Supporting People with Multiple Sclerosis in Employment: A United Kingdom Survey of Current Practice and Experience

By Townsend, Gail | British Journal of Occupational Therapy, March 2008 | Go to article overview

Supporting People with Multiple Sclerosis in Employment: A United Kingdom Survey of Current Practice and Experience


Townsend, Gail, British Journal of Occupational Therapy


This paper reports on one section of a larger project, which examined employment issues from the perspectives of people with multiple sclerosis (MS) and the professionals who may support them in retaining or regaining employment. The aims of the study were, first, to explore the knowledge and experience of MS specialists, occupational therapists and disability employment advisers of employment and MS and, second, to identify the current practice of professionals supporting people with MS in work. A postal questionnaire was used to elicit a wide range of responses.

The results showed that the impact of MS on employment was well understood, but that there was less awareness of the wider social influences on the ability to retain employment. There was evidence of a range of support being offered by some participants, but there appeared to be a gap between the problems reported and interventions offered overall.

There is a need for further research to develop effective interventions targeted at supporting people with MS in work, which will underpin the implementation of Quality Requirement 6 of the National Service Framework for Long-Term Conditions.

Key words: Multiple sclerosis, employment, practice, occupational therapy, vocational rehabilitation.

Introduction

Multiple sclerosis (MS) is a complex and progressive neurological condition commonly affecting adults of working age (Compston and Coles 2002). MS presents with a wide range of symptoms, and the pattern and course of the disease vary from individual to individual (Polman et al 2001). Research indicates that people with MS are vulnerable to becoming unemployed. A very large study that examined data relating to employment from the 123,000 respondents in the National MS Survey found that 91.9% of respondents had an employment history and 58.5% were employed at disease onset (Kornblith et al 1986). However, within 5 years only 37.5% of those who were working at the onset of the condition remained in employment. A more recent Spanish study found that 71.3% of patients with progressive MS and 65.8% of patients with relapsing remitting MS were unemployed (Morales-Gonzales et al 2004).

The importance of employment extends beyond financial independence. Work and other meaningful occupations help to maintain positive health and wellbeing (Wilcock 1998, Yerxa 1998, Reynolds 2003, Waddell and Burton 2006), although these positive aspects may not be appreciated until the opportunities for work and occupation are taken away (Yerxa 1998). People with MS have a near-normal life expectancy (Ebers 2001) which, coupled with the young age at onset, means that they and their families can spend a long time dealing with the consequences of unemployment.

The impact of MS on employment

Research in North America indicates that the factors influencing the ability of a person with MS to remain in employment are complex. The loss of employment cannot be ascribed simply to having MS, but is a combination of disease characteristics and workplace, social and demographic factors (LaRocca et al 1985, Edgley et al 1991, Dyck and Jongbloed 2000, Roessler et al 2001, Johnson et al 2004).

The loss of employment is associated with increased disability, as measured by the Kurtzke Expanded Disability Status Scale (EDSS) (Kurtzke 1983, Grima et al 2000, O'Connor et al 2005, Pompeii et al 2005). The EDSS does not measure fatigue, nor is fatigue clearly linked to levels of disability or impairment (Schwid et al 2002); however, fatigue is a common symptom that has a significant impact on one's ability to work (Gulick et al 1989, Dyck and Jongbloed 2000, Rumrill et al 2004). Roessler et al (2004) found that the severity and persistence of specific symptoms may be stronger influences on the ability to retain employment than general disability, recognising that some symptoms can interfere with performance in the workplace more than others. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Supporting People with Multiple Sclerosis in Employment: A United Kingdom Survey of Current Practice and Experience
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.