نگرش بِیماران مبتلا به MS نسبت به کیفیت زندگی خویش و خدمات مشاوره و روان شناسی

Quality of life is a multidimensional concept which shows the patient's understanding of his physical and psychological well-being (32 ).According to this definition, the patient's understanding and attitude is one of the most important factors affecting the quality of his life. MS patients' quality of life has been reported significantly lower than those of patients with chronic illnesses such as : rheumatoid arthritis, bowel inflammation, diabetes and epilepsy (31,20,19 ). MS is one of the most common self-immune, non-traumatic and progressive central nervous system illnesses with unknown etiology. It strikes about 0.1% of total population in young ages (29). Ms is a chronic and often disabling disease which negatively affect different Aspects of person's life and his family (26).
The aim of this survey was to study the attitude of Ms patients toward different dimensions of quality of their life and the role that counseling and psychology services could play in this regard. Population of the study consisted of patients referring to the country's MS associations and sample included 10% of the available patients ( 1000 individuals). The research instruments include a self-made questionnaire and semi-structured case interviews. Results indicated that there was a significant difference between men and women attitude toward emotional and psychological factors which begun or exacerbate their illness. Factors causing educational failure have affected women students more than men students. Also, economic problems and unemployment have been stronger starting or exacerbating factors for women than men. Family issues such as: inappropriate childhood, parents' divorce or conflicts, spouse infidelity, spouse re-marriage and death of loved ones have had more psychological pressure on women than men. Both sexes believe that responsibilities of today's women are more, their social contacts are less and they are more left alone than men. There is a significant difference between patients' religious attitudes and what they believe could be their cure (p=0/00001). Sex has not been an important factor of attitudes toward QOL. Attitudes of married and single patients toward physical, psychological and economic aspects of their quality of life are significantly different, but were not significantly different toward family, social and recreational aspects. Attitudes of employed and unemployed patients were the same only toward physical aspects of their illness, but different toward other five aspects, to the benefit of employed patients. The most important factors causing the disease from women's point of view were: personal, emotional and psychological problems and from men's point of view were: vocational and economical problems. Agitation and nervousness were considered the most disease exacerbating factor. 73.7% of the patients would like to receive guidance and counseling services. 79.6% had not received
such services yet. The most important suggestion of the study, besides physical and medical treatment, is paying attention to the patients' emotional, psychological and social problems through complementary services of counseling, psychology and social work in order to change patients' attitudes and enable them as to their social life. Training such personnel as nurse- counselor, to satisfy some of the before mentioned complementary services could be promising.