Figure 3
Causal and mutual relationships with FAMS symptom score. EDSS and knowledge of disease information scores have a direct negative affect on the FAMS symptom score. The standardized total effect of EDSS on FAMS symptom score is -.49, which consists of a standardized direct effect of -.39 and a standardized indirect effect of -.10. Conversely, communication with doctors has a direct positive influence on the FAMS symptom score. Increased scores for changes in employment status and EDSS reduce NAS-J anxiety/depression and acceptance scores, whereas knowledge of disease information scores positively affects these scores. Changes in employment status affect FAMS symptom score indirectly through the NAS-J anxiety/depression and acceptance scores. EDSS and knowledge of disease information scores affects FAMS symptom scores directly and indirectly through the NAS-J anxiety/depression and acceptance scores. d1, e1, e2, and e3 in the figure are error terms. Numbers are standardized path coefficients, and asterisks (*) indicate statistical significance (p < 0.05).