Neurological, physical and sociodemographic correlates of employment in multiple sclerosis: A meta-analysis

Gerhard, Larissa; Dorstyn, Diana; Murphy, Gregory C.; Roberts, Rachel

doi:10.1177/1359105318755262

Cited by 23 publications

(19 citation statements)

References 82 publications

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“…We did not find evidence that sex, self-reported cognitive function, depression or pain were associated with employment loss 2.5 years later, and the evidence for fatigue and age was weak. This is in line with a recent meta-analysis including 25 (mostly cross-sectional) studies reporting a key role of relapsing-remitting disease course and higher education and, to a lesser extent, fatigue, pain, disease duration and age, on employment status [13].…”

Section: Discussionsupporting

confidence: 91%

“…One of the strengths of this study is that employment was not operationalized as a dichotomous variable as often done in similar studies which include students and carers as unemployed [13]. Rather we have categorised participants as full time, part time, unemployment or not in the work force.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Discrimination in the workplace, which may lead to either unlawful discharge or failure to provide reasonable accommodations, is also a barrier to adequate employment in PwMS [11,12]. A 2018 meta-analysis highlighted that while many cross-sectional studies have investigated associations between employment and clinical and demographic characteristics, only two prospective studies have been published in this area, and more studies are needed [13].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Change in Employment Status and Associations with Quality of Life: A Prospective International Study of People with Multiple Sclerosis

et al. 2019

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Purpose This prospective international study aimed to assess the changes in employment, and predictors thereof, and associated change in mental health quality of life in people with multiple sclerosis (MS). Methods People with MS were recruited online through social media, forums and newsletters to complete an online English-language survey in 2012 and again in 2015, to assess changes in employment and clinical characteristics. Results 1276 people with MS of working age were included of whom 35.9% were employed full time, 25.6% part-time, 3.1% were unemployed and seeking employment, 19.7% were retired due to disability and 15.7% were not in the labour force. Part/full time employment decreased from 61.4 to 57.1% of the sample 2.5 years later, and 25.5% experienced some change in employment status. Lower level of education and higher level of disability at baseline predicted loss of employment at follow-up. 62.0% of the sample indicated that MS impacted on employment over their lifetime, associated with a lower level of education and progressive MS at time of diagnosis. Retiring due to disability was predictive of a decreased mental health related QOL score. Conclusion Employment status was negatively impacted by MS for most participants. We showed for the first time that employment loss was prospectively associated with poorer mental health related quality of life. Employment support including vocational services, reasonable flexibility in the workplace, and legal protection against discrimination should be widely available to assist people with MS, especially for those with progressive onset MS, higher disability and lower levels of education who are at higher risk of employment loss.

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Section: Discussionsupporting

confidence: 91%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of Change in Employment Status and Associations with Quality of Life: A Prospective International Study of People with Multiple Sclerosis

et al. 2019

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“…Für Patienten mit MS werden in dem biopsychosozialen Modell neben den funktionalen Beeinträchtigungen u.a. die Faktoren Erkrankungsdauer, progressive Verlaufsform, Fatigue, Vorbildung und Alter aufgeführt [6,13,14].…”

Section: Assoziation Zwischen Msfc Und Sleunclassified

Der Multiple Sclerosis Functional Composite korreliert mit der sozialmedizinischen Leistungsempfehlung zur Erwerbsfähigkeit von Rehabilitanden mit Multipler Sklerose

