The Relationship between Self-efficacy and Social Support with Fertility Desire in Multiple Sclerosis Patients referred to MS Society in Tehran, 2013-2014

Abstract

Abstract: Introduction: Being an inflammatory disease of the central nervous system with a heterogeneous and unpredictable duration , multiple sclerosis is the most common cause of non-traumatic disorders in young adults and middle-aged. This disease which is identified with inflammation, destruction of myelin and scars has usually a relapse and remission period. Pregnancy does not not have negative effects the disease has on the pregnancy outcome. The global incidence has increased from 30 to 33 per 100000. The prevalence in Iran has been reported to be 40000 cases. The statistics showed the rapid growth growth of this disease among youth in our country fertility issues among them were greatest concerns life with this chronic and non-predictable disease. Fertility desire is a psychological state showing a personal motivation to have offspring’s. The motivation represents the first step in deciding to act and is usually followed by the intent to act. The desire to have children is linked to self-efficacy. Self-efficacy refers to people’s ability to deal effectively with challenging situations and also includes that challenging situations can be successfully controlled. Bandura believes that social support and increase the personal level of self-efficacy. The present study has investigated the relationship between self-efficacy and social support with fertility desire and affecting the desires by the disease in men and women having MS and compared the two groups. Methods: this is a cross- sectional study was performed with=h convenience sampling on 300 women and 100 men with MS who were eligible to this study. Data collection tools for this study were demographic information and fertility desire questionnaires, Schwartz self-efficacy scale in MS, zine social support questionnaire and beck depression inventory, after determination of validity and reliability, the samples were complete questionnaires. To analyze the data, descriptive and inferential statistics were used. To assess meaningfulness, comparisons between men and women, t-test, chi-square, mann-whitney, ANOVA, turkey test and Pearson correlation coefficient were used. The data analysis was used by the software SPSS (version 13).P value was considered less than0.05. Finding: of the male group, the comparison of the relationship between self-efficacy (p<0.05) with fertility desire was significant, but such relationship was observed among the female group between the control efficacy efficacy subscale with future fertility desire (p<0.05). In both group, those with a negative future fertility desire had higher self-efficacy and social support scores. The Pearson correlation test suggested a statistically significant positive correlation between self-efficacy and social support in both men (p<0.05) and women (p<0.05).the total sample revealed a significant negative correlation between the self-efficacy and the fertility desire (p<0.05) as well as a negative correlation between the social support and the fertility desire (p<0.05). A significant positive correlation between self-efficacy and social support on the one hand, with the fertility desire in the total sample on the other was observed (p<0.05). The investigate relationship between depression and fertility desires results showed that women who had more depression, fertility desire had been affected by the MS disease (p<0.05). Statistically significant differences in fertility desire before diagnosis, fertility desires were affected by MS and future desire weren’t found between two groups (p<0.05). The results showed, in 50% of women. Men and 46% of women. Men more that women were concerns about sexual dysfunction problems (p<0.0.0001) and financial difficulties (p<0.0.001). In contrast, women more men were about: worsening of symptoms post pregnancy (p<0.0.001), the teratogenic effects of MS treatments (p<0.0.001) and stopping therapy when deciding to fertility (p<0.0.001). Conclusion: according to positive correlation between self-efficacy and social support in this study it will be possible to achieve the goals of reproductive health, psychosocial health promotion of patient with MS through the alignment of reproductive consultation, with the aim of fulfilling the reproductive desires with MS as well as the assessment of the two components and also integrating them into the care before pregnancy.