Date Presented 3/30/2017
This presentation demonstrates the effects of environmental and personal factors from positive psychology that contribute to increased role participation and satisfaction with maternal participation of mothers with multiple sclerosis. Practical ways to facilitate these factors are discussed.
Primary Author and Speaker: Ruth S. Farber
Additional Authors and Speakers: Andrea Tyszka
Contributing Authors: Margaret Kern, Eugene Brusilovskiy
PURPOSE: The purpose of this study is to demonstrate the contribution and synergy of the International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) framework (including environmental and personal factors) and a strength-based positive psychological approach (Ryff, 2014) for mothers with multiple sclerosis (MS). This study was designed to provide a framework to help discover factors that help women with chronic conditions cultivate fuller and more satisfying engagement in activities and life roles, especially with the occupation of mothering.
BACKGROUND: As the number of mothers with chronic illnesses like MS increases, empirical knowledge of factors that will help mothers be more resilient and engaged in their life roles, despite the challenges that chronic illness brings, is needed. MS is frequently diagnosed during peak childbearing years. New disease-modifying agents have reduced exacerbations’ intensity and frequency. Examining positive factors is particularly salient in light of the well-documented history of social bias and discrimination toward mothers with a disability or chronic disease like MS (National Council on Disabilities, 2012). By identifying positive factors that are correlated with increased role participation, occupational therapy treatment can be better targeted to not only improve function but also promote resilience and parental satisfaction.
DESIGN: This is a descriptive study designed to add to a theoretical framework. One hundred and eleven community-dwelling mothers with MS were solicited through the National MS Society newsletter. Participants needed to have at least one child age 12 or under. The type of MS included relapse–remit and progressive MS.
METHOD: To measure ICF environmental factors such as support and relationships, the Medical Outcomes Study Social Support Scale (Sherbourne & Stewart, 1991) was used. To measure positive personal factors, Ryff’s Psychological Well-Being Scales were used to measure self-acceptance, environmental mastery, and purpose in life. Role participation was measure using the SF–36 Role-Physical and Role-Emotional scales. All of these measures have acceptable reliability and validity and are widely used. Lastly, a satisfaction with parenting participation scale was developed for this study and had a strong Cronbach’s alpha. Hierarchical regression analyses tested unique effects of social support and positive personal factors (environmental mastery, self-acceptance, and purpose in life) on role participation and satisfaction with parenting. An additional analysis tested synergistic combinations of social support and positive personal factors.
RESULTS: Social support explained 35%–44% of variance in each outcome (role participation and satisfaction with parental participation). Positive personal factors explained an additional 9%–17% of the variance. The combination of social support and positive factors predicted greater role function and satisfaction with parenting than either alone.
CONCLUSION: Both ICF environmental factors (social support) and positive personal factors uniquely predicted better daily role participation and greater satisfaction with mothering, as expected. Further analyses demonstrated a synergistic relationship such that together, social support and positive personal factors predicted fuller participation and greater satisfaction with mothering than either alone.
IMPACT: The results of this study examining ICF environmental and positive psychological factors in role participation provide a useful evidence-based framework for occupational therapists to help mothers with MS participate more fully in meaningful life roles and transcend the limitations of illness.
References
National Council on Disabilities. (2012, September 27). Rocking the cradle: Ensuring the rights of parents with disabilities and their children. Retrieved from http://www.ncd.gov/publications/2012/Sep272012/
Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83, 10–28. http://dx.doi.org/10.1159/000353263
Sherbourne, C. D., & Stewart, A. L. (1991). The MOS Social Support Survey. Social Science and Medicine, 32, 705–714. http://dx.doi.org/10.1016/0277-9536(91)90150-B
World Health Organization. (2001). International classification of functioning, disability and health. Geneva: Author.
