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Ponzio M, Podda J, Pignattelli E, Verri A, Persechino B, Vitturi BK, Bandiera P, Manacorda T, Inglese M, Durando P, Battaglia MA. Work Difficulties in People with Multiple Sclerosis. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10149-9. [PMID: 37921967 DOI: 10.1007/s10926-023-10149-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE This study identifies potential predictors of unemployment and describes specific work difficulties and their determinants in a subgroup of employed people with multiple sclerosis (PwMS). The specific work difficulties were evaluated using a validated tool that measures the impact of respondents' symptoms and of workplace features. METHODS A cross-sectional study was carried out in Italy during 2021-2022. The subjects included were adults (18-65 years) with a diagnosis of MS, currently employed or unemployed. Logistic regression models were used to determine the association between each potential determinant and employment status, while linear regression models were used to determine the association between determinants and specific work difficulties. RESULTS The main risk factors associated with a higher risk of being unemployed were being older, living in the South of Italy/islands, and having a higher disability level, while protective factors against unemployment were having a high level of education and 'stable' employment (an open-ended contract). Fatigue was found to be associated with all work difficulties analyzed; mood disorders emerged as the main predictors of mental health-related work difficulties; level of disability and comorbidity significantly impacted physical health-related ones, and a good quality of life was found to improve both workplace-related and mental health-related difficulties at work. CONCLUSION Identifying the most significant difficulties is a crucial step in the development of vocational rehabilitation interventions tailored to maximize the ability of PwMS to handle their job-related duties and demands.
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Affiliation(s)
- Michela Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
- Department of Research, Italian Multiple Sclerosis Foundation, via Operai 40, 16149, Genoa, Italy.
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Elena Pignattelli
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Anna Verri
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | | | | | - Paolo Bandiera
- Italian Multiple Sclerosis Association (AISM), Genoa, Italy
| | | | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Alberto Battaglia
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- Department of Life Science, University of Siena, Siena, Italy
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Moccia M, Fontana L, Palladino R, Falco F, Finiello F, Fedele M, Lanzillo R, Reppuccia L, Triassi M, Brescia Morra V, Iavicoli I. Determinants of early working impairments in multiple sclerosis. Front Neurol 2022; 13:1062847. [PMID: 36570442 PMCID: PMC9784221 DOI: 10.3389/fneur.2022.1062847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Unemployment can directly affect social status and identity. Assessing and adjusting determinants of early working impairments in a chronic disease can thus reduce its long-term burden. Hereby, we aim to evaluate differences in occupational history and early working impairments between people with multiple sclerosis (MS) and healthy workers. Methods This is a cross-sectional study comparing 71 workers with MS [age 41.7 ± 9.4 years; females 59.1%; EDSS 2.0 (1.0-6.0)] and 71 controls (age 42.6 ± 11.9 years; females 33.8%). All participants filled in Work Ability Index (WAI), Work Productivity and Activity Impairment (WPAI), European Questionnaire for Quality of Life (EuroQoL), Beck Depression Inventory II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). In MS, we further collected expanded disability status scale (EDSS), MS Questionnaire for Job difficulties (MSQ-Job), Fatigue severity scale (FSS), and the Brief International Cognitive Assessment for MS (BICAMS). Results Workers with MS were more working disabled (p < 0.01), less exposed to workplace risks (p < 0.01), and more limited in fitness to work (p = 0.01), compared with controls. On linear regression models adjusted by age, sex, education, and type of contract, people with MS had worse WAI (Coeff=-5.47; 95% CI = -7.41, -3.53; p < 0.01), EuroQoL (Coeff = -4.24; 95% CI = -17.85, -6.50; p < 0.01), BDI-II (Coeff = 3.99; 95% CI = 2.37, 7.01; p < 0.01), and PSQI (Coeff = 4.74; 95% CI = 3.13, 7.61; p < 0.01), compared with controls, but no differences in WPAI (p = 0.60). EuroQoL, BDI-II, and PSQI were equally associated with both WAI and WPAI in MS and controls (all p< 0.01). In MS, worse MSQJob was associated with higher EDSS (Coeff = 5.22; 95% CI = 2.24, 7.95; p < 0.01), progressive disease (Coeff = 14.62; 95% CI = 5.56, 23.69; p < 0.01), EuroQoL (Coeff = 4.63; 95% CI = 2.92, 6.35; p < 0.01), FSS (Coeff = 0.55; 95% CI = 0.38, 0.72; p < 0.01), and cognitive impairment (Coeff = 4.42; 95% CI = 0.67, 8.22; p = 0.02). Discussion Early factors associated with working difficulties in MS include disability, fatigue, depression, and cognitive dysfunction. Early identification of clinical features potentially causing working difficulties should be considered to enhance job retention, along with targeted prevention and protection measures.
