141st APHA Annual Meeting

In This section

284404
Characteristics of people with multiple sclerosis associated with mistreatment

Sunday, November 3, 2013

Melanie Gironda, PhD, MSW , Department of Family Medicine, University of California, Irvine School of Medicine, Orange, CA
Annie Nguyen, PhD, MPH , Department of Family Medicine, Program in Geriatrics, University of California, Irvine School of Medicine, Orange, CA
Laura Mosqueda, MD , Department of Family Medicine, Univeristy of California, Irvine, Orange, CA
Dara Sorkin, PhD , Health Policy Research Institute, University of California, Irvine, Irvine, CA
Aileen Wiglesworth, PhD , Program in Geriatrics, University of California, Irvine, Orange, CA
Scott Beach, PhD , University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA
Elizabeth Morrison, MD, MSEd , Department of Neurology, University of Southern California, Keck School of Medicine, Los Angeles, CA
Objective: Ample evidence shows that caregiver mistreatment of people with disabilities is a nationwide problem. Given that approximately one in four people with Multiple Sclerosis (MS) experiences sufficient disability to require formal caregiving (Rivera-Navarro et al., 2003), data are needed to understand risk and protective factors associated with mistreatment among this group of individuals. The purpose of this study is to determine characteristics of people with MS and their caregivers associated with mistreatment. Methods: A nationwide sample of 206 persons with MS recruited from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, participated anonymously in a telephone survey. Univariate, bivariate, and multivariable analyses were performed using a validated 43-item self-report measure for detecting mistreatment. Results: Respondents were on average 59 years of age, with 30 years of disease duration, married (72%), female (74%), Caucasian (96%), Medicare/Medicaid beneficiaries (68%), and unemployed (88%). Mistreated persons (55%) reported less social support, greater fatigue and alcohol use, poorer relationship with caregivers prior to disease onset, and had a caregiver with a diagnosis of mental illness. In a logistic regression, low social support (OR=0.88, CI=0.78-0.99), poor caregiver mental health (OR=13.24, CI= 1.58-111.21), alcohol use (OR=2.22, CI=1.08-4.52), and poor quality of pre-morbid relationship (OR=2.79, CI=1.32-5.88) were significantly associated (p<=05) with a greater likelihood of reporting mistreatment. Conclusion: An outcome measure specifically designed to detect mistreatment among a national sample of people with MS found >50% reported mistreatment since becoming disabled, highlighting patient and caregiver characteristics that may be associated with increased vulnerability.

Learning Areas:
Chronic disease management and prevention
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify an estimated prevalence of mistreatment in a US population of people with MS. Describe patient characteristics associated with mistreatment in people with MS. Describe caregiver characteristics associated with mistreatment in people with MS.

Keywords: Disability, Caregivers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principle and co-investigator on multiple grants focusing on social networks and mistreatment among various populations. I have co-authored a number of manuscripts and book chapters on the centrality of social networks to the health and wellbeing of adults. I am currently involved in a cross site evaluation of California Elder Abuse Forensic Centers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.