Disability disclosure as an impression management technique used in the workplace: A grounded theory investigation.

BACKGROUND: In order to overcome obstacles to entry and inclusion in the workplace, individuals with disabilities engage in various impression management strategies to present themselves as the socially acceptable 'ideal employee.' OBJECTIVE: This study expands on previous disclosure research by asking individuals with disabilities to share their experiences of identity management and workplace challenges. METHODS: We leveraged qualitative research techniques to explore the reciprocal impact of workplace treatment and disclosure. RESULTS: Impression management emerged as an especially salient aspect of participants' disclosure decisions, and participants used an array of impression management tactics. Some employees with disabilities described positive experiences; however, we also learned that impression management can present unique challenges that may outweigh potential benefits. CONCLUSION: Our findings affirm that managing the image we project can be remarkably complicated and effortful when having a disability. This paper concludes with implementation recommendations for vocational rehabilitation counselors and human resource practitioners.

Investigating the challenges of air travel in the United States: a qualitative study of the lived experiences of wheelchair users with spinal cord injury or disorder.

STUDY DESIGN: Qualitative exploratory study. OBJECTIVES: To understand the lived experiences of individuals with spinal cord injuries or disorders (SCI/D) who use wheelchairs during air travel in the United States (US), with a focus on the challenges and barriers to accessing this form of transportation. SETTING: Wheelchair users with SCI/D living in the community in the US. METHODS: Semi-structured interviews were used to collect data from six wheelchair users with SCI/D. Data were analyzed using a six-step thematic analysis. RESULTS: Experiences of wheelchair users during air travel clustered into three themes; experiences interacting with the airport, experiences interacting with the airplane, and experiences across all stages of air travel. Barriers to airport accessibility were minimal. Physical barriers to airplane accessibility and damage to wheelchairs occurred when interacting with the airplane and airline staff. Undertrained staff and a shift in responsibility to the passenger with a disability impacted all stages of the experience. CONCLUSION: Wheelchair users with SCI/D encounter challenges that can result in unsafe and inaccessible air travel within the US. Adverse consequences of air travel often impact the individual's independence and quality of life during and after the flight. Participants provided recommendations to improve the air travel experience for wheelchair users, including the ability to remain in one's wheelchair while onboard the airplane.

Subjective well-being of adults with multiple sclerosis during COVID-19: Evaluating stress-appraisal-coping and person-environment factors.

BACKGROUND: People with multiple sclerosis (MS) have been coping with high levels of stress during the ongoing coronavirus pandemic, affecting their employment, physical, and mental health, and overall life satisfaction. OBJECTIVE: This study evaluated constructs of the stress-appraisal-coping theory and positive person-environment factors as predictors of subjective well-being for adults with MS. METHOD: Participants included 477 adults with MS recruited through the National Multiple Sclerosis Society. Hierarchical regression analysis was used to determine the incremental variance in subjective well-being accounted for by demographic covariates, functional disability, perceived stress, stress appraisal, coping styles, and positive person-environment contextual factors. RESULTS: Positive stress appraisal and coping flexibility were significantly associated with subjective well-being at the bivariate correlation level and at the step they were entered into the regression model. Marital status, household income, functional disability, perceived stress, hope, core self-evaluations, and social support were significant predictors in the final model, accounting for 60% of the variance in subjective well-being scores (R² = .60, f² = 1.48; large effect size). CONCLUSIONS: Findings from this study support a stress management and well-being model based on constructs of Lazarus and Folkman's stress-appraisal-coping theory and positive person-environment contextual factors, which can inform the development of theory-driven and empirically supported stress management and well-being interventions for people with MS during the ongoing global health crisis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Post-traumatic growth and trauma-informed care in vocational rehabilitation through the lens of the conservation of resources theory.

BACKGROUND: Trauma has high prevalence rates in populations of people with disabilities, and the effects of traumatic experiences can negatively impact employment. OBJECTIVE: The purpose of this article is to review the existing literature regarding post-traumatic growth (PTG), trauma informed care (TIC), and the conservation of resources (COR) theory. METHOD: We begin with an overview of PTG, TIC, and trauma in relation to disability and employment. Then, we review the personal, condition, object, and energy resources within the COR theory. RESULTS: The remainder of the article focuses on applying PTG and TIC in state-Federal VR programs with a theoretical framework defined by COR. We conceptualize the application in four major VR phases: (a) eligibility determination, (b) rehabilitation plan development, (c) service provision, and (d) job placement. CONCLUSION: By implementing TIC and considering the consumer's resources, VR counselors can help emphasize PTG throughout the process and prioritize PTG as the ultimate goal. The authors provide brief and preliminary implementation recommendations for VR counselors.

