title: 'Restricting choices and limiting independence': social and economic impact of multiple sclerosis upon households by level of disability.
abstract: OBJECTIVE
  To examine the relationship between the social and economic impact of multiple sclerosis (MS) and levels of MS-related disability upon households in the following domains: household composition, housing modification, employment, standard of living, children, intimate and close relationships, and social life.
  
  
  METHODS
  A national sample of people with MS (pwMS) (n = 920), consisting of members of the MS Society and those accessing the MS Society website, completed a cross-sectional survey to generate quantitative and qualitative data.
  
  
  RESULTS
  Over three-quarters of the sample reported that MS had impacted on at least some areas of daily life. The reported impact increased significantly in a linear fashion in each domain with increasing disability, as measured by an activities of daily living index, although there was a discernible 'levelling off' in terms of impact in some domains among those at the higher levels of disability and dependency. Analysis of the qualitative data suggests that this impact can be conceptualized as a gradual process of 'restricting choices' and 'limiting independence' for both pwMS and their households.
  
  
  CONCLUSIONS
  MS restricts social and economic opportunities for pwMS and those who they live with. These findings extend the literature to households to illustrate the impact of MS not only on pwMS but also on their partners, children and other family members.
authors.affiliation: Department of Health and Human Sciences, University of Essex, UK. gillgr@essex.ac.uk
authors.forename: G
authors.initials: G
authors.lastname: Green
authors.forename: J
authors.initials: J
authors.lastname: Todd
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003858:Dependency, Psychological; D005195:Family Relations; D005260:Female; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000191:economics* / Q000503:physiopathology / Q000523:psychology*; D012919:Social Behavior; D012959:Socioeconomic Factors