College of Health Professions, Medical University of South Carolina, Charleston, SC.
Health Economics Resource Center, VA Palo Alto, Menlo Park, CA.
Arch Phys Med Rehabil. 2022 Dec;103(12):2355-2361. doi: 10.1016/j.apmr.2022.05.013. Epub 2022 Jun 17.
To identify how prediagnosis employment, education, demographic statuses, and disease factors relate to job retention among people with multiple sclerosis (MS).
Cross-sectional logit model.
Data were collected at an academic Medical University and a specialty hospital, both in the Southeastern US.
People with MS (N=1126) who were employed at the time of MS diagnosis.
Not applicable.
Job retention was measured by employment status at the time of follow-up assessment.
Prediagnostic educational attainment was predictive of job retention. Among several prediagnostic employment characteristics, only working in production, transportation, and material moving was significantly related to a lower odds of job retention compared with those working in professional/managerial occupations. Aging factors were strongly related to job retention, with declines in job retention observed with increasing age and years since diagnosis. Non-Hispanic Black and Hispanic participants reported lower odds of job retention than non-Hispanic White participants, although there were no observed effects of sex. A significantly lower job retention rate was observed among those with progressive MS, compared with relapsing-remitting. Job retention was also less likely among people with greater MS severity and fatigue.
Job retention strategies and interventions should target people with greater MS complications and severity, as well as non-Hispanic Black and Hispanic persons, because these characteristics are more highly related to job retention than our prediagnostic employment and vocational history.
确定在多发性硬化症(MS)患者中,诊断前的就业、教育、人口统计学状况和疾病因素与工作保留之间的关系。
横截面逻辑回归模型。
数据收集于美国东南部的一所学术医学大学和一家专科医院。
在 MS 诊断时就业的 MS 患者(N=1126)。
不适用。
工作保留情况通过随访评估时的就业状况来衡量。
诊断前的教育程度是工作保留的预测因素。在几种诊断前的就业特征中,与从事专业/管理职业的人相比,仅从事生产、运输和物料搬运工作与工作保留的几率较低显著相关。年龄因素与工作保留密切相关,随着年龄和诊断后年限的增加,工作保留率下降。与非西班牙裔白人参与者相比,非西班牙裔黑人和西班牙裔参与者报告的工作保留几率较低,尽管性别没有观察到影响。与缓解复发型相比,进展型 MS 患者的工作保留率明显较低。MS 严重程度和疲劳程度较高的患者,工作保留的可能性也较低。
工作保留策略和干预措施应针对 MS 并发症和严重程度较高的患者,以及非西班牙裔黑人和西班牙裔人群,因为这些特征与工作保留的关系比我们的诊断前就业和职业历史更密切。