Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type


Degree Name





Eileen Gigliotti

Committee Members

Barbara Gail Montero

Aliza Ben-Zacharia

Subject Categories

Social and Behavioral Sciences


adherence, employment, multiple sclerosis, Neuman Systems Model, perceived health status, religious coping


Purpose: People living with MS need to employ both problem and emotion-focused coping strategies to maintain optimal health. Specifically, with one’s Perceived Health Status as an indicator of optimal health, treatment adherence and religious coping are indicators of problem and emotion-focused coping, respectively. This study aimed to examine the relations between Perceived Health Status, the dependent variable, and the independent variables Adherence to DMT and Religious Coping. Based on the Neuman Systems Model (Neuman & Fawcett, 2011) and Pargament's Theory of Religious Coping (1997), it was proposed that Adherence to DMT and Religious Coping are respectively one's physiological and spiritual lines of resistance that would affect reconstitution to the Normal Lines of Defense, Perceived Health Status.

Method: This was a cross-sectional randomized sample (N = 266), response rate 46%, of adults from a national MS registry (NARCOMS) who completed the RAND Short Form-36 (SF-36) questionnaire, the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) Barriers Subscale, the Brief Religious Cope (Brief RCOPE) Questionnaire, and demographic data to explore the relations among the variables. An alpha of 0.05, power at .80 with an anticipated effect size of .065, determined statistical significance. Data were analyzed using regression, correlations, ANOVA, chi-square, and t-tests.

Findings: Together, Adherence to DMT nor Religious Coping (R2 = .02, p = .159) did not influence Perceived Health Status in this study. However, ancillary analyses revealed the best predictor of Perceived Health Status was employment status (β = 6.29, p < .001) with significant variations noted among the employment groups (F (4,250) = 19.07, p < .001). People who report being unable to work had significantly lower mean Perceived Health (M = 40.09, SD = 14.79) scores than all other employment groups.

Conclusions: There is some support for the conceptual and theoretical link between Neuman's Systems Model (Neuman & Fawcett, 2011) and Pargament's Theory of Religious Coping (1997). The spiritual variable worked to weakly influence Reconstitution via Negative Religious Coping. Participants who used less Negative Religious Coping reported better Mental Health. Future studies should focus on employment status and its role as a stressor influencing the Lines of Resistance. Research with people with MS should include measuring appraisal methods they use to arrive at Perceived Health Status.