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ABSTRACT
Background: People with Multiple Sclerosis (PwMS) often report experiences of stigmatization in the workplace, leading to difficulty obtaining or maintaining employment. Stigma refers to feelings of inadequacy or undesirability due to a difference perceived by others who lack knowledge of that difference. This study examined the relationships between patient-reported stigma, employment status, and demographic factors.
Methods: We investigated the relationships between patient-reported stigma in PwMS and employment status, adjusting for age, sex, race, ethnicity, and level of education, using data from 196 PwMS enrolled in the Biorepository for Comprehensive Longitudinal Investigations of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB Bio). Stigma was measured using the computer-adaptive testing version of the Quality of Life in Neurological Disorders (Neuro-QoL), and employment data was collected through a health status questionnaire. Employment status was divided into three groups (employed, unemployed, and employed part-time), race was categorized as white or non-white, ethnicity as Hispanic/Latino or not Hispanic/Latino, and education as high school degree or less or greater than high school degree. Mean stigma scores were calculated for each category of employment. Linear regression was used to compare the mean stigma scores between employment groups, unadjusted and adjusted for demographic factors.
Results: Unemployed PwMS reported the highest level of stigma (51.1 (8.2) n=61), compared to part-time (48.9 (8.3) n=18) and employed (45.6 (8.1) n=117 PwMS. A significant difference in mean stigma between employed and unemployed PwMS was observed (difference in means =5.4, p<0.0001). After adjusting for age, sex, ethnicity, race, and educational level, the difference in mean stigma scores remained significant between employed and unemployed PwMS (adjusted difference in means= 6.1, p=.0003). Conclusions: PwMS who are unemployed report higher levels of stigma than PwMS employed full time. Adjusting for age, gender, ethnicity, race, and level of education mildly strengthened the relationship between unemployment and stigma. This finding demonstrates a need for better stigma prevention, specifically in unemployed PwMS. Future work should consider associations between disease characteristics as well as anxiety and depression, and employment status. References Anagnostouli, M., Katsavos, S., Artemiadis, A., Zacharis, M., Argyrou, P., Theotoka, I., Christidi, F., Zalonis, I., & Liappas, I. (2016). Determinants of stigma in a cohort of hellenic patients suffering from multiple sclerosis: a cross-sectional study. BMC Neurology, 16(1). Grothe, L., Grothe, M., Wingert, J., Schomerus, G., & Speerforck, S. (2021). Stigma in multiple sclerosis: the important role of sense of coherence and its relation to quality of life. International Journal of Behavioral Medicine, 29(4), 517–523. Guerra, T., Pipoli, A., Viterbo, R. G., Manghisi, N. M., Paolicelli, D., Iaffaldano, P., & Di Lorenzo, L. (2022). Predictors of unemployment status in people with relapsing multiple sclerosis: a single center experience. Neurological Sciences, 43(7), 4387–4392. https://doi.org/10.1007/s10072-022-06029-4 Maurino, J., Martínez-Ginés, M., García-Domínguez, J., Solar, M., Carcelén-Gadea, M., Arés- Luque, A., Ballabriga, J., Navarro-Cantó, L., Medrano, N., & Honan, C. A. (2020). Workplace difficulties, health-related quality of life, and perception of stigma from the perspective of patients with Multiple Sclerosis Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007). Stigma: ignorance, prejudice or discrimination? The British Journal of Psychiatry, 190(3), 192–193. Vijayasingham, L., & Mairami, F. F. (2018). Employment of patients with multiple sclerosis: the influence of psychosocial-structural coping and context. Degenerative Neurological and Neuromuscular Disease, Volume 8, 15–24. Vitturi, B. K., Rahmani, A., Dini, G., Montecucco, A., Debarbieri, N., Bandiera, P., Ponzio, M., Battaglia, M. A., Persechino, B., Inglese, M., & Durando, P. (2022). Stigma, Discrimination and Disclosure of the diagnosis of Multiple sclerosis in the workplace: a Systematic review. International Journal of Environmental Research and Public Health, 19(15), 9452.
