Acceptance of illness as a mediator of the relationship between neurological disability and health-related quality of life of people with multiple sclerosis

Introduction
Multiple sclerosis (SM) is a progressive demyelinating disease of the central nervous system that can lead to permanent disability, and is therefore a challenge for the process of mental adaptation and can lead to a decrease in quality of life. The aim of the study was to determine the relationship between neurological disability occurring in the course of SM, adaptation to the disease expressed by the degree of its acceptance and the healthrelated quality of life.

Material and methods
137 people diagnosed with SM participated in the study. Guy’s Neurological Disability Scale, the Acceptance of Illness Scale and the Multiple Sclerosis Impact Scale were used in the present study.

Results
The study showed a relationship between disability, acceptance of illness and healthrelated quality of life. It was also found that acceptance of illness mediated the relationship between neurological disability and the impact of multiple sclerosis on the quality of life and its individual spheres: mental and physical.

Conclusions
Neurological disability, causing limitations in everyday functioning, makes the disease harder to accept, which in turn has a negative impact on the healthrelated quality of life. Acceptance of illness is a better predictor of healthrelated quality of life than disability itself. Assessment of adaptation to the disease and quality of life can be the basis for creating rehabilitation programs and monitoring their effectiveness. This will make it possible to provide appropriate care to patients, discover deficiencies in current treatment and improve the level of support provided.