Determinants of on-the-job-barriers in employed persons with multiple sclerosis: The role of disability severity and cognitive indices

Carrieri L, Sgaramella TM, Bortolon F, Stenta G, Fornaro L, Cracco A, Perini F, Soresi S.  Dipartimento di Scienze Filosofiche, Università di Cassino, Cassino, Italy.  Work. 2013 Mar 26. [Epub ahead of print]

BACKGROUND: Literature has shown that work maintenance is central in order to guarantee participation to persons with disability. Knowledge about potential sources of difficulties and obstacles is then crucial in order to prevent barriers and facilitate work maintenance and career development for persons with disabilities.

OBJECTIVE: Studies analyzing on-the-job barriers among employed people with multiple sclerosis (MS) have found evidence for a role of clinical determinants. The aim of this study was to describe in more detail the role of disability severity and of cognitive indices on work barriers.

PARTICIPANTS: Thirty-two employed adults with a diagnosis of MS with mild to moderate disability severity were included in the study. They were involved in the descriptive study while attending their planned care in the MS unit.

METHODS: Subjects completed neurocognitive tasks, a self-report measure of executive functioning and a face-to-face semi-structured interview exploring their perception of barriers at work.

RESULTS: Regression analyses showed a specific role of disability severity on perception of barriers due to physical, cognitive and interpersonal relationships; while cognitive indices appeared to predict barriers ascribed to company policy (cognitive score), accessibility (planning score) or difficulties in cognitive and task related abilities (self-rated executive functioning).

CONCLUSION: These findings underline the relevance of objective tasks and self-report questionnaires direct and indirect multi-dimensional assessment of functioning for early intervention planning. An ecological model of career development in adults with disabilities is also supported.

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