Leniger

Heiker

Ghadimi

2019

Fortschr Neurol Psychiatr

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Zusammenfassung Ziel der Studie Der Multiple Sclerosis Functional Composite (MSFC) bewertet mit den Untertests Lauf- und Handfunktion sowie Kognition die Funktionseinschränkungen der Multiplen Sklerose (MS). In der medizinischen Rehabilitation könnte der MSFC sich als hilfreiches Assessmentinstrument für die sozialmedizinische Leistungsempfehlung zur Erwerbsfähigkeit (SLE) am Ende der stationären Rehabilitation erweisen. Ziel der Studie war, eine Korrelation des MSFC mit der SLE zu überprüfen, deren Gültigkeit sechs Monate nach der Rehabilitation erfragt wurde. Methodik In einer retrospektiven, unizentrischen Längsschnittstudie wurde der MSFC zu Beginn (t0) und zum Ende (t1) der stationären Rehabilitation bei 84 Rehabilitanden mit MS im erwerbsfähigen Alter erhoben. Der MSFC (Gesamtscore, Untertests) wurde mit der SLE am Ende der Rehabilitation korreliert (positive SLE: ≥ 3h täglich, negative SLE: < 3h täglich). Sechs Monate nach der Rehabilitation wurde der Return to Work (RTW) erfragt (positiver RTW: ≥ 3h täglich, negativer RTW: < 3h täglich). Ergebnis 70 der 84 Rehabilitanden (83 %) erhielten eine positive SLE. Sie zeigten hinsichtlich epidemiologischer, MS- und rehabilitations-spezifischer Charakteristika keinen Unterschied zu den 14 Rehabilitanden mit negativer SLE. Rehabilitanden mit positiver SLE wiesen im Vergleich zu denen mit negativer SLE signifikant bessere MSFC-Werte im Gesamtscore (z-Score: + 0,11 vs. −0,55, p < 0,001), in den Untertests Kognition (PASAT-3: 42,3 Punkte vs. 27,7 Punkte; p < 0,001) und Lauffunktion (T25FW: 5,1 s vs. 6,7s; p = 0,002) auf. Hingegen war die Handfunktion (NHPT: 23,4 s vs. 26,5s; p = 0,064) ohne signifikanten Unterschied. Beide Gruppen zeigten im Verlauf der Rehabilitation (t0; t1) nichtsignifikante Verbesserungen (Gesamtscore, Untertests). Bei 31 der 84 Rehabilitanden (37 %) konnte der RTW nach sechs Monaten erhoben werden. 90 % der 31 Rehabilitanden beurteilten die SLE als zutreffend. Eine positive SLE korrelierte signifikant mit einem positiven RTW nach sechs Monaten (r = 0,411; p = 0,022). Keine signifikante Assoziation bestand zwischen dem MSFC(t1) (Gesamtscore, Untertests) und dem RTW nach sechs Monaten. Schlussfolgerung Auf Funktionsebene korreliert der MSFC im Gesamtscore (z-Score ≥ 0) signifikant mit einer positiven SLE bei Entlassung, deren Validität mit dem RTW sechs Monate nach der Rehabilitation belegt wurde. Maßgeblich waren die Untertests Kognition und Lauffunktion. In der medizinischen Rehabilitation der MS bietet sich daher der Einsatz des MSFC an, um basierend auf dem ermittelten Funktionsniveau eine fundierte Teilhabeempfehlung in Form der SLE zu entwickeln.

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“…Fatigue is particularly common in multiple sclerosis (MS), where it affects over 70% of patients and it is often perceived as the most disabling symptom [2]. Importantly, fatigue is a major predictor of unemployment in MS [3,4] and significantly impairs quality of life [5].…”

Section: Introductionmentioning

confidence: 99%

In search of distinct MS-related fatigue subtypes: results from a multi-cohort analysis in 1.403 MS patients

et al. 2019

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Fatigue is among the most disabling symptoms in patients with multiple sclerosis (PwMS). The common distinction between cognitive and motor fatigue is typically incorporated in self-rating instruments, such as the Chalder Fatigue Questionnaire (CFQ), the Fatigue Scale for Motor and Cognitive Functions (FSMC) or the Modified Fatigue Impact Scale (MFIS). The present study investigated the factor structure of the CFQ, the FSMC and the MFIS utilizing exploratory (EFA) and confirmatory factor analysis (CFA) as well as exploratory structural equation modeling (ESEM). Data of 1.403 PwMS were analyzed, utilizing four samples. The first sample (N = 605) was assessed online and split into two stratified halves to perform EFA, CFA, and ESEM on the CFQ and FSMC. The second sample (N = 293) was another online sample. It served to calculate CFA and ESEM on the CFQ and FSMC. The third sample was gathered in a clinical setting (N = 196) and analyzed by applying CFA and ESEM to the FSMC. The fourth sample (N = 309) was assessed in a clinical setting and allowed to run a CFA and ESEM on the MFIS. Proposed factor structures of all questionnaires were largely confirmed in EFA. However, none of the calculated CFAs and ESEMs could verify the proposed factor structures of the three measures, even with oblique rotation techniques. The findings might have implications for future research into the pathophysiological basis of MS-related fatigue and could affect the suitability of such measures as outcomes for treatment trials, presumably targeting specific sub-components of fatigue.

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Neurological, physical and sociodemographic correlates of employment in multiple sclerosis: A meta-analysis

Cited by 23 publications

References 82 publications

Predictors of Change in Employment Status and Associations with Quality of Life: A Prospective International Study of People with Multiple Sclerosis

Predictors of Change in Employment Status and Associations with Quality of Life: A Prospective International Study of People with Multiple Sclerosis

Der Multiple Sclerosis Functional Composite korreliert mit der sozialmedizinischen Leistungsempfehlung zur Erwerbsfähigkeit von Rehabilitanden mit Multipler Sklerose

In search of distinct MS-related fatigue subtypes: results from a multi-cohort analysis in 1.403 MS patients

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