Determinants of unemployment in multiple sclerosis (MS): The role of disease, person-specific factors, and engagement in positive health-related behaviors

Published:September 02, 2020DOI:https://doi.org/10.1016/j.msard.2020.102487

      Highlights

      • Rates of unemployment are high among individuals with multiple sclerosis (MS), particularly early on in the disease process.
      • The majority of individuals who leave the workforce do within the first three to five years after diagnosis.
      • Identification of the factors that put those “at risk” for leaving the workforce need to be identified so that early intervention can be utilized.
      • The present investigation examines the demographic, disease, and person-specific factors as well as the engagement in health-related behaviors and their associated risk for unemployment in MS.

      Abstract

      Background

      : Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%.

      Objective

      : This study examines disease, person-specific factors (e.g., personality, self-efficacy), and health-related behaviors, which may account for individuals leaving the workforce.

      Method

      : 252 individuals with MS were enrolled in a prospective study examining the factors related to unemployment in MS. Sixty-seven were “at risk” for leaving the workforce. These individuals were compared to those “not at risk” on measures of disease, person-specific factors, and health-related behaviors.

      Results

      : Certain disease factors differentiated those “at risk” and those “not at risk.” In particular, those “at risk” were more likely to have a progressive course and reported greater fatigue, sleep problems, pain, depression, and anxiety. They also reported lower levels of locus of control and MS self-efficacy and engaging in maladaptive coping. On a measure of personality, they endorsed higher levels of neuroticism and lower levels of conscientiousness, extraversion, and agreeableness. Finally, those “not at risk” reported engaging in more positive health-related behaviors. Taken together, disease course, fatigue, MS self-efficacy, and diet/exercise were the most significant factors, accounting for 16% of the variance.

      Conclusions

      : Findings suggest that greater consideration and interventions tailored to these factors is warranted, which may assist individuals with MS staying employed and/or making appropriate accommodations.

      Keywords

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