Employment-associated factors in multiple sclerosis: Results of a cross-sectional study in Germany

Abstract

Aims: Identification of employment-associated factors with regard to patients with multiple sclerosis (PwMS) in Germany: the impact of the working situation on PwMS, the subjective difficulties and problems PwMS may experience at their work place and the reasons for withdrawing from work. Methods: 279 PwMS (189 employed (EM), and 90 early retired (ER)) completed a comprehensive questionnaire with standardized instruments: Multiple sclerosis work difficulties questionnaire (MSWDQ) on workplace related problems, Würzburger screening (WüScr) on perceived burden of disease with regard to work. Further general data about employment status, multiple sclerosis disease information including main symptoms and patients adaptations for an optimal working place were collected. Employed PwMS were asked about their challenges at current working place, ER PwMS about their last job and their reasons for stop working. Results: Statistically significant factors for employment were disease duration (p lessthan 0.001), EDSS (p lessthan 0.001) and educational level (p = 0.0237). According to MSWDQ, PwMS rated employment as very important, 48% of EM patients considered not to stop working or to change job completely (58%) and 40% did not plan to reduce work. According to WüScr PwMS were highly burdened by their disease. Perceived burden of work and workplace-related factors contributed to early retirement. Multivariable regression analyses showed the main symptoms associated with workplace difficulties: mobility/walking, pain, mood, balance, cognitive impairment, vision disturbances and fatigue. With regard to maintenance of employment, EM and ER patients requested adaptations of their work place such as better accessibility, flexible working time, less stress and more ergonomically designed elements. Conclusion: In order to keep PwMS longer in employment, the results of our study indicate that it is necessary to properly assess MS symptoms and treat them adequately, to optimize their work places, and to raise awareness among employers and colleagues for the special needs of PwMS.