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Van Hijfte L, Cambron M, Capron B, Dachy B, Decoo D, Dive D, Dubois B, Sankari SE, London F, Perrotta G, Popescu V, Van Pesch V, Van Wijmeersch B, Willekens B, Laureys G. Multiple Sclerosis Multidisciplinary Care: A National Survey and Lessons for the Global Community. Mult Scler Relat Disord 2024; 85:105540. [PMID: 38489948 DOI: 10.1016/j.msard.2024.105540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Access to, standardization and reimbursement of multidisciplinary care for people with MS (PwMS) is lacking in many countries. Therefore, this study aims to describe the current multidisciplinary care for people with MS (PwMS) in Belgium and identify benefits, needs and future perspectives METHODS: A survey for PwMS questioned various aspects of MS and viewpoints on care. For MS nurses (MSN) and neurologists, employment, education, job-content, care organization and perspectives were inquired. Descriptive and univariate statistics were performed RESULTS: The PwMS survey comprised 916 respondents with a mean age of 46±12.7 years and 75,4 % of the respondents being female. The majority of the participants had relapsing remitting MS (60.8 %) and the mean patient determined disease steps (PDDS) was 2.0 (IQR=3). 65.3 % and 60.4 % of the PwMS reported having access to a multidisciplinary team (MDT) or MSN. Access to an MSN was associated with more frequent disease modifying treatment (p=.015), spasticity (p=.042) and gait treatment (p=.035), but also more physiotherapy (p=.004), driver's license adjustment (p<.001) and a higher employment rate (p=.004). MDT access was associated with more frequent symptomatic bladder treatment (p=.047), higher physiotherapy rate (p<.001), higher work- (p=.002), insurance- (p<.001) and home support measures (p=.019). PwMS without an available MDT more often indicated that MS care needs improvement (p<.001). MSN's (n = 22) were mainly funded through various budgets, including hospital and neurology practice budgets. Finally, 69 % and 75 % neurologists (n = 62) working without an MSN or MDT stated a need of such support and 61 % agreed that MDT's should be organized at hospital-network level CONCLUSION: MDT and MSN availability may enhance medical and socio-economic support for PwMS. Guidelines, alignment and reimbursement are needed.
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Affiliation(s)
- Liesbeth Van Hijfte
- Ghent University Hospital, 4Brain Research Unit, Department of Neurology, Gent, Belgium.
| | - Melissa Cambron
- Sint-Jan Bruges Hospital, Department of Neurology, Brugge, Belgium
| | - Brigitte Capron
- CHU de Charleroi, Department of Neurology, Lodelinsart, Belgium
| | - Bernard Dachy
- Hôpital Brugmann, Université Libre de Bruxelles, Department of Neurology, Brussels, Belgium
| | - Danny Decoo
- AZ Alma, Department of Neurology, Eeklo, Belgium
| | | | - Bénédicte Dubois
- University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Souraya El Sankari
- Cliniques Universitaires Saint-Luc, UCLouvain, Department of Neurology, Brussels, Belgium
| | - Frederic London
- CHU UCL Namur, Université catholique de Louvain, Department of Neurology, Yvoir, Belgium
| | - Gaetano Perrotta
- Hôpital Erasme, Université Libre de Bruxelles, Department of Neurology, Brussels, Belgium
| | - Veronica Popescu
- University MS Centre (UMSC), Hasselt-Pelt, Belgium; Noorderhart Hospitals, Revalidation and MS, Pelt, Belgium
| | - Vincent Van Pesch
- Cliniques Universitaires Saint-Luc, UCLouvain, Department of Neurology, Brussels, Belgium
| | - Bart Van Wijmeersch
- University MS Centre (UMSC), Hasselt-Pelt, Belgium; Noorderhart Hospitals, Revalidation and MS, Pelt, Belgium
| | - Barbara Willekens
- Antwerp University Hospital, Department of Neurology and UNiCA (University Neuroimmunology Center Antwerp), Edegem, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Translational Neurosciences Research Group, Wilrijk, Belgium
| | - Guy Laureys
- Ghent University Hospital, 4Brain Research Unit, Department of Neurology, Gent, Belgium
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2
