Women with Multiple Sclerosis and the Importance and Satisfaction They Ascribe to Selected Employment Concerns: Results from a National Survey

The purpose of this article is to (a) describe key issues related to the employment outcomes of women with multiple sclerosis (MS) and (b) recommend effective rehabilitation interventions to address those issues. In spite of the fact that the ratio of women to men with MS is increasing worldwide, the specific employment and vocational rehabilitation experiences of women with MS have not been thoroughly examined in extant research. Thus, the aim of this study was to identify high-priority employment concerns from the perspectives of a national sample of women with MS whose needs for employment services and supports must be better understood by rehabilitation professionals, employers, and other stakeholders. Overview of Multiple Sclerosis MS is an immune-mediated disease that involves inflammation and demyelination in the central nervous system (CNS). Demyelination, or damage to the myelin sheath, results in disruption in the transmission of nerve impulses between the brain and the spinal cord. MS is a chronic, often progressive, neurological condition associated with a wide range of symptoms, the most commonly reported being fatigue, numbness, gait-related difficulties, spasticity, vision problems, sexual dysfunction, weakness, dizziness and vertigo, pain, bowel and bladder problems, cognitive problems, depression, and emotional changes (National Multiple Sclerosis Society [NMSS], 2015). Perhaps even more intrusive than the wide-ranging symptoms that can accompany MS is the unpredictable and episodic course that the disease typically follows (Kalb, 2012). MS is one of the most common neurological diseases in the world, with an estimated prevalence of 2.3 million people worldwide and 450,000 in the US (Multiple Sclerosis Coalition, 2014; NMSS, 2014). Approximately 10,000 new cases of MS are diagnosed each year in the US. Although MS can occur at any age, initial symptoms are most often evident during early adulthood, typically between the ages of 20 and 50 (Kalb, 2012), the period of life associated with career initiation, exploration, and establishment (Super, 1980). In fact, half of MS diagnoses are conferred before the person's 30th birthday, three-quarters of Americans with MS were diagnosed before the age of 40 (Fraser et al., 2006), and the mean disease duration is 38 years (Moore et al., 2013). Epidemiological studies have revealed higher MS prevalence rates in temperate regions of the globe than in warmer climates. Countries that have particularly high rates of MS include the United Kingdom, Canada, Germany, Denmark, Norway, Sweden, Finland, and the United States (Smith and Schapiro, 2004). Two-thirds of Americans with MS reside in the northernmost 50 percent of the general populace, with the states of Vermont and Washington reporting the highest prevalence rates (Fraser et al., 2006). MS has historically been much more common among Caucasians of European descent than among people of color, but recent studies indicate that the incidence of MS among African Americans and Hispanics/Latinos in the United States is increasing dramatically (Langer-Gould et al., 2013). MS is two to three times more common in women than in men, a gender link that is found in a number of other autoimmune diseases, and the ratio of women to men who are diagnosed with the disease appears to be increasing (NMSS, 2012). Impact of MS on Employment and Career Development As Moore et al. (2013) and others (e.g., Bradley et al., 2004; Sweetland, Riazi, Cano, & Playford, 2007) have noted, work is one of the most important societal commitments. In addition to financial remuneration, employment provides opportunities for social interaction and support, access to health insurance and other forms of security, a sense of identity, and self-esteem. The onset of MS and subsequent development of disability has consistently been found to cause a significant disruption in people's career and educational paths. …

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