Abstract
Objective
To identify predictors for employment status after 10 years in a cohort of people
with multiple sclerosis (MS), with the aim to increase knowledge concerning factors
present at an early stage that are important for working life and work-life balance.
Design
A 10-year longitudinal observational cohort study.
Setting
University hospital.
Participants
A consecutive sample of people with MS (N=154) of working age were included at baseline,
of which a total of 116 people participated in the 10-year follow-up; 27 people declined
participation and 11 were deceased.
Interventions
Not applicable.
Main Outcome Measures
Baseline data on personal factors and functioning were used as independent variables.
Employment status 10 years after baseline, categorized as full-time work, part-time
work, and no work, was used as the dependent variable. A generalized ordinal logistic
regression was used to analyze the predictive value of the independent variables.
Results
Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years.
Conclusions
This study underlines the complexity of working life for people with MS, and indicates
that it may be valuable to give more attention to the balance between working and
private life, both in clinical practice and future research, to achieve a sustainable
working life over time.
Keywords
List of abbreviations:
EDSS (Expanded Disability Status Scale), MS (multiple sclerosis), PwMS (people with multiple sclerosis), VIF (variance inflation factor)To read this article in full you will need to make a payment
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References
- Incidence and prevalence of multiple sclerosis in Europe: a systematic review.BMC Neurol. 2013; 13: 128
- High nationwide prevalence of multiple sclerosis in Sweden.Mult Scler. 2011; 17: 901-908
- Increasing prevalence and incidence of multiple sclerosis in South East Wales.J Neurol Neurosurg Psychiatry. 2009; 80: 386-391
- Relative mortality and survival in multiple sclerosis: findings from British Columbia, Canada.J Neurol Neurosurg Psychiatry. 2012; 83: 61-66
- The cost and benefits of employment: a qualitative study of experiences of persons with multiple sclerosis.Arch Phys Med Rehabil. 2004; 85: 201-209
- Health-related quality of life in multiple sclerosis: the impact of disability, gender and employment status.Qual Life Res. 2006; 15: 259-271
- Quality of life and employment in persons with multiple sclerosis.Work. 2014; 49: 281-287
- Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis.Cochrane Database Syst Rev. 2009; : CD007256
- Costs and quality of life of patients with multiple sclerosis in Europe.J Neurol Neurosurg Psychiatry. 2006; 77: 918-926
- Factors that influence the employment status of people with multiple sclerosis: a multi-national study.J Neurol. 2009; 256: 1989-1996
- Demographic and clinical factors associated with changes in employment in multiple sclerosis.Mult Scler. 2013; 19: 1647-1654
- Work-life balance: does age matter?.Work. 2016; 55: 679-688
- High prevalence of sickness absence and disability pension among multiple sclerosis patients: a nationwide population-based study.Mult Scler. 2013; 19: 1923-1930
- International classification of functioning, disability and health (ICF).World Health Organization, Geneva2001
- Short term predictors of unemployment in multiple sclerosis patients.Can J Neurol Sci. 2003; 30: 137-142
- Living with multiple sclerosis: longitudinal changes in employment and the importance of symptom management.J Neurol. 2010; 257: 926-936
- Employment among patients with multiple sclerosis-a population study.PLoS One. 2014; 9: e103317
- Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis.J Int Neuropsychol Soc. 2015; 21: 156-168
- Clinically meaningful performance benchmarks in MS: timed 25-foot walk and the real world.Neurology. 2013; 81: 1856-1863
- Factors influencing work retention for people with multiple sclerosis: cross-sectional studies using qualitative and quantitative methods.J Neurol. 2005; 252: 892-896
- The influence of coping styles on long-term employment in multiple sclerosis: a prospective study.Mult Scler. 2017; 23: 1008-1017
- Longitudinal changes in sickness absence and disability pension, and associations between disability pension and disease-specific and contextual factors and functioning, in people with multiple sclerosis.J Neurol Sci. 2016; 367: 319-325
- High concurrent presence of disability in multiple sclerosis. Associations with perceived health.J Neurol. 2007; 254: 767-773
- Variations in functioning and disability in multiple sclerosis. A two-year prospective study.J Neurol. 2008; 255: 967-973
- New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann Neurol. 1983; 13: 227-231
- The structure and properties of the sense of coherence scale.Soc Sci Med. 1993; 36: 725-733
- The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure.Brain. 2001; 124: 962-973
- Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS).Neurology. 1983; 33: 1444-1452
- Symbol Digit Modalities Test (SDMT).in: Lezak M.D. Neuropsychological assessment. Oxford University Press, New York1983: 379-381
- The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus.Arch Neurol. 1989; 46: 1121-1123
- An inventory for measuring depression.Arch Gen Psychiatry. 1961; 4: 561-571
- Adult norms for the 9 hole peg test of finger dexterity.OTJR. 1985; 5: 24-38
- The significant change for the Timed 25-foot Walk in the multiple sclerosis functional composite.Mult Scler. 2000; 6: 286-290
- Social activities after stroke: measurement and natural history using the Frenchay Activities Index.Int Rehabil Med. 1985; 7: 176-181
- Partial proportional odds Models for ordinal response variables.J R Stat Soc Ser C Appl Stat. 1990; 39: 205-217
- Generalized ordered logit/partial proportional odds models for ordinal dependent variables.Stata J. 2006; 6: 58-82
- Missing data imputation: focusing on single imputation.Ann Transl Med. 2016; 4: 9
- Predictive mean matching imputation of semicontinuous variables.Stat Neerl. 2014; 68: 61-90
- Conditional logit analysis of qualitative choice behavior.in: Zarembka P. Frontiers in econometrics. Wiley, New York1973
Hensher DA, Stopher PR. Behavioural travel modelling. In: Proceedings of the Third International Conference on Behavioural Travel Modelling; 1977 Apr 2-7; Tanunda (Australia). London: Croom Helm; 1979.
- When can you safely ignore multicollinearity? Statistical Horizons.(Available at:) (Accessed October 27, 2016)
- How are cognitive impairment, fatigue and signs of depression related to participation in daily life among persons with multiple sclerosis?.Disabil Rehabil. 2014; 36: 2012-2018
Article info
Publication history
Published online: February 03, 2018
Footnotes
Supported by the Health Care Sciences Postgraduate School and the Doctoral School in Health Care Sciences at Karolinska Institutet; Neuro Sweden; and the Norrbacka-Eugenia Foundation.
Disclosures: Dr. Fink has received an unrestricted academic research grant from Biogen and payments for lectures from Biogen, Teva, and Novartis, which have been exclusively used to support research activities. The other authors have nothing to disclose.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