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Zarghami A, Fuh-Ngwa V, Claflin SB, van der Mei I, Ponsonby AL, Broadley S, Simpson-Yap S, Taylor BV. Changes in employment status over time in multiple sclerosis following a first episode of central nervous system demyelination, a Markov multistate model study. Eur J Neurol 2024; 31:e16016. [PMID: 37525323 DOI: 10.1111/ene.16016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND AND PURPOSE Understanding predictors of changes in employment status among people living with multiple sclerosis (MS) can assist health care providers to develop appropriate work retention/rehabilitation programs. We aimed to model longitudinal transitions of employment status in MS and estimate the probabilities of retaining employment status or losing or gaining employment over time in individuals with a first clinical diagnosis of central nervous system demyelination (FCD). METHODS This prospective cohort study comprised adults (aged 18-59 years) diagnosed with FCD (n = 237) who were followed for more than 11 years. At each review, participants were assigned to one of three states: unemployed, part-time, or full-time employed. A Markov multistate model was used to examine the rate of state-to-state transitions. RESULTS At the time of FCD, participants with full-time employment had an 89% chance of being in the same state over a 1-year period, but this decreased to 42% over the 10-year follow-up period. For unemployed participants, there was a 92% likelihood of remaining unemployed after 1 year, but this probability decreased to 53% over 10 years. Females, those who progressed to clinically definite MS, those with a higher relapse count, and those with a greater level of disability were at increased risk of transitioning to a deteriorated employment state. In addition, those who experienced clinically significant fatigue over the follow-up period were less likely to gain employment after being unemployed. CONCLUSIONS In our FCD cohort, we found a considerable rate of employment transition during the early years post-diagnosis. Over more than a decade of follow-up post-FCD, we found that females and individuals with a greater disability and a higher relapse count are at higher risk of losing employment.
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Affiliation(s)
- Amin Zarghami
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Valery Fuh-Ngwa
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Suzi B Claflin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Broadley
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Steve Simpson-Yap
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Jaworski MG, Gillies JK, Youngs M, Wojcik C, Santivasci C, Jakimovski D, Bergsland N, Weinstock-Guttman B, Benedict RH. Predicting employment deterioration with the Processing Speed Test (PST) and SDMT in multiple sclerosis. Mult Scler 2023; 29:1327-1336. [PMID: 37503838 DOI: 10.1177/13524585231187283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Employment deterioration is common in people with multiple sclerosis (PwMS). Clinicians often learn of job loss after its occurrence, leaving no opportunity for preventive measures. OBJECTIVES Identify which neuropsychological measures discriminate between healthy volunteers (HVs) and employed/disabled PwMS at baseline and predict work deterioration over 2 years. METHODS We examined 198 PwMS with computerized tests such as the Processing Speed Test (PST) and conventional tests such as the Symbol-Digit Modalities Test (SDMT), administered at baseline. Employment was assessed via Buffalo Vocational Monitoring Survey. Univariate and regression analyses identified significant predictors of PwMS categorized as work-stable versus work-deteriorated status. RESULTS PwMS were impaired on all baseline assessments relative to HVs (p's < 0.001). Post hoc analyses showed that employed PwMS and HVs performed similarly and better than work-disabled PwMS. At the univariate level, both PST and SDMT discriminated between work-deteriorated and work-stable PwMS (p's < 0.01). The logistic regression model accounting for all measures retained PST and the computerized Walking Speed Test. PwMS with increased negative work events had lower PST (p < 0.001), SDMT (p < 0.001), and BVMT-R (p < 0.01) scores than stable PwMS. The related regression model retained PST and BVMT-R (p < 0.001). CONCLUSION Cognition, as measured by the PST and BVMT-R, are predictive of job deterioration in PwMS and may be a useful screening tool to identify those at high risk of unemployment.
