Person-environment contextual factors as mediators for the relationship between symptom cluster and employment outcome in multiple sclerosis

BACKGROUND: Multiple sclerosis (MS) symptoms often make it difficult for individuals with MS to stay at work or return to work. It is important to understand the relationship between symptom clusters and employment. Person-environment (P-E) contextual factors such as core self-evaluations (CSE) and social support have been found to be effective mediators for the relationship between disability and participation in rehabilitation research and may be able to reduce the adverse impact of MS symptom cluster on employment outcome of people with MS. OBJECTIVE: To evaluate the mediation effect of CSE and social support on the relationship between symptom cluster and employment in MS. METHOD: Quantitative descriptive research design using two simple mediation analyses. 154 persons with multiple sclerosis participated in this study. RESULTS: Results show that symptom cluster, CSE, and social support were significantly related to employment. Both CSE and social support were significant mediators of the relationship between symptom cluster and employment, with CSE a stronger mediator than social support. CONCLUSIONS: Managing MS symptoms and increasing CSE and social support will reduce the adverse impact of MS symptom cluster on employment outcome. Therefore, CSE and social support can be viewed as protective factors for maintaining employment in MS. These results provide support for the use of positive psychology interventions by vocational rehabilitation counselors working with individuals with multiple sclerosis.