Advertisement

Barriers and Facilitators to Employment: A Comparison of Participants With Multiple Sclerosis and Spinal Cord Injury

Published:March 05, 2021DOI:https://doi.org/10.1016/j.apmr.2021.02.015

      Abstract

      Objective

      To compare self-reported barriers and facilitators to employment among employed and unemployed participants with multiple sclerosis (MS) and spinal cord injury (SCI).

      Design

      Cross-sectional study using self-report assessment obtained by mail or online.

      Setting

      Medical university in the southeastern United States.

      Participants

      Participants (N=2624) identified from either a specialty hospital or a state-based surveillance system in the southeastern United States, including 1234 with MS and 1390 with SCI. All participants were aged <65 years at the time of assessment.

      Interventions

      Not applicable.

      Main Outcome Measures

      Self-reported barriers and facilitators to employment.

      Results

      Overall, the MS participants reported more barriers, particularly stress, cognition, and fatigue, whereas those with SCI were more likely to report not having the proper education and training, resources, transportation, and attendant care. Follow-up analyses broken down by employment status indicated that several barriers and facilitators were significantly related to diagnosis for either employed or unemployed participants, but not both. Among those employed, participants with SCI were more likely to report they could not do the same types of jobs as they could pre-SCI and those with MS were more likely to state that they did not know much about jobs for people with disabilities (no differences were noted for these variables among unemployed participants). Unemployed individuals with SCI were more likely to report that the jobs for which they were trained were not accessible.

      Conclusions

      The primary barriers for individuals with MS revolve around the condition itself, whereas the barriers for SCI appear to be more related to modifiable factors. Vocational rehabilitation specialists need to identify diagnostic-specific barriers to promote employment outcomes.

      List of abbreviations:

      MS (multiple sclerosis), SCI (spinal cord injury)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Schiavolin S
        • Leonardi M
        • Giovannetto AM
        • et al.
        Factors related to difficulties with employment in patients with multiple sclerosis: a review of 2002-2011 literature.
        Int J Rehabil Res. 2013; 36: 105-111
        • National Spinal Cord Injury Statistical Center
        Spinal cord injury facts and figures at a glance.
        University of Alabama, Birmingham2020
        • Post MW
        • Reinhardt JD
        • Avellanet M
        • et al.
        Employment among people with spinal cord injury in 22 countries across the world: results from the international spinal cord injury community survey.
        Arch Phys Med Rehabil. 2020; 101: 2157-2166
        • Krause JS
        • Dismuke-Greer CE
        • Reed K
        • Backus D
        • Rumrill P.
        Gainful employment and earnings among those with spinal cord injury and mutiple sclerosis.
        J Vocat Rehabil. 2020; 52: 19-28
        • Krause JS
        • Dismuke-Greer CE
        • Reed KS
        • Rumrill P.
        Employment and job benefits among those with spinal cord dysfunction: a comparison of people with spinal cord injury and multiple sclerosis.
        Arch Phys Med Rehabil. 2019; 100: 1932-1938
        • Coyne KS
        • Boscoe AN
        • Currie BM
        • Landrian AS
        • Wandstrat TL.
        Understanding drivers of employment changes in a multiple sclerosis population.
        Int J MS Care. 2015; 17: 245-252
        • Jellie B
        • Sweetland J
        • Riazi A
        • Cano SJ
        • Playford ED.
        Staying at work and living with MS: a qualitative study of the impact of a vocational rehabilitation intervention.
        Disabil Rehabil. 2014; 36: 1594-1599
        • Kirk-Brown AK
        • Van Dijk PA
        • Simmons RD
        • Bourne MP
        • Cooper BK.
        Disclosure of diagnosis of multiple sclerosis in the workplace positively affects employment status and job tenure.
        Mult Scler. 2014; 20: 871-876
        • Reed KS
        • Meade M
        • Jarnecke M
        • Rumrill P
        • Krause JS.
        Disclosing disability in the employment setting: perspectives from workers with multiple sclerosis.
        J Vocat Rehabil. 2017; 47: 175-184
        • Sweetland J
        • Riazi A
        • Cano SJ
        • Ed Playford
        Vocational rehabilitation services for people with multiple sclerosis: what patients want from clinicians and employers.
        Mult Scler. 2007; 13: 1183-1189
        • Krause JS
        • Reed KS.
        Barriers and facilitators to employment after spinal cord injury: underlying dimensions and their relationship to labor force participation.
        Spinal Cord. 2011; 49: 285-291
        • Krause JS
        • Pickelsimer E.
        Relationship of perceived barriers to employment and return to work five years later: a pilot study among 343 participants with spinal cord injury.
        Rehabil Couns Bull. 2008; 51: 118-121
        • US Census Bureau
        Current population survey (CPS).
        2009 (Available at) (Accessed March 19, 2021)
        • Centers for Medicare and Medicaid Services
        Medicare health outcomes survey (HOS).
        2014 (Available at:) (Accessed March 19, 2021)
      1. Aust R, Jarnecke M, Krause JS, Reed KS, Meade M. Considerations and consequences for employment of disclosing a diagnosis of multiple sclerosis (MS). Available at: https://worksupport.com/documents/Research_Study_2_Brief_31.pdf. Accessed March 19, 2021.

        • Henry AD
        • Petkauskos K
        • Stanislawyzk J
        • Vogy J.
        Employer-recommended strategies to increase opportunities for people with disabilities.
        J Vocat Rehabil. 2014; 41: 237-248
        • Moore P
        • Harding KE
        • Clarkson H
        • Pickersgill TP
        • Wardle M
        • Robertson NP.
        Demographic and clinical factors associated with changes in employment in multiple sclerosis.
        Mult Scler. 2013; 19: 1647-1654