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Affiliation(s)
- Michael G Jaworski
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - John K Gillies
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Margaret Youngs
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Curtis Wojcik
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Celeste Santivasci
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Ralph Hb Benedict
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
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Vitturi BK, Rahmani A, Dini G, Montecucco A, Debarbieri N, Bandiera P, Ponzio M, Battaglia MA, Brichetto G, Inglese M, Persechino B, Durando P. Work Barriers and Job Adjustments of People with Multiple Sclerosis: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:450-462. [PMID: 36399281 DOI: 10.1007/s10926-022-10084-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Purpose The aim was to carry out a systematic review dedicated to describing the work barriers and the job adjustments that are particularly sensitive to people with Multiple Sclerosis (PwMS). Methods Four electronic databases (PubMed/MEDLINE, Scopus, SciVerse ScienceDirect, and Web of Science) were searched for peer-reviewed original articles reporting the barriers at work and/or the job adjustments used by PwMS. MS must have been diagnosed according to accepted international criteria at the time of the study and/or confirmed by a doctor. No time limits were set for the search. Articles that were published in English, Italian, Spanish, French, and Portuguese were accepted. Each article was screened by three experienced and trained investigators. The protocol was registered in PROSPERO (CRD42022299994). Results The initial systematic search yielded 104,228 results, of which 49 articles provided sufficient information and were considered suitable for inclusion in the study. Overall, the studies included 30283 participants with MS. Thirteen (27.1%) studies reported on barriers to work, 14 (29.2%) addressed reasonable adjustments and 21 (43.7%) assessed both outcomes. Job characteristics are the most important barriers for PwMS. Other reported barriers concern the work environment, social relationships at work, negative work events and lack of information. PwMS are more vulnerable to the need for adjustments at the workplace, being the management of the workload the most commonly used one. Conclusions PwMS are exposed to a wide variety of work barriers and job adjustments. Future studies are still highly encouraged on the topic.
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Affiliation(s)
- Bruno Kusznir Vitturi
- Department of Health Sciences, University of Genoa, Building 3, L.Go R. Benzi, 10-16132, Genoa, Italy.
| | - Alborz Rahmani
- Department of Health Sciences, University of Genoa, Building 3, L.Go R. Benzi, 10-16132, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Building 3, L.Go R. Benzi, 10-16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, Building 3, L.Go R. Benzi, 10-16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Nicoletta Debarbieri
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
| | - Paolo Bandiera
- Italian Multiple Sclerosis Association (AISM), Genoa, Italy
| | - Michela Ponzio
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Mario Alberto Battaglia
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | | | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Neurology Unit, Genoa, Italy
| | | | - Paolo Durando
- Department of Health Sciences, University of Genoa, Building 3, L.Go R. Benzi, 10-16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Occupational Medicine Unit, Genoa, Italy
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van der Hiele K, van Egmond EEA, van Gorp DAM, Jongen PJ, Reneman MF, van der Klink JJL, Beenakker EAC, van Eijk JJJ, Frequin STFM, Hoitsma E, Gerlach OHH, Mostert JP, Verhagen WIM, Heerings MAP, Middelkoop HAM, Visser LH. Personality traits are not associated with changes in employment status over 3 years in persons with multiple sclerosis. Mult Scler J Exp Transl Clin 2022; 8:20552173221145576. [PMID: 36570872 PMCID: PMC9772955 DOI: 10.1177/20552173221145576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Previous research discovered a protective effect of higher conscientiousness against a 3-year deterioration in employment status in persons with multiple sclerosis (pwMS). To replicate these findings, we used data from a multicentre prospective cohort study where 145 employed pwMS completed questionnaires, neurological and neuropsychological examinations at baseline and after 3 years. A 3-year deterioration in employment status was reported in 31.0%. We observed no differences in personality, demographics or clinical characteristics between pwMS with deteriorated or stable employment status. These null findings may be partly explained by the classification of deteriorated employment status, which does not reflect Dutch labour conditions.
