Functional and self-care capacity of people with multiple sclerosis.
Ana Railka de Souza Oliveira-Kumakura, Larissa Maria Bezutti, Juliany Lino Gomes Silva and 1 others
PMID 31596417WHAT IT FOUND
Most outpatients with MS had self-care capacity (82.1%), but 51.2% were moderately dependent for basic tasks.
Higher disability and older age were linked to greater dependence.
Key findings
01Most participants were classified as having self-care capacity (82.1%), but many had dependence for basic activities (51.2% moderate dependence) and instrumental activities (55.9% partial dependence).
02Patients with lower EDSS scores were more independent for basic, instrumental and advanced activities of daily living.
03Pyramidal manifestations were the only clinical variable associated with self-care, and clinical manifestations were associated with greater dependence for all activities.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study is cross-sectional, so it can show links but cannot prove that age, EDSS, disease duration or clinical manifestations cause functional decline. It was done in one outpatient public hospital in Brazil, so it may not apply to people with MS in other settings or with more severe disease. Most participants had a mean EDSS of 3.9 and the study did not find people with greater need for self-care, so it says little about those with severe disability or the greatest self-care deficits. Some information came from medical charts and interviews, which can include reporting errors. Data were collected by a last-year undergraduate nursing student after training, not by the main researchers.
The easy way to misread this
Do not read the 82.1% self-care capacity as independence in daily activities. Many participants were dependent for basic or instrumental tasks, and the cross-sectional design cannot show cause or effect.