Beier Meghan, Hartoonian Narineh, D'Orio Vanessa L, Terrill Alexandra L, Bhattarai Jagriti 'Jackie', Paisner Noah D, Alschuler Kevin N
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Division of Rehabilitation Psychology and Neuropsychology, Baltimore, MD, USA.
Multiple Sclerosis Center of Excellence, VA Puget Sound Health Care System, Seattle Division, Seattle, WA, USA.
Work. 2019;62(2):243-249. doi: 10.3233/WOR-192859.
Many individuals with multiple sclerosis (MS) are unemployed relatively soon after diagnosis. There is a paucity of research on the relationship between psychological distress and employment status in persons with MS.
To explore the relative distress of employed versus unemployed individuals with MS.
Secondary cross-sectional analysis of a mailed survey. Variables were categorized by demographics (age, gender, education, marital status), disease (EDSS, MS symptom duration, fatigue, MS-type), and psychosocial factors (depression, anxiety, perceived stress, self-reported general cognitive concerns, self-reported executive dysfunction). Univariate logistic regression analysis was used to identify variables significantly associated with employment status. All significant variables were then included in a multivariate model to identify the most salient correlates.
Univariate analyses identified 10 variables that were significantly associated with employment status: age, education, EDSS, MS symptom duration, MS-type, depression symptoms, perceived stress, fatigue, and self-reported cognitive symptoms. The multivariate model yielded four demographic and disease-related variables and one emotional distress variable (older age, moderate disability [EDSS], longer symptom duration, MS-type, higher perceived stress) as significant.
After adjusting for disease variables, demographics, and significant psychosocial factors, perceived stress remained associated with employment status, such that greater perceived stress was associated with being unemployed.
许多多发性硬化症（MS）患者在确诊后不久就失业了。关于MS患者心理困扰与就业状况之间关系的研究很少。
探讨MS在职与失业个体的相对困扰情况。
对邮寄调查进行二次横断面分析。变量按人口统计学特征（年龄、性别、教育程度、婚姻状况）、疾病（扩展残疾状态量表[EDSS]、MS症状持续时间、疲劳、MS类型）和心理社会因素（抑郁、焦虑、感知压力、自我报告的一般认知问题、自我报告的执行功能障碍）进行分类。单因素逻辑回归分析用于确定与就业状况显著相关的变量。然后将所有显著变量纳入多变量模型，以确定最显著的相关因素。
单因素分析确定了10个与就业状况显著相关的变量：年龄、教育程度、EDSS、MS症状持续时间、MS类型、抑郁症状、感知压力、疲劳和自我报告的认知症状。多变量模型得出四个与人口统计学和疾病相关的变量以及一个情绪困扰变量（年龄较大、中度残疾[EDSS]、症状持续时间较长、MS类型、较高的感知压力）具有显著性。
在对疾病变量、人口统计学特征和显著的心理社会因素进行调整后，感知压力仍然与就业状况相关，即较高的感知压力与失业相关。