Providing quality employment services to people living with asthma in the vocational rehabilitation program: A model for meeting the needs of an emerging clientele.

BACKGROUND: With incidence and prevalence rates of asthma diagnoses steadily increasing in the United States and worldwide over the past 30 years, people with asthma are an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: This article describes the job acquisition and return to work considerations facing employees with asthma. METHODS: Following an overview of the etiology, incidence, prevalence, and career development implications of this chronic respiratory disease, the authors present career preparatory and return to work recommendations to meet the needs of Americans with asthma across the phases of the VR process. RESULTS: The importance of access to quality healthcare, lifestyle, and environmental modifications to promote respiratory health, employer consultation, workplace accommodations and universal design, and interface with medical and mental health professionals is emphasized throughout the article. CONCLUSION: Asthma is an emerging disability that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the needs of this growing and diverse clientele as people with asthma seek assistance from the VR program in acquiring, maintaining, and advancing in meaningful, satisfying employment.

A "win-win" perspective on workplace accommodations: RETAIN Kentucky's self-advocacy guide to promote successful return to work and stay at work outcomes for workers with disabilities.

BACKGROUND: Research has long documented the low cost and effectiveness of most workplace accommodations to enable qualified people with disabilities to seek, secure, and maintain employment. OBJECTIVE AND METHOD: RETAIN Kentucky's return to work and stay at work intervention involves focused training for participants on requesting needed accommodations from their employers. RESULTS: In this article, we describe the win-win approach to reasonable accommodations, which serves as the basis for helping Kentuckians with disabilities identify and request on-the-job supports to aid in their efforts to remain in the workforce. CONCLUSIONS: Workers with disabilities are more likely to stay in the workforce and continue making valuable contributions to the national and global economies if they have effective accommodations and other employment supports available to them.

Emerging vocational rehabilitation strategies for people with diabetes mellitus.

BACKGROUND: People with diabetes mellitus constitute an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: The objective of this article is to (a) describe the characteristics and needs of Americans with diabetes mellitus, (b) examine the often devastating effects that this highly prevalent disease of the endocrine system has on employment and career development, and (c) suggest strategies that rehabilitation professionals can use to improve VR services and outcomes. METHOD: Following an overview of the etiology, incidence, prevalence, and impact of this high incidence endocrinological disease, the authors present strategies to meet the service and support needs of Americans with diabetes mellitus across the phases of the VR process. RESULTS: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to self-care and symptom management regimens is emphasized throughout the article. CONCLUSION: Diabetes mellitus is an emerging disability that can affect people of any age, one that disproportionally affects people of color and people who live in poverty. Rehabilitation professionals must be prepared to meet the service needs of this growing clientele.

Anxiety and employment discrimination: Implications for counseling and return to work practice.

BACKGROUND: The most prevalent mental health diagnosis is anxiety disorder, which remains largely undertreated. OBJECTIVE: This investigation considered differences in workplace discrimination against adults with anxiety disorders during two eras of legal history: the original Americans with Disabilities Act (ADA, 1990-2008) and the ADA Amendments Act (ADAAA, 2009-present). METHOD: Research questions addressed differential (a) numbers and types of allegations, (b) case resolutions, and (c) demographic characteristics of the charging parties. RESULTS: Results indicated substantially more allegations and merit-based resolutions filed by charging parties with anxiety disorders post-ADAAA. Furthermore, the post-ADAAA era revealed increases in allegations from women and people from non-white racial groups. CONCLUSION: These findings can inform advocacy and counseling and rehabilitation services for clients who experience anxiety.

Return to work considerations in the lingering COVID-19 Era: Long COVID, multiple chemical sensitivity, and universal design.

This article discusses how COVID-19 has impacted the American workforce, symptoms of Long COVID syndrome, Multiple Chemical Sensitivity, and ways to avoid triggering its symptoms when sanitizing the workplace and using Universal Design practices to increase accessibility and decrease transmission of COVID-19 among workers. Interface with healthcare providers, rehabilitation professionals, and employers is emphasized.

Examining the Role of Resilience and Hope in Grit in Multiple Sclerosis.