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Affiliation(s)
- Marcello Moccia
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy,Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,*Correspondence: Marcello Moccia
| | - Luca Fontana
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, Federico II University of Naples, Naples, Italy,Department of Primary Care and Public Health, Imperial College, London, United Kingdom
| | - Fabrizia Falco
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Ferdinando Finiello
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Mauro Fedele
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Liberata Reppuccia
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Ivo Iavicoli
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
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Vitturi BK, Rahmani A, Dini G, Montecucco A, Debarbieri N, Sbragia E, Bandiera P, Ponzio M, Battaglia MA, Manacorda T, Persechino B, Buresti G, Inglese M, Durando P. Occupational outcomes of people with multiple sclerosis: a scoping review. BMJ Open 2022; 12:e058948. [PMID: 35777874 PMCID: PMC9252209 DOI: 10.1136/bmjopen-2021-058948] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature. DESIGN Scoping review. DATA SOURCES A comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits. ELIGIBILITY CRITERIA We included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information. METHODS This review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings. RESULTS The initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: 'Changes in work and occupational status due to MS', 'work-related socio-economic consequences of MS', 'risk factors for unfavourable occupational outcomes', 'reported barriers to employment', 'reported job accommodations and vocational rehabilitation strategies', 'job satisfaction, stigma, and disclosing the diagnosis in the workplace' and 'rating clinical scales'. CONCLUSIONS There are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS.
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Affiliation(s)
| | - Alborz Rahmani
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicoletta Debarbieri
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elvira Sbragia
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paolo Bandiera
- Italian Multiple Sclerosis Association (AISM), Genoa, Italy
| | - Michela Ponzio
- Research Area, Italian Multiple Sclerosis Association, Genoa, Italy
| | - Mario Alberto Battaglia
- Research Area, Italian Multiple Sclerosis Association, Genoa, Italy
- Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
- Department of Life Science, University of Siena, Siena, Italy
| | | | | | | | - Matilde Inglese
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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van Egmond E, van Gorp D, Honan C, Heerings M, Jongen P, van der Klink J, Reneman M, Beenakker E, Frequin S, de Gans K, Hengstman G, Hoitsma E, Mostert J, Verhagen W, Zemel D, Middelkoop H, Visser L, van der Hiele K. A Dutch validation study of the Multiple Sclerosis Work Difficulties Questionnaire in relapsing remitting multiple sclerosis. Disabil Rehabil 2019; 43:1924-1933. [PMID: 31702954 DOI: 10.1080/09638288.2019.1686072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The current study aimed to evaluate the psychometric properties of the Dutch version of the Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23). METHODS Two hundred and thirty-nine employed persons with multiple sclerosis (MS) and 59 healthy controls completed the MSWDQ-23. To verify the factor structure, a confirmatory factor analysis was conducted. To assess construct validity, the MSWDQ-23 scores were correlated to measures of physical disability, fatigue, cognitive and neuropsychiatric problems, depression, health-related quality of life, and work-related variables. MSWDQ-23 scores were compared within different age groups, gender, education levels, and job types. Predictive validity was assessed using a logistic regression analysis to predict a deterioration in employment status after one year based on MSWDQ-23 scores. RESULTS The internal consistency of the MSWDQ-23 was acceptable (α = 0.913, 95% CI = 0.897-0.928) and the results indicated a fair fit. The MSWDQ-23 showed acceptable construct validity, confirming 94% of the hypotheses. The total scale and the psychological/cognitive subscale were able to predict a deterioration in employment status after one year (χ2(1)=18.164, p < 0.001). CONCLUSIONS The Dutch version of the MSWDQ-23 is a valid and internally consistent instrument to measure self-reported work difficulties in persons with MS.Implications for rehabilitationThe Dutch version of the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) is a reliable and valid tool to measure self-reported work difficulties in people with multiple sclerosis (MS).More psychological and cognitive work difficulties are predictive of a deteriorated employment status after one year.The MSWDQ-23 is a helpful tool for researchers and (occupational) health professionals to identify current work difficulties in persons with MS and identify persons at risk for a deterioration in employment one year later.
