Work - Volume 52, issue 4

Article Type: Editorial

DOI: 10.3233/WOR-152199

Citation: Work, vol. 52, no. 4, pp. 723-724, 2015

Authors: Bishop, Malachy | Rumrill, Phillip D.

Article Type: Research Article

Abstract: BACKGROUND: This article presents an overview of multiple sclerosis (MS), one of the most common neurological disorders in the Western Hemisphere. We explore the impacts of MS on employment, career development, and community living, and the implications for rehabilitation professionals. OBJECTIVE: The objective in this article is to provide a current and comprehensive review of the etiology and symptoms, incidence and prevalence, and current treatment strategies for MS, and the effects of MS on vocational and psychosocial outcomes. METHODS: This analysis represents a comprehensive review of the relevant medical, vocational, community living, and rehabilitation research literature. …RESULTS: Living with MS is associated with wide-ranging and unpredictable effects on employment, career development, and community independence. Effective responses by health and rehabilitation professionals require a comprehensive understanding of this progressive and complex condition and its psychosocial impacts. CONCLUSIONS: Customized interventions from allied health professionals and rehabilitation counselors that are grounded in the unique features of MS and that reflect current best practices in Vocational Rehabilitation are required to improve rehabilitation outcomes for people with MS. Show more

Keywords: Chronic illness, vocational rehabilitation, allied health, independent living

DOI: 10.3233/WOR-152200

Citation: Work, vol. 52, no. 4, pp. 725-734, 2015

Authors: Rumrill Jr., Phillip D. | Roessler, Richard T. | Li, Jian | Daly, Katherine | Leslie, Mykal

Article Type: Research Article

Abstract: BACKGROUND: The recent rehabilitation literature does not include a thorough assessment of the employment concerns of people with MS. OBJECTIVE: This article presents descriptive findings from a national survey of the employment concerns of Americans with multiple sclerosis (MS; N  = 1,924), representing nine chapters of the National Multiple Sclerosis Society. METHODS: Respondents were asked to evaluate 38 employment concerns items on two dimensions, importance and satisfaction, for the purpose of identifying strengths and weaknesses in the employment policies and practices affecting the labor force participation of people with MS. RESULTS: Results revealed a total …of 32 employment strengths and six employment weaknesses. CONCLUSIONS: In spite of a jobless rate of more than 60 percent, people with MS were satisfied with the majority of employment concerns. Implications of these findings for rehabilitation policy and service delivery are examined. Show more

Keywords: Chronic illness, career development, vocational rehabilitation

DOI: 10.3233/WOR-152201

Citation: Work, vol. 52, no. 4, pp. 735-748, 2015

Authors: Chiu, Chung-Yi | Chan, Fong | Edward Sharp, Seneca | Dutta, Alo | Hartman, Ellie | Bezyak, Jill

Article Type: Research Article

Abstract: OBJECTIVE: To examine the relationship between employment status (no employment, part-time employment, and full-time employment) and functional disability, health-related quality of life, and life satisfaction of people with MS. METHODS: 157 individuals with MS completed a survey packet, including employment status, self-report disability severity, and health-related scales. A series of multivariate analysis of variance was performed to determine the differences between employment groups in health-related outcomes. RESULTS: The unemployed group had the highest levels of incapacity and social impairments among the three groups. They also had the lowest physical health-related quality of life and life satisfaction. …The part-time employed group had the lowest levels of depression and higher levels of physical activity participation among the three groups of individuals with MS. CONCLUSIONS: Employment is significantly related to health-related quality of life, and as a result, it should be considered an important public health intervention for people with MS. Show more

Keywords: Employment, poverty, functional disability, health-related quality of life, multiple sclerosis

DOI: 10.3233/WOR-152202

Citation: Work, vol. 52, no. 4, pp. 749-756, 2015

Authors: Bishop, Malachy | Rumrill Jr, Phillip D. | Roessler, Richard T.

Article Type: Research Article

Abstract: BACKGROUND: This article presents a replication of Rumrill, Roessler, and Fitzgerald’s 2004 analysis of a three-factor model of the impact of multiple sclerosis (MS) on quality of life (QOL). The three factors in the original model included illness-related, employment-related, and psychosocial adjustment factors. OBJECTIVE: To test hypothesized relationships between QOL and illness-related, employment-related, and psychosocial variables using data from a survey of the employment concerns of Americans with MS (N  = 1,839). METHODS: An ex post facto, multiple correlational design was employed incorporating correlational and multiple regression analyses. RESULTS: QOL was positively related to educational …level, employment status, job satisfaction, and job-match, and negatively related to number of symptoms, severity of symptoms, and perceived stress level. The three-factor model explained approximately 37 percent of the variance in QOL scores. CONCLUSIONS: The results of this replication confirm the continuing value of the three-factor model for predicting the QOL of adults with MS, and demonstrate the importance of medical, mental health, and vocational rehabilitation interventions and services in promoting QOL. Show more