The purpose of this study was to examine the effects of resilience and hope on grit when controlling for demographic covariates, depression, and anxiety in people with multiple sclerosis (MS). This was a cross-sectional study with a sample of 348 participants with MS. Descriptive statistics were performed to examine participants' demographic characteristics. A three-step hierarchical regression analysis was conducted to evaluate the extent to which resilience and hope explain the unique variance in grit while controlling for demographic covariates, depression, and anxiety. Findings suggested that resilience and hope explained a significant amount of variance in grit when controlling for demographic covariates, depression, and anxiety. Furthermore, higher resilience and hope scores were associated with higher grit scores. Given that resilience, hope, and grit are modifiable, rehabilitation and mental health professionals (e.g., psychologists, psychiatrists, rehabilitation counselors) can integrate strength-based interventions into their practices to bolster resilience, hope, and grit in people with MS. Our paper also has implications for interdisciplinary research and clinical practice.

Job Retention Among Individuals With Multiple Sclerosis: Relationship With Prediagnostic Employment and Education; Demographic Characteristics; and Disease Course, Severity, and Complications.

OBJECTIVE: To identify how prediagnosis employment, education, demographic statuses, and disease factors relate to job retention among people with multiple sclerosis (MS). DESIGN: Cross-sectional logit model. SETTING: Data were collected at an academic Medical University and a specialty hospital, both in the Southeastern US. PARTICIPANTS: People with MS (N=1126) who were employed at the time of MS diagnosis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Job retention was measured by employment status at the time of follow-up assessment. RESULTS: Prediagnostic educational attainment was predictive of job retention. Among several prediagnostic employment characteristics, only working in production, transportation, and material moving was significantly related to a lower odds of job retention compared with those working in professional/managerial occupations. Aging factors were strongly related to job retention, with declines in job retention observed with increasing age and years since diagnosis. Non-Hispanic Black and Hispanic participants reported lower odds of job retention than non-Hispanic White participants, although there were no observed effects of sex. A significantly lower job retention rate was observed among those with progressive MS, compared with relapsing-remitting. Job retention was also less likely among people with greater MS severity and fatigue. CONCLUSIONS: Job retention strategies and interventions should target people with greater MS complications and severity, as well as non-Hispanic Black and Hispanic persons, because these characteristics are more highly related to job retention than our prediagnostic employment and vocational history.

RETAIN Kentucky: A return-to-work and stay-at-work program for people with disabilities grounded in the conservation of resources theory.

This article, the first in the Return-to-Work (RTW) Corner series, summarizes a comprehensive RTW and Stay-at-Work (SAW) program in Kentucky, which is funded by the United States Department of Labor. The program, Retaining Employment and Talent After Injury/Illness Network: Kentucky (RETAIN Kentucky), focuses on RTW and SAW strategies, depending upon participants' employment status at the time of enrollment in the project. RETAIN Kentucky services are implemented by RTW Coordinators (RTWCs) who help people with non-work-related injuries and illnesses continue in the workforce. The first Phase of RETAIN Kentucky, which lasted for nearly 3 years, is now informing the Phase 2 intervention, which began in October 2021 and will enroll participants for 30 months. In this article, we outline the employment retention problem that RETAIN Kentucky addresses, describe the key features and services of the program, summarize our findings so far, and present future directions for Phase 2.

Quality of life and experience with the national multiple sclerosis society strategic plan priorities for people with multiple sclerosis: Findings from a path analysis.

BACKGROUND: The National Multiple Sclerosis Society (NMSS) strives to ensure that people affected by multiple sclerosis (MS) can live their best lives. This mission is reflected in the Society's strategic plan, which establishes the roadmap for the Society's continued commitment to a world free of MS. OBJECTIVE: The purpose of this article is to add to the understanding of both the scope and complexity of the impact of MS and MS-related supports on quality of life (QOL). METHODS: A national sample of people with MS (n = 748) participated in the study by completing validated surveys assessing their QOL, physical and mental health, MS self-efficacy, resilience, participation in NMSS, perceived stress, emotional support, and social roles and activities. A path model was used to examine how the frequently identified MS QOL predictors, including demographic, MS, psychosocial, and physical functional status variables relate to each other and to QOL. RESULTS: The model exhibited reasonable model fit with hypothesized paths being statistically significant and in the hypothesized direction. CONCLUSION: Findings revealed that the relationships among mental health, demographic factors, overall MS experiences, QOL, NMSS participation, and resonance with the mission of the NMSS are complex, highly nuanced, and yet strongly correlated. More importantly, the study highlights the strong influence of variables that are more readily amenable to change through programmatic and clinical intervention, and active self-management and participation.

