Figure 6

Causal and mutual relationships with FAMS thinking and fatigue score. Knowledge of disease information and EDSS scores negatively affect the FAMS thinking and fatigue score directly. Changes in household income and knowledge of disease information scores positively affect the NAS-J anxiety/depression, acceptance, and attitude scores and thus affect the FAMS thinking and fatigue score indirectly. d1, e1, e2, e3, and e4 in the figure are error terms. Numbers are standardized path coefficients, and asterisks (*) indicate statistical significance (p < 0.05).