Abstract
<title>Abstract</title> <p> <bold>Background</bold> Multiple sclerosis (MS) profoundly impacts patients’ psychological and social well-being. This study investigated the relationship between the quality of the shared decision-making (SDM) process and hope among patients with MS in northwest Iran. <bold>Method</bold> This correlational study selected 300 patients with MS covered by the Ardabil MS Association via stratified random sampling. Data were collected using a sociodemographic questionnaire, the AGA-25 scale, and Snyder’s Adult Hope Scale. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, and a linear regression model in SPSS 26. <bold>Results</bold> In this analytical cross-sectional study of 300 patients with multiple sclerosis (mean age = 32.20 ± 10.20 years; 66.3% women), most participants had a relapsing–remitting disease course (76%) and a moderate level of both hope (mean = 38.97 ± 6.33) and shared decision-making (SDM) quality (mean = 75.0 ± 9.72). The mean scores of hope and its subscales were significantly below the established criteria (p < 0.01), while the SDM total score exceeded its criterion (p < 0.01). The quality of SDM was significantly associated with patients’ education, occupation, age, number of children, and disease duration (p < 0.05). A positive correlation was found between SDM quality and hope (r = 0.37, p < 0.001). Regression analysis identified satisfaction with information during SDM (β = 2.85, p = 0.004), DMT convenience (p < 0.001), and information reliability (p = 0.047) as significant predictors of hope, collectively explaining 12.2% of its variance. <bold>Conclusion</bold> The findings demonstrated a positive and significant relationship between the quality of the SDM process and hope in patients with MS. These results underscore the importance of enhancing patient participation in therapeutic decision-making to improve the psychological well-being of individuals with MS and develop targeted interventions. </p>