Barriers and Facilitators to Employment: A Comparison of Participants With Multiple Sclerosis and Spinal Cord Injury.

OBJECTIVE: To compare self-reported barriers and facilitators to employment among employed and unemployed participants with multiple sclerosis (MS) and spinal cord injury (SCI). DESIGN: Cross-sectional study using self-report assessment obtained by mail or online. SETTING: Medical university in the southeastern United States. PARTICIPANTS: Participants (N=2624) identified from either a specialty hospital or a state-based surveillance system in the southeastern United States, including 1234 with MS and 1390 with SCI. All participants were aged <65 years at the time of assessment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported barriers and facilitators to employment. RESULTS: Overall, the MS participants reported more barriers, particularly stress, cognition, and fatigue, whereas those with SCI were more likely to report not having the proper education and training, resources, transportation, and attendant care. Follow-up analyses broken down by employment status indicated that several barriers and facilitators were significantly related to diagnosis for either employed or unemployed participants, but not both. Among those employed, participants with SCI were more likely to report they could not do the same types of jobs as they could pre-SCI and those with MS were more likely to state that they did not know much about jobs for people with disabilities (no differences were noted for these variables among unemployed participants). Unemployed individuals with SCI were more likely to report that the jobs for which they were trained were not accessible. CONCLUSIONS: The primary barriers for individuals with MS revolve around the condition itself, whereas the barriers for SCI appear to be more related to modifiable factors. Vocational rehabilitation specialists need to identify diagnostic-specific barriers to promote employment outcomes.

Personal, health and function, and career maintenance factors as determinants of quality of life among employed people with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an intrusive disease that significantly affects labor force participation. OBJECTIVE: This study examined the extent to which factors at the personal, health and function, and environmental/career maintenance levels contribute to the predictability power for quality of life among employed people with MS. METHOD: Participants consisted of 523 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. These individuals were employed at the time of the survey, and they were primarily middle age (average age of 48 years) and Caucasian (74%). RESULTS: The final hierarchical multiple regression model explained 54 percent of the variability in participants' quality of life scores, although none of the hypothesized personal/demographic predictors were significant. Participants who perceived better overall health and lower levels of stress, who experienced less severe cognitive and mobility-related MS symptoms, and who expressed stronger job-person matches and higher levels of job satisfaction reported higher quality of life scores than did other participants. CONCLUSIONS: The findings underscore the complexity involved in predicting perceived quality of life among employed people with MS. Implications of these findings for future research and clinical practice are discussed.

The employment discrimination experiences of younger and older Americans with cancer under Title I of the Americans with Disabilities Act.

PURPOSE: The goal of the research was to describe discrimination, both actual and perceived, that has occurred against younger individuals with cancer (i.e., 35 years of age and under) in comparison with older individuals with cancer (i.e., over age 35) through analysis of the US Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. METHODS: An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from younger people with cancer from 2009 through 2016 (n = 1001) in comparison with older people with cancer over the same time period (n = 8874). RESULTS: Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared with older charging parties with cancer, the younger charging parties with cancer had proportionally more individuals who were male and who identified as African American and proportionally fewer individuals who identified as Caucasian. CONCLUSIONS: Younger people with cancer were more likely to allege discrimination in the areas of promotion, training, reinstatement, and referrals to other employers. They were less likely to allege discrimination in the area of benefits. The younger group was also significantly less likely than the older group to find that EEOC investigations of their allegations resulted in merit-based case resolutions, that is, discrimination had indeed occurred. IMPLICATIONS FOR CANCER SURVIVORS: Psychosocial programs and vocational programming assisting young adults with career development should focus on the types of discrimination that young adults experience, which is unique compared with older adult cancer survivors.

A conceptual framework to promote career development for vocational rehabilitation consumers with traumatic brain injuries.

The purpose of this article is to describe the Illinois Work and Well-being Model (ILW2M), a multi-domain framework for conceptualizing the employment development of people with traumatic brain injuries (TBIs). The model emphasizes the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A brief discussion of potential implications regarding vocational rehabilitation research and service is offered with the overall goal of reinforcing employment development as the foundation of vocational rehabilitation services for adults with TBIs.

The Workplace Discrimination Experiences of Individuals with Cancer in the Americans with Disabilities Act Amendments Act Era.

