A-71 Subjective Employment Concerns: Correlates and Impact on Employment Status One Year Later in Women with Multiple Sclerosis

Objective Loss of employment is common in multiple sclerosis (MS) and is associated with fatigue, depression, and cognitive dysfunction. This study looked at a “low-risk” group of women, with subclinical levels of these factors, to evaluate whether subjective concerns about employment would relate to decreased employment status over time. Secondarily, fatigue, depressive symptoms, and cognition were also examined in relation to employment concerns at baseline, to determine whether subjective concerns might indicate prodromal psychiatric and cognitive dysfunction. Methods Our sample includes 52 employed women with MS who participated in a larger quasi-experimental employment study. Screening included open-ended questions about employment concerns and measures of fatigue (Fatigue Severity Scale), depression (Patient Health Questionnaire), and cognitive functioning (Symbol-Digit Modalities Test). Because this subset of women were considered “low-risk,” they were followed over time (1 year) with no active intervention. Results Overall, 16/52 women (44%) voiced employment concerns. A chi-square analysis revealed that 5 (31.3%) of those women had decreased employment status at one year, while only 3 (8.3%) women without employment concerns had decreased employment status (p = 0.049, Fisher’s exact). Comparison of women with and without employment concerns (independent t-tests), indicated that those with concerns had higher depressive symptoms (p = 0.017); groups did not differ in cognitive functioning or fatigue at baseline. Conclusions Findings suggest that women with MS who were previously thought to be “low-risk” may still experience negative functional outcomes such as decreased employment status, when they voice subjective employment concerns. Employment concerns may also indicate prodromal depressive symptoms.

Employment concerns experienced by ovarian cancer patients and caregivers.

69 Background: Our aim was to obtain patient input on the impact of cancer treatment on employment. Methods: We recruited patients with ovarian cancer receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Participants completed a 45-minute interview with 2 interviewers on their costs of care, including employment concerns. Interviews were recorded, transcribed, and coded by 3 analysts using inductive thematic analysis. Results: Of 22 participants, 86% were <65 years old and 28% were on curative intent treatment. There were 18 with currently evaluable interviews. Themes are shown in the table. Conclusions: Cancer care has a negative impact on patient and caregiver work productivity, income, and employer benefits. Incorporating resources to navigate workplace factors, such as Family Medical Leave Act benefits and negotiating accommodations with an employer, could improve care delivery. [Table: see text]

Determinants of General Satisfaction With the Employment Situation Among People With Multiple Sclerosis

BackgroundSocial and environmental participation endeavors are theorized to shape one's general satisfaction with the overall employment situation facing people with MS.ObjectiveResponding to a national survey of the employment concerns of Americans with multiple sclerosis (MS), this study examined the extent to which factors at the demographic, disease-related, and social and environmental participation levels contribute to the predictability power for general satisfaction with the employment situation for people with MS.MethodParticipants in this study consisted of 1,149 members of nine National Multiple Sclerosis Society (NMSS) chapters representing 21 states and Washington, DC. In a hierarchical multiple regression analysis, participants were mostly older (average age of 50 years) White (74%) individuals, nearly half of whom were unemployed (47%) but well educated (98% were high school graduates, 45% were college graduates).FindingsFindings underscore the complexity involved in predicting how satisfied people with MS are with their overall employment situation.ConclusionsYounger, less educated individuals with higher levels of perceived quality of life who were employed full-time and experiencing no or lower levels of cognitive impairment were more likely than other participants to be satisfied with 17 high-priority employment concerns.

Employment after prison: Navigating conditions of precarity and stigma

In an effort to extend understanding of the employment concerns faced by former prisoners released into the community, we draw from the voices of 24 individuals released from federal prison in Canada. We explore how the stigma imposed on individuals with prior experiences of incarceration interacts with the employment programming government and community-based agencies offer; particularly within the current climate of precarious employment. Findings evidence that participants, too often, attain employment involving manual labour and report experiencing low-wage and non-gratifying jobs, despite participation in pre-employment programming, which drives their re-evaluation and re-creation of career aspirations. We show how the conditions underpinning the movement toward employment for former prisoners can encourage the potential exploitation of their labour within both formal and informal job markets.