Academic journal article The Journal of Rehabilitation

Predictors of Return to Work Intention among Unemployed Adults with Multiple Sclerosis: A Reasoned Action Approach

Academic journal article The Journal of Rehabilitation

Predictors of Return to Work Intention among Unemployed Adults with Multiple Sclerosis: A Reasoned Action Approach

Article excerpt

The purpose of this study was to examine precursors to the intention to return to work among a sample of unemployed adults with multiple sclerosis (MS). One promising approach for understanding factors influencing a commitment to resume employment is referred to as the reasoned action model developed by Fishbein and Ajzen (2010). Employment interventions based on such a model of human behavior can potentially improve the involvement in the work force of a talented and experienced, but underemployed, group of workers such as people with MS.

Multiple Sclerosis and Unemployment

With its onset typically occurring in early to middle adulthood, MS affects people in the prime of life, and no domain of personal or social functioning is impervious to the unpredictable symptoms associated with this neurological disease (Kalb, 2016). The person's employment status is a frequent casualty of the illness. Although the vast majority of people with MS have employment histories and most were working at the time of diagnosis (Roessler, Rumrill, Li, & Leslie, 2015), the onset and continuation of the disease prompt what appears, in all too many cases, to be a premature exit from the labor force.

In fact, a majority of people with MS are no longer working five years post diagnosis, and the overall employment rate for people with MS hovers between 30 and 45 percent (Uccelli, Specchia, Battaglia, & Miller, 2009). In a review of international literature on MS and employment spanning a ten-year period (2002-2011), Schiavolin et al. (2013) found that 59% of adults with MS worldwide were unemployed. Furthermore, an identical jobless figure was reported in a recent national survey of Americans with MS by Rumrill, Roessler, Li, Daly, and Leslie (2015). Stressing that multiple, interacting factors influence the employment rates of adults with MS, Chiu, Chan, Bishop, DaSilva Cardosa, and O'Neill (2013) reported recent data from the NARCOMS (North American Research Committee on Multiple Sclerosis) Patient Registry indicating that the jobless rate for adults with MS was 58%. According to Chiu's et al. research, higher than typical unemployment rates persist for adults with MS even with the intervention of vocational rehabilitation (VR) services. Only 48% of clients with MS achieved the closed employed status following VR services, which contrasts with the 62% closed employed rate for all VR clients nationwide.

Of particular importance is the social and personal impact that these high unemployment rates have on individuals with MS and society. In the aforementioned national survey by Rumrill et al. (2015), despite the high unemployment rates reported, members of the sample had strong employment and educational records. For example, 98 percent of respondents had employment histories, and 82 percent were still working at the time of diagnosis. In regard to educational background, 98 percent of participants were high school graduates, and 46 percent were college graduates (Rumrill et al.). With MS impacting approximately 450,000 Americans, and an estimated 10,000 new cases identified each year in the US (an incidence rate that has increased steadily over the past 50 years; Murray, 2016), the high rate of attrition from the workforce means that society is losing a great many highly qualified people from the labor market (NMSS, 2016).

From the personal perspectives of individuals with MS, being unemployed negatively affects general quality of life, identity, and self-esteem, along with much needed financial resources and health benefits (Nissen & Rumrill, 2016; Rubin, Roessler, & Rumrill, 2016; Szymanski & Parker, 2010). Leyshon (2012) stressed that employment is an important life role, one that many people with disabilities are committed to maintaining as long as possible for the benefits they gain from working. Moore et al. (2013) and Antao et al. (2013) also pointed out that psychological gains accrue in addition to the material benefits derived from greater household income and access to health insurance and retirement plans. …

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