Keywords: Employment, chronic illness, mental health, psychosocial

DOI: 10.3233/WOR-152203

Citation: Work, vol. 52, no. 4, pp. 757-765, 2015

Authors: Fong, Mandy W.M. | Lee, Eun-Jeong | Sheppard-Jones, Kathy | Bishop, Malachy

Article Type: Research Article

Abstract: BACKGROUND: For people with multiple sclerosis (MS), limitations in performing activities of daily living can have a significant impact on personal independence, residential safety, and quality of life. In this study we explored the utility of the Home Functioning Scale in identifying home functioning profiles and generating rehabilitation interventions. OBJECTIVE: The objective of this study was to determine whether distinctive and meaningful home functioning profiles could be identified among adults with MS based on Home Functioning Scale scores. METHODS: Home Functioning Scale scores and additional data from a representative national sample of 3,834 adults were analyzed. …We used cluster analysis and MANOVA to identify and evaluate group differences. RESULTS: Three distinct home functioning profiles emerged in the analysis: (1) minimal impairment (31.1% of participants); (2) moderate impairment (52.4%); and (3) severe impairment (16.5%). The three groups exhibited significant differences on demographic and MS related characteristics, perceived cognitive function, perceived MS impact on physical and psychological function, and life satisfaction. CONCLUSION: The profile characteristics of the identified groups are presented and the implications of the results for rehabilitation practitioners and the investigation of home functioning in activities of daily living are discussed. Show more

Keywords: Cluster analysis, activities of daily living

DOI: 10.3233/WOR-152204

Citation: Work, vol. 52, no. 4, pp. 767-776, 2015

Authors: Lee, Eun-Jeong | Pieczynski, Jessica | DeDios-Stern, Samantha | Simonetti, Camille | Lee, Gloria K.

Article Type: Research Article

Abstract: BACKGROUND: Caregivers of individuals with MS may experience unique caregiver strain due to the age at onset and progressive nature of the disease. Additionally, because MS is more prevalent in women, men often become spousal caregivers. However, gender differences in psychosocial adjustment among caregivers have not been fully explored. OBJECTIVE: The purpose of this study was to explore gender differences in the need for various supports and type of social support needed, caregiver strain, and quality of life among caregivers for individuals with MS. METHODS: 106 caregivers participated in this study. Independent sample t -tests and …multiple regression analyses were conducted to examine gender differences in strain, need for supports, social support, and quality of life. RESULTS: Analyses revealed gender difference among important psychosocial variables. Specifically, women reported higher levels of caregiver strain, higher needs for emotional support, and higher perceived social support. Additionally, multiple regression analyses revealed an inverse relationship between expressed emotional needs and quality of life for men, but not for women. CONCLUSIONS: MS caregivers experience significant strain that diminishes quality of life. Social support and needs fulfillment can act to buffer this stress; however, results indicate that this varies by gender, with gender differences observed in strain, perceived support, and expressed needs among MS caregivers. The study implications for rehabilitation research are discussed. Show more

Keywords: Caregiving, gender differences, multiple sclerosis

DOI: 10.3233/WOR-152205

Citation: Work, vol. 52, no. 4, pp. 777-787, 2015

Authors: Li, Jian | Fitzgerald, Shawn M. | Bishop, Malachy | Rumrill, Phillip D. | Wang, Fangning

Article Type: Research Article

Abstract: BACKGROUND: Due to the extent and complexity of its physical, cognitive, and psychological accompaniments, multiple sclerosis has tremendously negative effects on employment outcomes for adults with the disease. OBJECTIVE: This article extends the current understanding of the relationship between disease-related and functional factors and employment status among adults with multiple sclerosis. METHODS: Findings are reported in terms of descriptive statistics and logistic regression. The logistic regression analysis was completed to determine the extent to which disease-related and functional predictors contributed to the overall prediction model for the employment status of adults with MS. RESULTS: …The combined variables explained approximately 33% of the variance in employment status. In addition to three items of the Psychological subscale and 12 items of the Physical subscale, one of the items from the Cognitive Functioning Scale contributed to the prediction of employment status. CONCLUSIONS: The findings emphasize the importance of including physical, psychological, and cognitive functioning variables when predicting employment status among adults with multiple sclerosis. Show more

Keywords: Multiple sclerosis, employment, cognitive functioning, psychological symptom, physical symptom

DOI: 10.3233/WOR-152206

Citation: Work, vol. 52, no. 4, pp. 789-797, 2015

Article Type: Editorial

DOI: 10.3233/WOR-152207

Citation: Work, vol. 52, no. 4, pp. 799-799, 2015

Article Type: Other

DOI: 10.3233/WOR-152209

Citation: Work, vol. 52, no. 4, pp. 801-801, 2015