Coping strategies in relation to negative work events and accommodations in employed multiple sclerosis patients.

BACKGROUND: Job loss is common in multiple sclerosis (MS) and is known to exert a negative effect on quality of life. The process leading up to job loss typically includes negative work events, productivity losses and a need for accommodations. By using active coping strategies job loss may be prevented or delayed. OBJECTIVE: Our goal was to examine negative work events and accommodations in relation to coping strategies in employed relapsing-remitting MS patients. METHODS: Ninety-seven MS patients (77% females; 21-59 years old) completed questionnaires concerning the patient's work situation, coping strategies, demographics, physical, psychological and cognitive functioning. Forward binary logistic regression analyses were conducted to examine coping strategies and other (disease) characteristics predictive of reported negative work events and accommodations. RESULTS: Nineteen per cent of the employed MS patients reported one or more negative work events, associated with a higher use of emotion-oriented coping and more absenteeism. Seventy-three per cent reported using one or more work accommodations, associated with a higher educational level and more presenteeism. MS patients reporting physical changes to the workplace employed more emotion-oriented coping, while flexible scheduling was associated with task-oriented coping. CONCLUSION: Emotion-oriented and task-oriented coping strategies are associated with negative work events and the use of accommodations.

Utility of Routine Neuropsychological Assessment for Early Identificationof Cognitive Impairment in MS.

In addition to physical disability, multiple sclerosis (MS) is increasingly recognized for its association with neuropsychological (NP) impairment, including cognitive deficits and disorders of mood and affect. NP impairment can occur as early as the first demyelinating episode. Often insidious in nature, NP impairment has a significant impact on a wide range of quality-of-life measures including vocational status, social functioning, and instrumental activities of daily living. Objective, performance-based measures of NP status are important but underutilized tools used to evaluate and quantify deficits. These NP tests help clinicians make treatment decisions and assist in monitoring clinical status over time. Additionally, there is growing interest in developing improved screening measures to indicate when referral for NP testing is advised. This article reviews research findings pertaining to screening and monitoring NP status in MS as well as the clinical meaning of NP impairment.