Strober Lauren B, Chiaravalloti Nancy, DeLuca John
Kessler Foundation, East Hanover, NJ, USA.
Department of Physical Medicine and Rehabilitation, Rutgers, State University of New Jersey - New Jersey Medical School, Newark, NJ, USA.
Work. 2018;59(1):39-47. doi: 10.3233/WOR-172667.
Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. While several factors for such high rates of unemployment have been identified, they do not account for the majority of the variance.
This study examines person-specific factors such as personality and coping, which may better account for individuals leaving the workforce.
Forty individuals with MS (20 considering reducing work hours or leaving the workforce and 20 remaining employed) were matched on age, gender, education, disease duration, and disease course, and administered a comprehensive survey of factors purported to be related to employment status.
Based on multiple, logistic regression analyses certain disease factors and person-specific factors differentiate those who are considering leaving work or reducing work hours and those staying employed. In particular, those expressing the need to reduce work hours or leaving the workforce reported more fatigue, anxiety, depression, and use of behavioral disengagement as a means of coping. In contrast, those staying employed reported greater levels of extraversion, self-efficacy, and use of humor as a means of coping. Together, fatigue, use of humor, and use of behavioral disengagement as a means of coping were the most significant factors, accounting for 44% of the variance.
Findings suggest that greater consideration be given to these factors and that interventions tailored to address these factors may assist individuals with MS staying employed and/or making appropriate accommodations.
多发性硬化症（MS）患者的失业率高达80%。虽然已经确定了导致如此高失业率的几个因素，但它们并不能解释大部分差异。
本研究考察了个人特定因素，如个性和应对方式，这些因素可能更能解释个体离开劳动力市场的原因。
40名MS患者（20名考虑减少工作时间或离开劳动力市场，20名仍在就业）在年龄、性别、教育程度、病程和疾病进程方面进行匹配，并接受了一项关于据称与就业状况相关因素的综合调查。
基于多项逻辑回归分析，某些疾病因素和个人特定因素区分了那些考虑离开工作或减少工作时间的人和仍在就业的人。特别是，那些表示需要减少工作时间或离开劳动力市场的人报告了更多的疲劳、焦虑、抑郁，并使用行为脱离作为一种应对方式。相比之下，仍在就业的人报告了更高水平的外向性、自我效能感，并使用幽默作为一种应对方式。疲劳、使用幽默以及使用行为脱离作为一种应对方式共同构成了最显著的因素，解释了44%的差异。
研究结果表明，应更多地考虑这些因素，针对这些因素的干预措施可能有助于MS患者继续就业和/或做出适当调整。
