliable and patient-centred instrument for measuring the tasks which MS patients identify in their adaptation process.