Symptom Burden Tied to Marital Adjustment and Quality of Life in Multiple Sclerosis

Higher multiple sclerosis-related symptom burden is associated with lower marital adjustment and poorer health-related quality of life among married patients, according to a cross-sectional study published in BMC Neurology. The study, which framed its analysis within Conservation of Resources theory and Affective Events Theory, recruited a convenience sample of 190 married patients with MS from a tertiary neurology clinic and assessed them from the patient’s perspective using validated scales.

Researchers measured symptom burden with the MS-RS scale, marital adjustment with the RDAS, and health-related quality of life with the EQ-5D-3L instrument. Data were analyzed using correlation analyses and simple and two-predictor linear regression models with 95% confidence intervals. MS is a chronic autoimmune disease that impairs not only physical functioning but also psychological well-being and interpersonal relationships, and the authors noted that the associations between cumulative symptom burden and marital dynamics remain insufficiently addressed within holistic nursing frameworks.

The regression results showed that higher symptom burden was associated with lower marital adjustment (β = -0.30, 95% CI -0.43 to -0.17) and with lower quality of life on both EQ-5D measures: the EQ-5D index (β = -0.74, 95% CI -0.80 to -0.67) and the EQ-VAS (β = -0.52, 95% CI -0.62 to -0.41). All of these associations were statistically significant at p < 0.001.

Higher marital adjustment, in turn, was associated with better quality of life. The standardized coefficients were β = 0.31 (95% CI 0.18 to 0.43) for the EQ-5D index and β = 0.33 (95% CI 0.20 to 0.45) for the EQ-VAS, again with all p values below 0.001. In models that accounted for symptom burden simultaneously, marital adjustment remained associated with the EQ-VAS (β = 0.19, 95% CI 0.06 to 0.32) but was no longer significantly associated with the EQ-5D index (β = 0.09, 95% CI -0.01 to 0.19), suggesting that the relational measure added explanatory value for the self-rated health scale but not for the index score once symptom burden was taken into account.

The authors concluded that symptom burden was associated with both lower marital adjustment and poorer health-related quality of life, and that marital adjustment was positively associated with quality of life.

The team was careful to emphasize the limits of the design. Because the data were cross-sectional, the study does not allow causal or directional inferences; it cannot establish whether heavier symptom burden erodes marital adjustment, whether poorer marital adjustment amplifies the experience of symptoms, or whether both are shaped by other factors. The convenience sample of 190 married patients from a single tertiary clinic also limits generalizability. The authors proposed that assessing relational functioning alongside symptoms may help nurses identify patients who could benefit from family-centered support, an approach they said should be evaluated in longitudinal and interventional studies before any firm practice recommendations can be made.

Subject of Research: Associations among symptom burden, marital adjustment, and health-related quality of life in married patients with multiple sclerosis

Article Title: A resource-based approach to symptom burden, marital adjustment, and health-related quality of life among patients with multiple sclerosis: a cross-sectional study

Article References: YALÇIN, G. Y., DÜNYA, C. P., TUNCER, M., GÜNDÜZ, T., & KÜRTÜNCÜ, M. (2026). A resource-based approach to symptom burden, marital adjustment, and health-related quality of life among patients with multiple sclerosis: a cross-sectional study. BMC Neurology. https://doi.org/10.1186/s12883-026-05583-0

Image Credits: AI Generated

DOI: 10.1186/s12883-026-05583-0

Keywords: multiple sclerosis, symptom burden, marital adjustment, health-related quality of life, cross-sectional study, EQ-5D, nursing, Conservation of Resources theory, chronic illness, neurology, resource-based, approach