Multiple Sclerosis (MS), the leading cause of neurological disability among young and middle-aged adults, is a variable and unpredictable disease known to significantly impact individuals'overall sense of well-being and quality of life. Unemployment is a particularly pressing issue in MS, with rates as high as 80%. Given the age at which MS is most common (20 to 50 years of age) and the knowledge that employment is a vital component for overall well-being and quality of life during these years, efforts to assist individuals with MS in maintaining employment or to assist practitioners in making informed decisions regarding employment is a priority. As indicated by the NCMRR, the primary goal of patient-oriented research is to develop the "scientific knowledge necessary to enhance the health, productivity, independence, and quality of life of people with disabilities." Given this, te proposed Mentored Patient-Oriented Research CDA aims to develop a conceptual model of unemployment in MS. This will take into account known factors associated with unemployment in MS (e.g., demographics, disease variables), as well as person-specific factors (e.g., personality), which have not been extensively investigated but have been purported to significantly contribute to the high rates of unemployment in MS. More specifically, the aims of this study are to: (1) prospectively identify and verify previously identified factors related to unemployment in MS using a multivariate framework;(2) examine the role of personality, coping, and health-related behaviors as well as demographics and disease variables on one's decision to leave the workforce;and (3) develop a conceptual model that can be ultimately used as a predictive model of unemployment in MS and decision tool for practitioners.
These research aims will be addressed by identifying individuals with MS who are beginning to make decisions with their practitioners regarding employment. Individuals who remain in the workforce and those that ultimately decide to leave will undergo a comprehensive assessment measuring disease variables, secondary factors of MS (e.g., fatigue, cognition), personality, coping style, health-related behaviors, psychosocial factors, and work factors. The concurrent career development plan for the Candidate will allow for: (1) advanced training in research methodology, ethics, and study design;(2) advanced training and experience with multivariate statistical analyses;(3) a greater knowledge base regarding personality psychology and the role of personality on various outcomes in MS;and (4) continued training and mentorship in the professional skills necessary for successful, independent patient-oriented research. The Candidate will draw on the wealth of expertise in MS, personality psychology, and epidemiology and multivariate statistics provided by a team of exceptional mentors, collaborators, and consultants to achieve these goals. Ultimately, it is anticipated that the findings of this investigation will substantially assist practitioners in making informed decisions regarding employment with their patients and hence, improve the overall care and quality of life of individuals with MS.
The proposed investigation's ultimate aim is to assist practitioners in making informed decisions regarding employment issues and thus improving the lives and productivity of individuals with MS. Moreover, it is a first attempt at examining the rol of personality, coping, and health-related behaviors on disease management and their influence on the decision to leave the work force.