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多发性硬化症患者工作保留的心理决定因素。

Psychological determinants of job retention in multiple sclerosis.

机构信息

Leeds Centre for Neurosciences, Leeds General Infirmary, Leeds, UK.

School of Psychology, University of Leeds, Leeds, UK.

出版信息

Mult Scler. 2019 Mar;25(3):419-426. doi: 10.1177/1352458518754362. Epub 2018 Jan 24.

Abstract

BACKGROUND

Maintaining paid work is a key issue for people with multiple sclerosis (PwMS). Different factors, including psychological attributes, can influence job retention. Understanding their role should inform potential interventions to help PwMS retain employment.

OBJECTIVES

The aim of this study was to identify the key factors which improve job retention in an employed cohort of PwMS.

METHODS

This three-year longitudinal study used validated self-completed measures of physical and psychological factors at four time points over 28 months.

RESULTS

Of 208 employed PwMS, just over 1 in 10 was no longer working at the end of the study. Three variables were predictive of continuing employment; low 'work instability' at baseline increased the odds of job retention by a factor of 12.76; high levels of self-efficacy by a factor of 4.66 and being less than 50 years of age increased the odds of job retention by a factor of 3.90. Path analysis demonstrated the mediating role of self-efficacy between the physical impact of MS and the level of work instability at exit.

CONCLUSION

Screening for work instability and self-efficacy in a clinical setting followed by appropriate interventions to increase self-efficacy and reduce work instability could aid job retention in MS.

摘要

背景

对于多发性硬化症患者(PwMS)来说,维持有薪工作是一个关键问题。包括心理特征在内的不同因素可能会影响工作保留率。了解这些因素的作用,应该可以为潜在的干预措施提供信息,以帮助 PwMS 保留工作。

目的

本研究的目的是确定哪些关键因素可以提高就业多发性硬化症患者群体的工作保留率。

方法

这项为期三年的纵向研究使用了经过验证的、自我完成的身体和心理因素测量方法,在 28 个月的时间内进行了 4 次测量。

结果

在 208 名在职 PwMS 中,只有不到 10%的人在研究结束时不再工作。有三个变量可以预测继续就业;基线时较低的“工作不稳定”使保留工作的几率增加了 12.76 倍;自我效能感较高,几率增加了 4.66 倍;年龄小于 50 岁,几率增加了 3.90 倍。路径分析表明,自我效能感在 MS 的身体影响和离职时的工作不稳定程度之间起中介作用。

结论

在临床环境中对工作不稳定和自我效能进行筛查,然后采取适当的干预措施来提高自我效能感和降低工作不稳定,这可能有助于多发性硬化症患者保留工作。

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