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Affiliation(s)
- Elianne van Egmond
- National Multiple Sclerosis Foundation, Rotterdam, The Netherlands.,Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Dennis van Gorp
- National Multiple Sclerosis Foundation, Rotterdam, The Netherlands.,Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Cynthia Honan
- Discipline of Psychology, School of Medicine, University of Tasmania, Tasmania, Australia
| | - Marco Heerings
- National Multiple Sclerosis Foundation, Rotterdam, The Netherlands
| | - Peter Jongen
- MS4 Research Institute, Nijmegen, The Netherlands.,Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jac van der Klink
- Department of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Michiel Reneman
- Department of Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Ernesto Beenakker
- Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Stephan Frequin
- Department of Neurology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Koen de Gans
- Department of Neurology, Groene Hart Hospital, Gouda, The Netherlands
| | - Gerald Hengstman
- Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands
| | - Elske Hoitsma
- Department of Neurology, Alrijne Hospital Leiden, Leiden, The Netherlands
| | - Jop Mostert
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Wim Verhagen
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Désirée Zemel
- Department of Neurology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Huub Middelkoop
- Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Leo Visser
- Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.,Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Karin van der Hiele
- National Multiple Sclerosis Foundation, Rotterdam, The Netherlands.,Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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5
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PERSECHINO B, FONTANA L, BURESTI G, FORTUNA G, VALENTI A, IAVICOLI S. Improving the job-retention strategies in multiple sclerosis workers: the role of occupational physicians. INDUSTRIAL HEALTH 2019; 57:52-69. [PMID: 30249932 PMCID: PMC6363588 DOI: 10.2486/indhealth.2017-0214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Several studies evaluated whether a person with multiple sclerosis is employed or not and investigated the main symptoms that hinder the job performance. However, despite occupational physicians are fundamental in managing disabled subjects, there is a serious lack of data regarding their role in improving employability of these workers. In this regard, we assessed occupational physicians' professional activity and training/updating needs in order to identify and develop management tools, operative procedures and training programs helpful to support and implement adequate job-retention strategies. Four hundred three Italian occupational physicians compiled a self-administered questionnaire to evaluate individual demographics, health surveillance system, fitness for work and training needs. Our findings confirmed the suitability to adopt environmental adjustments at workplace (particularly referring to the ergonomics of workstation, the typology of occupational risk factors and the working time) to accommodate individual's needs in order to improve working ability among multiple sclerosis workers. Moreover, training events discussing operational guidelines and standardized instruments and/or methodologies to adequately manage the disable workers should be fostered. Therefore, in this regard, occupational physicians could play a key role but they need more high-quality training especially concerning the different tools that are currently available to assess the work issues in multiple sclerosis patients.
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Affiliation(s)
- Benedetta PERSECHINO
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Luca FONTANA
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Giuliana BURESTI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Grazia FORTUNA
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Antonio VALENTI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Sergio IAVICOLI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
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6
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Kahraman T, Özdoğar AT, Honan CA, Ertekin Ö, Özakbaş S. The multiple sclerosis work difficulties questionnaire: translation and cross-cultural adaptation to Turkish and assessment of validity and reliability. Disabil Rehabil 2018; 41:2556-2562. [PMID: 29741962 DOI: 10.1080/09638288.2018.1470262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose: To linguistically and culturally adapt the Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) for use in Turkey, and to examine its reliability and validity. Methods: Following standard forward-back translation of the MSWDQ-23, it was administered to 124 people with multiple sclerosis (MS). Validity was evaluated using related outcome measures including those related to employment status and expectations, disability level, fatigue, walking, and quality of life. Randomly selected participants were asked to complete the MSWDQ-23 again to assess test-retest reliability. Results: Confirmatory factor analysis on the MSWDQ-23 demonstrated a good fit for the data, and the internal consistency of each subscale was excellent. The test-retest reliability for the total score, psychological/cognitive barriers, physical barriers, and external barriers subscales were high. The MSWDQ-23 and its subscales were positively correlated with the employment, disability level, walking, and fatigue outcome measures. Conclusions: This study suggests that the Turkish version of MSWDQ-23 has high reliability and adequate validity, and it can be used to determine the difficulties faced by people with multiple sclerosis in workplace. Moreover, the study provides evidence about the test-retest reliability of the questionnaire. Implications for rehabilitation Multiple sclerosis affects young people of working age. Understanding work-related problems is crucial to enhance people with multiple sclerosis likelihood of maintaining their job. The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a valid and reliable measure of perceived workplace difficulties in people with multiple sclerosis: we presented its validation to Turkish. Professionals working in the field of vocational rehabilitation may benefit from using the MSWDQ-23 to predict the current work outcomes and future employment expectations.
