Workplace Difficulties and Work Outcomes in Individuals with Multiple Sclerosis

Abstract

Multiple Sclerosis (MS) is one of the most common neurological disorders in working adults. Difficulties experienced by people with MS (pwMS) in the workplace due to their MS, may play a key role in their decision to leave work. Using a community sample of 189 pwMS, Paper 1 aimed to develop and validate a comprehensive and psychometrically sound questionnaire, the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), which addressed these employment difficulties. Also examined was the contribution of these difficulties to current employment outcomes including withdrawal from employment, reducing work hours, and changing the type of work performed due to MS; and the expectations of pwMS regarding their future employment. Paper 2 explored the simpler second-order structure of the MSWDQ reflecting the broader physical, cognitive, and psychological consequences of MS. The MSWDQ-Short Version (MSWDQ-SV) was developed and validated based on this structure. Using a subsample of 111 pwMS, Paper 3 examined the contribution of perceived vs. actual neuropsychological difficulties to employment outcomes and expectations, and the potential mediating and/or moderating role of self-reported depression. The results indicated that the 50-item MSWDQ measuring 12 domains of workplace difficulties, and the 23-item MSWDQ-SV measuring three higher second-order domains of workplace difficulties, predicted both current work outcomes and future employment expectations in pwMS. Both perceived and objective neuropsychological difficulties were important predictors of current work outcomes, whereas perceived neuropsychological difficulties better informed the expectations of pwMS regarding their future employment. Depression severity was unrelated to workplace outcomes and did not moderate between perceived or actual neuropsychological difficulties to the workplace outcomes or expectations. However, it influenced perceptions of neuropsychological difficulties in the workplace and expectations about future employment, and it mediated some of the relationships between these variables. The findings may have important implications for vocational rehabilitation programs for pwMS.