title: Determinants of on-the-job-barriers in employed persons with multiple sclerosis: the role of disability severity and cognitive indices.
abstract: BACKGROUND
  Literature has shown that work maintenance is central in order to guarantee participation to persons with disability. Knowledge about potential sources of difficulties and obstacles is then crucial in order to prevent barriers and facilitate work maintenance and career development for persons with disabilities.
  
  
  OBJECTIVE
  Studies analyzing on-the-job barriers among employed people with multiple sclerosis (MS) have found evidence for a role of clinical determinants. The aim of this study was to describe in more detail the role of disability severity and of cognitive indices on work barriers.
  
  
  METHODS
  Thirty-two employed adults with a diagnosis of MS with mild to moderate disability severity were included in the study. They were involved in the descriptive study while attending their planned care in the MS unit.
  
  
  METHODS
  Subjects completed neurocognitive tasks, a self-report measure of executive functioning and a face-to-face semi-structured interview exploring their perception of barriers at work.
  
  
  RESULTS
  Regression analyses showed a specific role of disability severity on perception of barriers due to physical, cognitive and interpersonal relationships; cognitive indices, on the other hand, predicted barriers ascribed to company policy (cognitive score), to accessibility (planning score) or difficulties in cognitive and task related abilities (self-rated executive functioning).
  
  
  CONCLUSIONS
  These findings underline the relevance of objective tasks and self-report questionnaire, direct and indirect multi-dimensional assessment of functioning for an early intervention planning. An ecological model of career development in adults with disabilities is also supported.
authors.affiliation: Dipartimento di Scienze Filosofiche, Università di Cassino, Cassino, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Carrieri
authors.affiliation: Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, Italy.
authors.forename: T M
authors.initials: TM
authors.lastname: Sgaramella
authors.affiliation: Divisione di Neurologia, Ospedale Civile S. Bortolo, Vicenza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bortolon
authors.affiliation: Divisione di Neurologia, Ospedale Civile S. Bortolo, Vicenza, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Stenta
authors.affiliation: Centro Sclerosi Multipla e Continuità Assistenziale Neurologica, Ospedale S. Bortolo, Vicenza, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fornaro
authors.affiliation: Servizio di Psicologia, Ospedale Civile S. Bortolo, Vicenza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cracco
authors.affiliation: Divisione di Neurologia, Ospedale Civile S. Bortolo, Vicenza, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Perini
authors.affiliation: Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Soresi
mesh_terms: D000328:Adult; D001107:Architectural Accessibility; D003071:Cognition; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D016134:Organizational Policy; D012720:Severity of Illness Index; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000458:organization & administration / Q000523:psychology
keywords: Progressive disability; predictors; workplace barriers