title: Factors influencing work retention for people with multiple sclerosis: cross-sectional studies using qualitative and quantitative methods.
abstract: OBJECTIVE
  To identify factors that impact on the ability of patients with multiple sclerosis (MS) to remain in work in order to make recommendations for future clinical management.
  
  
  METHODS
  Cross-sectional studies using qualitative (phase one) and quantitative (phase two) methods. In phase one, 62 patients were interviewed and completed an exploratory questionnaire regarding the impact of MS on employment. In phase two, 100 patients attending an MS outpatient clinic completed an impact on work questionnaire, the self-report Barthel index, and the General Health Questionnaire (GHQ-28).
  
  
  RESULTS
  In phase one, 17 areas were identified as impacting on MS patients' ability to remain in work, either relating to MS or environment. In phase two, both MS related factors and environmental factors were reported to have a major impact on ability to work. Only 20% of patients had received any advice about work retention. Unemployed patients (N = 64) had greater disability than employed patients on the Barthel index (difference 5.1; p < 0.001), but similar psychological wellbeing on the GHQ-28.
  
  
  CONCLUSIONS
  The issues that prevent people with MS from working tend to be disease-related, as well as work-related. Many patients are isolated, as they are unaware of sources of help. Effective management by healthcare professionals has a potentially important role in helping people with multiple sclerosis to remain employed.
authors.affiliation: Rehabilitation Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
authors.forename: Rory J
authors.initials: RJ
authors.lastname: O'Connor
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Cano
authors.forename: Lluis
authors.initials: L
authors.lastname: Ramió i Torrentà
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: E Diane
authors.initials: ED
authors.lastname: Playford
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000191:economics / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D014937:Work / Q000523:psychology / Q000706:statistics & numerical data*