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Affiliation(s)
- K van der Hiele
- K. van der Hiele,
Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, PO box 9555, 2300 RB Leiden, The Netherlands.
| | - EEA van Egmond
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands,Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands,National Multiple Sclerosis Foundation, Rotterdam, The Netherlands,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - DAM van Gorp
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - PJ Jongen
- MS4 Research Institute, Nijmegen, The Netherlands,Department of Community & Occupational Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - MF Reneman
- Department of Rehabilitation Medicine, Centre for Rehabilitation, University of Groningen, University Medical Centre Groningen, Haren, The Netherlands
| | - JJL van der Klink
- Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, Tilburg University, Tilburg, The Netherlands,Optentia, North West University of South Africa, Vanderbijlspark, South Africa
| | - EAC Beenakker
- Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - JJJ van Eijk
- Department of Neurology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands
| | - STFM Frequin
- Department of Neurology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - E Hoitsma
- Department of Neurology, Alrijne Hospital Leiden, Leiden, The Netherlands
| | - OHH Gerlach
- Department of Neurology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - JP Mostert
- Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - WIM Verhagen
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - MAP Heerings
- Department of Human Genetics, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - HAM Middelkoop
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands,Department of Neurology & Neuropsychology, Leiden University Medical Centre, Leiden, The Netherlands
| | - LH Visser
- Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands,Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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Stigma, Discrimination and Disclosure of the Diagnosis of Multiple Sclerosis in the Workplace: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159452. [PMID: 35954811 PMCID: PMC9367867 DOI: 10.3390/ijerph19159452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/18/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The objective of the study was to describe and analyze the stigma, discrimination and the disclosure of the diagnosis of Multiple Sclerosis (MS) in the workplace. The protocol was registered in PROSPERO (CRD42022320437). We systematically searched four scientific databases with key search terms. We included any original peer-reviewed articles reporting the stigma or discrimination experienced at work due to MS or the disclosure of the diagnosis of MS in the workplace. No time limits were set for the search. An appraisal of the individual study quality was performed with the JBI critical appraisal checklist. Overall, 26 studies were deemed to fulfil all the eligibility criteria. The total number of participants in this review was 9571. The prevalence of people with MS who experience some degree of stigma in the workplace can be as high as 79.2%. Those who report greater feelings of discrimination are more likely to be unemployed. The prevalence of employers’ and co-workers’ awareness of the diagnosis varies from 31.7 to 90.2%. The main reason for non-disclosure is the fear of being discriminated against. The psychosocial work environment needs to be taken into consideration as part of public and individual policies to promote the health of patients with MS.
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Vitturi BK, Rahmani A, Dini G, Montecucco A, Debarbieri N, Sbragia E, Bandiera P, Ponzio M, Battaglia MA, Manacorda T, Persechino B, Buresti G, Inglese M, Durando P. Occupational outcomes of people with multiple sclerosis: a scoping review. BMJ Open 2022; 12:e058948. [PMID: 35777874 PMCID: PMC9252209 DOI: 10.1136/bmjopen-2021-058948] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To update the knowledge on the occupational outcomes associated with multiple sclerosis (MS), systematically examine the extent, scope and nature of the pre-existing literature and identify research gaps in the existing literature. DESIGN Scoping review. DATA SOURCES A comprehensive database search of PubMed/MEDLINE, Scopus, SciVerse ScienceDirect and Web of Science was performed. There were no time limits. ELIGIBILITY CRITERIA We included any peer-reviewed original article reporting the occupational outcomes of people with MS between the ages of 18 and 65 years. We excluded those off-topic and with insufficient information. METHODS This review was conducted following the Joanna Briggs Institute recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review checklist. Screening, reading of full-texts and data extraction was performed in a standardised way by expert reviewers from 14 July 2021 to 31 October 2021. We provided a narrative synthesis and an overview of findings. RESULTS The initial systematic search yielded 104 228 results. After removing duplicates and applying the exclusion criteria, 403 articles were included in the review. In total, the studies evaluated 492 062 subjects with MS. One hundred fifty-four (38.2%) articles were published in the last 5 years, mostly from Europe and North America (50.9% and 33.0%, respectively). Concerning the occupational outcomes, studies mostly addressed unemployment (311, 77.2%), early retirement (120, 29.8%), disability pension (117, 29.0%), sick leave (77, 19.1%), the indirect cost of MS (74, 18.4%) and work characteristics (57, 14.1%). The results were categorised into seven subtopics: 'Changes in work and occupational status due to MS', 'work-related socio-economic consequences of MS', 'risk factors for unfavourable occupational outcomes', 'reported barriers to employment', 'reported job accommodations and vocational rehabilitation strategies', 'job satisfaction, stigma, and disclosing the diagnosis in the workplace' and 'rating clinical scales'. CONCLUSIONS There are several issues that deserve further in-depth study by the scientific community in order to improve the occupational outcomes of people with MS.
