Factors Associated with Employment Status in Individuals with Multiple Sclerosis.
Factors Associated with Employment Status in Individuals with Multiple Sclerosis.
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DOI：
10.7224/1537-2073.2014-057
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发表时间：
2015-11-01
影响因子：
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通讯作者：
Arnett, Peter
中科院分区：
文献类型：
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作者：
Cadden, Margaret;Arnett, Peter
背景：失业在多发性硬化症（MS）患者中很常见，并与巨大的社会经济负担相关。一些与ms相关的因素被发现与就业状况有关，包括疲劳、抑郁、认知问题和运动困难。然而，很少有研究在预测就业时综合考察这些因素。本研究旨在探讨这些变量对多发性硬化症患者就业状况的影响。方法：对53名多发性硬化症患者进行认知、情绪和社会因素的调查。综合评分采用代表认知、疲劳、抑郁和运动功能的因素分析。这些综合得分，以及扩展残疾状态量表得分，通过逻辑回归作为就业状态（工作，不工作）的预测因子进行了探讨。对中介模型也进行了研究。结果：一个包括运动功能、认知、抑郁和疲劳综合得分的模型显著区分了失业和就业人群。然而，只有认知、运动和疲劳的综合得分被发现与失业有显著的联系。使用1000个bootstrap样本的中介分析结果表明，认知和疲劳复合得分显著中介残疾对工作状态的影响。结论：认知功能和疲劳介导了MS残疾对就业状态的影响。针对多发性硬化症的认知困难和疲劳的干预措施可能有效地帮助个体维持就业。
BACKGROUND: Unemployment is common in individuals with multiple sclerosis (MS) and is associated with substantial socioeconomic burden. Several MS-related factors have been found to be associated with employment status, including fatigue, depression, cognitive problems, and motor difficulties. However, few studies have examined these factors collectively in predicting employment. The present study aimed to explore these variables together in predicting employment status in MS.METHODS: Fifty-three individuals with MS participating in a research study of cognitive, emotional, and social factors related to MS were examined. Composite scores were created using factor analysis that represented cognition, fatigue, depression, and motor function. These composite scores, along with the Expanded Disability Status Scale score, were explored as predictors of employment status (working, not working) via logistic regression. Models of mediation were also investigated.RESULTS: A model including composite scores of motor function, cognition, depression, and fatigue significantly distinguished those who are unemployed versus employed. However, only the cognitive, motor, and fatigue composite scores were found to be significantly associated with unemployment individually. RESULTS of a mediation analysis using 1000 bootstrap samples indicated that the cognitive and fatigue composite scores significantly mediated the effect of disability on work status.CONCLUSIONS: Cognitive function and fatigue mediate the effect of MS disability on employment status. Interventions targeting cognitive difficulties and fatigue in MS may be effective in helping individuals maintain employment.