Background The purpose of this study was to investigate the patterns in allegations of workplace discrimination filed by individuals with cancer. Objective The goal of the research was to describe discrimination, both actual and perceived, that has occurred against individuals with cancer in comparison to a group of individuals with other general disabilities (GENDIS) through analyses of the United States Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. Methods An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from people with cancer from 2009 through 2016 (n = 10,848) in comparison to the GENDIS group over the same time period (n = 13,338). Results Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared to the GENDIS group, the cancer group was significantly older and had proportionally more individuals who identified as Asian than the GENDIS group. People with cancer were more likely to allege discrimination in the areas of unlawful discharge, demotion, wages, layoff, benefits, and referrals. They were less likely to allege discrimination in areas of reasonable accommodation, hiring, and suspension. Also, the cancer group was more likely than the GENDIS group to file allegations against smaller employers and employers in the Southeast region of the United States, while employers in the Mid-Atlantic and Rocky Mountain regions were less likely to be named in allegations by people with cancer. The cancer group was also significantly more likely than the GENDIS group to find that EEOC investigations of their allegations resulted in merit-based case resolution, that is, discrimination had indeed occurred. Owing to the large sample size, some of these between-group differences were small in magnitude. Conclusion The workplace discrimination experiences of people with cancer are substantially different from those of people with other disabilities.

Employment and Job Benefits Among Those With Spinal Cord Dysfunction: A Comparison of People With Spinal Cord Injury and Multiple Sclerosis.

OBJECTIVE: (1) Identify the proportion of participants with spinal cord dysfunction (SCD) reporting each of 10 job benefits and compare the proportions between participants with spinal cord injury (SCI) and multiple sclerosis (MS); and (2) examine if diagnostic criteria, demographics, education level, and functional limitations are associated with the number of job benefits received. DESIGN: Econometric modeling of cross-sectional data using a 2-step data analytic model of employment and job benefits. SETTING: Medical university in the southeastern United States. PARTICIPANTS: Participants (N=2624) were identified from the southeastern United States. After eliminating those age 65 and older, there were 2624 adult participants with SCD; 1234 had MS and 1390 had SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Current employment status; number of benefits received and specific benefits received. RESULTS: A greater proportion of participants with MS received benefits, with significant differences observed on all but 1 type of benefit. Among those who were employed, a greater number of benefits was associated with having MS, greater education, younger age, married or in an unmarried couple, and not having functional restrictions with cognition, doing errands, or shopping alone in the community, and walking. CONCLUSIONS: Employed participants with MS were more likely to receive job benefits, indicative of a higher quality of employment, compared to participants with SCI. Employment without benefits is a form of underemployment that disproportionately affects individuals with many of the same characteristics that initially lead to disparities in probability of gainful employment.

Employment and Gainful Earnings Among Those With Multiple Sclerosis.

OBJECTIVE: To identify demographic, educational, and disease-related characteristics associated with the odds of employment and earnings among participants with multiple sclerosis (MS). DESIGN: Cross-sectional using self-report assessment obtained by mail or online. SETTING: Medical university in the southeastern United States. PARTICIPANTS: Participants with MS (N=1059) were enrolled from a specialty hospital in the southeastern United States. All were adults younger than 65 years at the time of assessment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Current employment status and earnings. RESULTS: MS factors were highly related to employment, yet not as strongly to conditional earnings. Those with no symptoms reported 6.25 greater odds of employment than those with severe current symptoms. Compared with those with progressive MS, those with relapsing or remitting had greater odds of employment (odds ratio [OR]=2.24). Participants with no perceived cognitive impairment had 1.83 greater odds of employment than those with moderate to severe perceived cognitive impairment. Those with <10 years since MS diagnosis had 2.74 greater odds of employment compared with those with >20 years since diagnosis. An absence of problematic fatigue was highly related to the probability of employment (OR=5.01) and higher conditional earnings ($14,454), whereas the remaining MS variables were unrelated to conditional earnings. For non-MS variables, education was highly related to employment status and conditional earnings, because those with a postgraduate degree had 2.87 greater odds of employment and $44,346 greater conditional earnings than those with no more than a high school certificate. Non-Hispanic whites had 2.22 greater odds of employment and $16,118 greater conditional earnings than non-Hispanic blacks, and men reported $30,730 more in conditional earnings than women. CONCLUSIONS: MS indicators were significantly associated with employment status including time since diagnosis, fatigue, symptom severity, and presence of cognitive impairment. However, among those who were employed, conditional earnings were less highly related to these factors and more highly related to educational attainment.