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Affiliation(s)
| | - Alborz Rahmani
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alfredo Montecucco
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicoletta Debarbieri
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elvira Sbragia
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paolo Bandiera
- Italian Multiple Sclerosis Association (AISM), Genoa, Italy
| | - Michela Ponzio
- Research Area, Italian Multiple Sclerosis Association, Genoa, Italy
| | - Mario Alberto Battaglia
- Research Area, Italian Multiple Sclerosis Association, Genoa, Italy
- Italian Multiple Sclerosis Foundation (FISM), Genova, Italy
- Department of Life Science, University of Siena, Siena, Italy
| | | | | | | | - Matilde Inglese
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI) and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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8
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Szcześniak M, Potemkowski A, Brola W, Kroplewski Z, Szałachowski RR, Zak M, Wilski M, Sobolewski P, Bartosik-Psujek H, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Ratajczak A, Ratajczak M. The Big Five Personality Traits and Positive Orientation in Polish Adults with Multiple Sclerosis: The Role of Meaning in Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095426. [PMID: 35564821 PMCID: PMC9099940 DOI: 10.3390/ijerph19095426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
Scientific achievements concerning the direct relation between personality traits and positive orientation among patients with multiple sclerosis do not explain the role of potential mediators. In fact, some researchers argue that the traits–positivity association is much more complex than it seems to be. For this reason, we made an attempt to analyze the indirect relationship between the above-mentioned variables, including meaning in life as a mediator. In total, 618 patients with MS took part in the study. The NEO Five-Factor Inventory, the Positive Orientation Scale, and the Meaning in Life Questionnaire were used. The results showed that positive orientation/the presence of meaning/searching for meaning correlated positively with extraversion, openness to experience, agreeableness, and conscientiousness, and were negatively associated with neuroticism. Moreover, meaning in life in both its dimensions acted as a mediator in 9 of 10 models. It can be assumed that a propensity to establish interpersonal relationships (extraversion), use active imagination (openness), inspire confidence among others (agreeableness), and take responsibility (conscientiousness) can have an impact on someone’s positive attitude toward oneself and the surrounding world (positive orientation) when people have meaning in life and when they are seeking it.