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Affiliation(s)
- Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University , Izmir , Turkey
| | - Asiye Tuba Özdoğar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University , Izmir , Turkey
| | - Cynthia Alison Honan
- Department of Psychology, School of Medicine, University of Tasmania , Newnham , Australia
| | - Özge Ertekin
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University , Izmir , Turkey
| | - Serkan Özakbaş
- Department of Neurology, Faculty of Medicine, Dokuz Eylül University , Izmir , Turkey
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7
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Raggi A, Giovannetti AM, Schiavolin S, Brambilla L, Brenna G, Confalonieri PA, Cortese F, Frangiamore R, Leonardi M, Mantegazza RE, Moscatelli M, Ponzio M, Torri Clerici V, Zaratin P, De Torres L. Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis. Disabil Rehabil 2018; 41:2255-2263. [PMID: 29658343 DOI: 10.1080/09638288.2018.1461937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Materials and methods: Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. Results: A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Conclusions: Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.
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Affiliation(s)
- Alberto Raggi
- a Neurology, Public Health and Disability Unit , Neurological Instiute C. Besta, IRCCS Foundation , Milan , Italy
| | - Ambra Mara Giovannetti
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy.,c Unit of Neuroepidemiology , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Silvia Schiavolin
- a Neurology, Public Health and Disability Unit , Neurological Instiute C. Besta, IRCCS Foundation , Milan , Italy
| | - Laura Brambilla
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Greta Brenna
- d Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Paolo Agostino Confalonieri
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Francesca Cortese
- d Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Rita Frangiamore
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Matilde Leonardi
- a Neurology, Public Health and Disability Unit , Neurological Instiute C. Besta, IRCCS Foundation , Milan , Italy
| | - Renato Emilio Mantegazza
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Marco Moscatelli
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Michela Ponzio
- e Scientific Research Area, Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Valentina Torri Clerici
- b Department of Neuroimmunology and Neuromuscular Diseases , Neurological Institute C. Besta, IRCCS Foundation , Milan , Italy
| | - Paola Zaratin
- e Scientific Research Area, Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Laura De Torres
- a Neurology, Public Health and Disability Unit , Neurological Instiute C. Besta, IRCCS Foundation , Milan , Italy
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8
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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Castro SSD, Castaneda L, Araújo ESD, Buchalla CM. Aferição de funcionalidade em inquéritos de saúde no Brasil: discussão sobre instrumentos baseados na Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 19:679-687. [DOI: 10.1590/1980-5497201600030018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Luciana Castaneda
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Brasil
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10
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Giovannetti AM, Schiavolin S, Brenna G, Brambilla L, Confalonieri P, Cortese F, Covelli V, Frangiamore R, Leonardi M, Mantegazza R, Moscatelli M, Ponzio M, Torri Clerici V, Zaratin P, Raggi A. Cognitive function alone is a poor predictor of health-related quality of life in employed patients with MS: results from a cross-sectional study. Clin Neuropsychol 2016; 30:201-15. [PMID: 26930374 DOI: 10.1080/13854046.2016.1142614] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Depression, anxiety, disease severity, and cognitive functions impact on the quality of life of people with MS. However, the majority of studies were not based on multivariate models and did not target employed patients. The aim of this study was to investigate predictors of HRQoL in persons with MS in the workforce considering cognitive, psychological, disease severity, and disability-related variables. METHODS Cross-sectional study. Hierarchical block regression analyses were conducted to identify predictors of physical and mental components of HRQoL, measured with the MSQOL-54. Candidate predictors included cognitive functioning (a selection of Rao's BRB-NT), sample features (age, education, MS duration), depressive symptoms (BDI-II), anxiety (STAI-Y), disability (WHODAS 2.0), and MS severity (EDSS): those that correlated with PCS and MCS with p < .250 and those that correlated with other predictors with coefficients >.800 were excluded from regression analyses. RESULTS In total, 181 patients (60.8% females, mean age 39.6, median EDSS 1.5) were included. In both models, cognitive variables had a poor explicative power. The models improved significantly when psychological, as well as, disease severity and disability variables were added. R(2) of complete models was 0.732 for the physical component, 0.697 for the mental one: BDI-II, STAI-State and, some WHODAS 2.0 scales were significant predictors of HRQoL. CONCLUSIONS Monitoring anxiety, depressive symptoms, and level of disability through self-reported questionnaires may provide useful suggestions to improve the HRQoL of persons with MS in the workforce, permitting to address possible problems in the work context and plan corrective actions.
