Vanotti Sandra, Jaworski Michael, Ayala Oscar Daniel, Román María Sol, González Federico Martín, Abulafia Carolina, Iglesias Passada Juan, Bardoneschi Lara, Saladino María Laura, Cáceres Fernando, Macías Islas Miguel Ángel, Benedict Ralph H B
INERE - Institute of Restorative Neurosciences, Buenos Aires, Argentina.
Universidad de Buenos Aires, Facultad de Psicología, Instituto de Investigaciones en Psicología, Buenos Aires, Argentina.
J Occup Rehabil. 2025 Aug 18. doi: 10.1007/s10926-025-10318-y.
In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM.
A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey.
(i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations.
Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.
鉴于拉丁美洲多发性硬化症患者（PwMS）失业率不断上升且工作条件恶劣，多发性硬化症专家成立了生活质量工作组。本研究旨在：（i）描述拉丁美洲PwMS的职业结局和就业状况；（ii）调查不同残疾水平与就业状况之间的关系；（iii）量化工作场所便利措施的使用情况，并探索拉丁美洲工作场所便利措施潜在的临床、认知和社会人口学预测因素。
从阿根廷、智利、哥伦比亚、墨西哥和巴拉圭共招募了86名PwMS，其中79名（91%）具有复发缓解型表型，61名（70.9%）为女性。评估方案包括简易视觉记忆量表（BVMS）、多发性硬化症简易国际认知评估量表（BICAMS）、多发性硬化症神经心理学筛查问卷、贝克抑郁量表第二版（BDI-II）、疲劳严重程度量表（FSS）以及社会经济地位（SES）调查。
（i）根据就业状况特征，47名PwMS（54.6%）被归类为工作稳定组，18名PwMS（20.9%）被归类为工作有挑战组，21名PwMS（24.4%）被归类为失业组，此外还描述了临床和社会人口学特征。（ii）层次聚类分析根据认知和身体残疾水平将PwMS分为三组，结果表明残疾水平较低与维持稳定就业的可能性较高相关。（iii）认知障碍自我意识更强、社会经济地位更高、教育程度更高以及身体残疾程度更高均预测了工作场所便利措施的使用情况，所有这些因素都导致工作场所便利措施的使用增加。
身体和神经心理残疾增加了被归类为失业组的可能性，而认知障碍自我意识、社会经济地位、残疾程度和教育程度等因素与工作场所便利措施的更多使用相关。拉丁美洲PwMS的失业率几乎比总体失业率高三倍，凸显了多发性硬化症对就业的重大影响。
