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
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Article info
Publication history
Published online: March 05, 2021
Accepted:
February 13,
2021
Received in revised form:
January 26,
2021
Received:
December 14,
2020
Footnotes
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant nos. 90RT5035 and 90DP0050). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and endorsement by the Federal government should not be assumed.
Disclosures: none.
Identification
Copyright
© 2021 Published by Elsevier Inc. on behalf of The American Congress of Rehabilitation Medicine.