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Affiliation(s)
- Ambra Mara Giovannetti
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Silvia Schiavolin
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Greta Brenna
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Laura Brambilla
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Paolo Confalonieri
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Francesca Cortese
- c Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Venusia Covelli
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Rita Frangiamore
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Matilde Leonardi
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Renato Mantegazza
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Marco Moscatelli
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Michela Ponzio
- d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Valentina Torri Clerici
- a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
| | - Paola Zaratin
- d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy
| | - Alberto Raggi
- b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy
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11
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Schiavolin S, Giovannetti AM, Leonardi M, Brenna G, Brambilla L, Confalonieri P, Frangiamore R, Mantegazza R, Moscatelli M, Clerici VT, Cortese F, Covelli V, Ponzio M, Zaratin P, Raggi A. Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job): definition of the cut-off score. Neurol Sci 2016; 37:777-80. [PMID: 26842465 DOI: 10.1007/s10072-016-2495-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/25/2016] [Indexed: 11/29/2022]
Abstract
Multiple Sclerosis (MS) mainly affects people of working age. The Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job) was designed to measure difficulties in work-related tasks. Our aim is to define cut-off score of MSQ-Job to identify potential critical situations that might require specific attention. A sample of patients with MS completed the MSQ-Job, WHODAS 2.0 and MSQOL-54 respectively for work difficulties, disability and health-related quality of life (HRQoL) evaluation. K-means Cluster Analysis was used to divide the sample in three groups on the basis of HRQoL and disability. ANOVA test was performed to compare the response pattern between these groups. The cut-off score was defined using the receiver operating characteristic (ROC) curve analyses for MSQ-Job total and count of MSQ-Job items scores ≥3: a score value corresponding to the maximum of the sensitivity-to-specificity ratio was chosen as the cut-off. Out of 180 patients enrolled, twenty were clustered in the higher severity group. The area under the ROC curve was 0.845 for the MSQ-Job total and 0.859 for the count of MSQ-Job items scores ≥3 while the cut-off score was 15.8 for MSQ-Job total and 8 for count of items scored ≥3. We recommend the use of MSQ-Job with this calculation as cut-off for identifying critical situations, e.g. in vocational rehabilitation services, where work-related difficulties have a significant impact in terms of lower quality of life and higher disability.
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Affiliation(s)
- Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy.
| | - Ambra Mara Giovannetti
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy
| | - Greta Brenna
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Laura Brambilla
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Paolo Confalonieri
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Rita Frangiamore
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Renato Mantegazza
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Marco Moscatelli
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Valentina Torri Clerici
- Department of Neuroimmunology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Francesca Cortese
- Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | | | - Michela Ponzio
- Scientific Research Area, Italian Foundation of Multiple Sclerosis, Genoa, Italy
| | - Paola Zaratin
- Scientific Research Area, Italian Foundation of Multiple Sclerosis, Genoa, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy
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12
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Raggi A, Covelli V, Schiavolin S, Scaratti C, Leonardi M, Willems M. Work-related problems in multiple sclerosis: a literature review on its associates and determinants. Disabil Rehabil 2015. [DOI: 10.3109/09638288.2015.1070295] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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