PMID- 31586801
OWN - NLM
STAT- MEDLINE
DCOM- 20200608
LR  - 20200608
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 36
DP  - 2019 Nov
TI  - Predictors of vocational status among persons with multiple sclerosis.
PG  - 101411
LID - S2211-0348(19)30391-8 [pii]
LID - 10.1016/j.msard.2019.101411 [doi]
AB  - BACKGROUND: Multiple Sclerosis (MS) is a common cause of neurological disability 
      in young to middle-aged adults, resulting in physical, psychosocial, and 
      cognitive impairments. Manifestation of these symptoms during crucial work-life 
      years can greatly influence the ability of persons with (PwMS) to retain 
      employment. It is unknown what factors are most important in leading to work 
      disability, and if/how these different factors interact with each other and 
      result in work disability. OBJECTIVE: To determine significant predictors of 
      vocational status among PwMS using a structural equation modeling approach. 
      METHODS: A retrospective chart review identified PwMS at an academic tertiary 
      care hospital. The following data was collected: demographics and disease 
      characteristics, vocational status, physical disability status (Expanded 
      Disability Status Scale, EDSS), fine motor function (Nine Hole Peg Test, NHPT), 
      generalized fatigue (Fatigue Severity Scale, FSS), mood and anxiety symptoms 
      (Hospital Anxiety and Depression Scale, HADS) and cognitive function (Symbol 
      Digit Modalities Test, SDMT). An exploratory structural equation model (SEM) was 
      developed to examine the predictive utility of clinical and psychosocial 
      variables on vocational status after controlling for demographic and disease 
      characteristics. The fit of the model to the data was examined using the 
      comparative fit index (CFI), normal fit index (NFI), root-mean-squared error of 
      approximation (RMSEA), and standardized root mean residual (SRMR). RESULTS: There 
      were 158 PwMS included in the analysis. The final model demonstrated that SDMT 
      (beta = 0.16), EDSS (beta = -0.33), and HADS-D (beta = -0.23) significantly predicted 
      vocational status (ps < 0.05). It explained 37% of the variance and provided a 
      good fit to the data (chi(2)(11) = 13.01, p > 0.05, SRMR = 0.055, RMSEA = 0.034, 
      NFI = 0.94, CFI = 0.99. CONCLUSIONS: Physical disability, depressive symptoms, 
      and reduced information processing affect work-related disability and vocational 
      status among PwMS. Interventions targeting these factors should be prioritized by 
      clinicians.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Povolo, Christopher A
AU  - Povolo CA
AD  - London Health Sciences Center, London, Ontario, Canada.
FAU - Blair, Mervin
AU  - Blair M
AD  - Department of Clinical Neurological Sciences, Schulich School of Medicine and 
      Dentistry, Parkwood Institute, Lawson Health Research Institute, University of 
      Western Ontario, 550 Wellington Rd, London, ON, Canada.
FAU - Mehta, Swati
AU  - Mehta S
AD  - Lawson Health Research Institute, Department of Physical Medicine and 
      Rehabilitation, Western University, 750 Base Line Rd E, London, ON N6C 2R5, 
      Canada.
FAU - Rosehart, Heather
AU  - Rosehart H
AD  - London Health Sciences Center, London, Ontario, Canada.
FAU - Morrow, Sarah A
AU  - Morrow SA
AD  - London Health Sciences Center, London, Ontario, Canada; University of Western 
      Ontario, Department of Clinical Neurological Sciences, Western University, 339 
      Windermere Road, London, Ontario, N6A 5A5, Canada. Electronic address: 
      sarah.morrow@lhsc.on.ca.
LA  - eng
PT  - Journal Article
DEP - 20190926
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
SB  - IM
MH  - Adult
MH  - Cognitive Dysfunction/etiology/*physiopathology
MH  - Depression/etiology/*physiopathology
MH  - *Disabled Persons/statistics & numerical data
MH  - *Employment/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/complications/*physiopathology
MH  - *Severity of Illness Index
OTO - NOTNLM
OT  - Cognition
OT  - Depression
OT  - Functional Status
OT  - Multiple Sclerosis
OT  - Structural Equation Model
OT  - Vocation
EDAT- 2019/10/07 06:00
MHDA- 2020/06/09 06:00
CRDT- 2019/10/07 06:00
PHST- 2019/05/22 00:00 [received]
PHST- 2019/08/16 00:00 [revised]
PHST- 2019/09/23 00:00 [accepted]
PHST- 2019/10/07 06:00 [pubmed]
PHST- 2020/06/09 06:00 [medline]
PHST- 2019/10/07 06:00 [entrez]
AID - S2211-0348(19)30391-8 [pii]
AID - 10.1016/j.msard.2019.101411 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2019 Nov;36:101411. doi: 10.1016/j.msard.2019.101411. 
      Epub 2019 Sep 26.