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Affiliation(s)
- Małgorzata Szcześniak
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
- Correspondence:
| | - Andrzej Potemkowski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Zdzisław Kroplewski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | | | - Marek Zak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznan University of Physical Education, 61-871 Poznań, Poland;
| | - Piotr Sobolewski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland;
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Agata Czarnowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, 01-755 Warszawa, Poland;
| | - Jacek Zaborski
- Department of Neurology and Neurological Rehabilitation and Stroke Sub-Division, Specialist Hospital in Międzylesie, 04-749 Warszawa, Poland;
| | - Anna Ratajczak
- Postgraduate Study, Pomeranian Medical University, 70-204 Szczecin, Poland;
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9
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Fuchs TA, Jaworski MG, Youngs M, Abdel-Kerim O, Wojcik C, Weinstock-Guttman B, Benedict RH. Preliminary Support of a Behavioral Intervention for Trait Conscientiousness in Multiple Sclerosis. Int J MS Care 2022; 24:45-53. [PMID: 35462870 PMCID: PMC9017661 DOI: 10.7224/1537-2073.2021-005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Background Conscientiousness, or the proclivity for deliberation, achievement, and order, declines in many individuals with multiple sclerosis (MS). Decreased conscientiousness predicts future cognitive deterioration, brain atrophy, and employment loss in individuals with MS. As a psychological trait, it may be an actionable antecedent to these important outcomes. We pilot tested an application (app)-facilitated behavioral intervention to help adaptation to low conscientiousness and, in turn, improve employment. Methods Eleven individuals with MS (5 treatment, 6 control) with low conscientiousness were recruited for a 12-week randomized controlled trial. The treatment group received a newly developed behavioral treatment and smartphone app designed to help people behave more conscientiously, 2 teleconference booster sessions, and weekly telephone calls to monitor progress. Employment changes were recorded at baseline and follow-up. Patients provided detailed posttreatment interviews. Results Participant groups were matched on baseline age, sex, education, disease duration, hours worked, and conscientiousness. All participants in the treatment arm reported benefits, found the app easy to use, and would recommend it to others. The treatment group reported significantly more positive work outcomes relative to controls at follow-up (P = .028). Other positive life changes were described by treatment participants during post-treatment interviews. Conclusions These results support the hypothesis that behaviors typically associated with low conscientiousness may be addressed by behavioral therapy in the MS population. In addition to the positive employment changes in the treatment group, several other quality of life changes were described by study participants. Additional research is needed.
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Affiliation(s)
- Tom A. Fuchs
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
- The Buffalo Neuroimaging Analysis Center (TAF), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael G. Jaworski
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Margaret Youngs
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Omar Abdel-Kerim
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Curtis Wojcik
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ralph H.B. Benedict
- From the Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
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10
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Fuchs TA, Schoonheim MM, Broeders TAA, Hulst HE, Weinstock-Guttman B, Jakimovski D, Silver J, Zivadinov R, Geurts JJG, Dwyer MG, Benedict RHB. Functional network dynamics and decreased conscientiousness in multiple sclerosis. J Neurol 2021; 269:2696-2706. [PMID: 34713325 DOI: 10.1007/s00415-021-10860-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Conscientiousness is a personality trait that declines in people with multiple sclerosis (PwMS) and its decline predicts worse clinical outcomes. This study aims to investigate the neural underpinnings of lower Conscientiousness in PwMS by examining MRI anomalies in functional network dynamics. METHODS 70 PwMS and 50 healthy controls underwent personality assessment and resting-state MRI. Associations with dynamic functional network properties (i.e., eigenvector centrality) were evaluated, using a dynamic sliding-window approach. RESULTS In PwMS, lower Conscientiousness was associated with increased variability of centrality in the left insula (tmax = 4.21) and right inferior parietal lobule (tmax = 3.79); a relationship also observed in regressions accounting for handedness, disease duration, disability, and tract disruption in relevant structural networks (ΔR2 = 0.071, p = 0.003; ΔR2 = 0.094, p = 0.004). Centrality dynamics of the observed regions were not associated with Neuroticism (R2 < 0.001, p = 0.956; R2 < 0.001, p = 0.945). As well, higher Conscientiousness was associated with greater variability in connectivity for the left insula with the default-mode network (F = 3.92, p = 0.023) and limbic network (F = 5.66, p = 0.005). CONCLUSION Lower Conscientiousness in PwMS was associated with increased variability in network centrality, most prominently for the left insula and right inferior parietal cortex. This effect, specific to Conscientiousness and significant after accounting for disability and structural network damage, could indicate that overall stable network centrality is lost in patients with low Conscientiousness, especially for the insula and right parietal cortex. The positive relationship between Conscientiousness and variability of connectivity between left insula and default-mode network potentially affirms that dynamics between the salience and default-mode networks is related to the regulation of behavior.
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Affiliation(s)
- Tom A Fuchs
- Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tommy A A Broeders
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jacob Silver
- Department of Orthopedics, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.,Center for Biomedical Imaging, Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ralph H B Benedict
- Jacobs Multiple Sclerosis Center for Treatment and Research, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
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11
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van der Hiele K, van Gorp DAM, van Egmond EEA, Jongen PJ, Reneman MF, van der Klink JJL, Arnoldus EPJ, Beenakker EAC, van Eijk JJJ, Frequin STFM, de Gans K, Hengstman GJD, Hoitsma E, Gerlach OHH, Verhagen WIM, Heerings MAP, Middelkoop HAM, Visser LH. Self-reported occupational functioning in persons with relapsing-remitting multiple sclerosis: Does personality matter? J Neurol Sci 2021; 427:117561. [PMID: 34216973 DOI: 10.1016/j.jns.2021.117561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) poses a major threat to sustainable employability. Identifying conditions and factors that promote work participation is of great importance. Our objective was to explore the contribution of personality traits in explaining occupational functioning in MS. METHODS 241 participants with relapsing-remitting MS (78% female, median age: 42.0 years, median EDSS: 2.0) and 60 healthy controls (70% female, median age: 45.0 years) underwent neuropsychological and neurological examinations and completed questionnaires. Multivariate logistic and linear regression analyses were conducted to examine relations between personality traits and self-reported occupational functioning, while accounting for known correlates. RESULTS Personality traits were not associated with self-reported occupational functioning when correcting for known correlates. A higher impact of fatigue (B = -0.05, p = .005 and B = -0.04, p = .009) and depression (B = -0.22, p = .008 and B = -0.21, p = .01) were associated with no paid job (R2 = 0.13) and considering to reduce work hours (R2 = 0.12). A higher impact of fatigue (B = -0.05, p = .008, β = 0.46, p = .001 and β = -0.36, p = .001) was associated with absenteeism from work (R2 = 0.15), more presenteeism (R2 = 0.35) and lower work ability (R2 = 0.25). A higher impact of fatigue (β = 0.46, p = .001) and anxiety (β = 0.25, p = .001) were associated with more work difficulties (R2 = 0.54). CONCLUSION Personality traits did not explain additional variance in self-reported occupational functioning in persons with relapsing-remitting MS with mild disability. The impact of fatigue was the main and most consistent correlate of occupational functioning, often combined with depression or anxiety. Total explained variance of the models was limited, emphasizing the need to additionally examine other (contextual) factors when considering occupational challenges in MS.
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Affiliation(s)
- K van der Hiele
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands.
| | - D A M van Gorp
- University of Humanistic Studies, Utrecht, the Netherlands
| | - E E A van Egmond
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; University of Humanistic Studies, Utrecht, the Netherlands; National Multiple Sclerosis Foundation, Rotterdam, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - P J Jongen
- MS4 Research Institute, Nijmegen, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Community & Occupational Medicine, Groningen, the Netherlands
| | - M F Reneman
- University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Haren, the Netherlands
| | - J J L van der Klink
- Tilburg University, Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg, the Netherlands; Optentia, North West University of South Africa, Vanderbijlspark, South Africa
| | - E P J Arnoldus
- Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
| | - E A C Beenakker
- Medical Centre Leeuwarden, Department of Neurology, Leeuwarden, the Netherlands
| | - J J J van Eijk
- Jeroen Bosch Hospital, Department of Neurology's-Hertogenbosch, the Netherlands
| | - S T F M Frequin
- St. Antonius Hospital, Department of Neurology, Nieuwegein, the Netherlands
| | - K de Gans
- Groene Hart Hospital, Department of Neurology, Gouda, the Netherlands
| | | | - E Hoitsma
- Alrijne Hospital Leiden, Department of Neurology, Leiden, the Netherlands
| | - O H H Gerlach
- Zuyderland Medical Centre, Department of Neurology, Sittard-Geleen, the Netherlands
| | - W I M Verhagen
- Canisius-Wilhelmina Hospital, Department of Neurology, Nijmegen, the Netherlands
| | - M A P Heerings
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - H A M Middelkoop
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University Medical Centre, Department of Neurology, Leiden, the Netherlands
| | - L H Visser
- University of Humanistic Studies, Utrecht, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Neurology, Tilburg, the Netherlands
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