 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Carrie M Kuehn, MA, Kurt L. Johnson, PhD, CRC, Kathryn M. Yorkston, PhD, Dagmar Amtmann, PhD, and Estelle R. Klasner, PhD. Rehabilitation Medicine, University of Washington, MS Rehabilitation Research & Training Center, Box 356490, Seattle, WA 98195, 206-221-5687, cmkuehn@u.washington.edu
Multiple Sclerosis (MS) has a significant impact on employment and participation for individuals living with MS. MS is typically diagnosed in young adults when most are in the early stages of their careers and family growth. A disabling disease of the central nervous system, MS affects between 250,000 and 350,000 people living in the U.S. The rate of employment among individuals living with MS is much lower than would be expected given their characteristics such as age, educational status, and other variables. High levels of unemployment among individuals with MS have been attributed to a number of biological and psychosocial variables including cognitive and physical changes associated with MS. To better understand how these factors affect employment and participation, we used a combination of latent class and profile analysis to examine variables that describe physical, cognitive, and social aspects of functioning of people with multiple sclerosis such as MS type, EDSS score, pain, fatigue and cognitive changes. Latent variable modeling was used to empirically determine qualitatively meaningfully different subgroups within a sample. Using this approach allowed us to identify a set of mutually exclusive latent classes and assign each individual in the sample to a specific class. Survey data from 785 respondents were analyzed and four reliably different subgroups were identified. The analysis revealed two groups that were easily distinguished by their disease and demographic characteristics. Also revealed were two groups with similar profiles, but divergent levels of employment. Clinical differences between individuals in these classes appear to be subtle, but their outcomes are substantially different. It is of public health importance to understand factors that tip the balance between fuller, more active participation and withdrawal from employment and other activities among individuals with MS who have similar bio-psycho-social profiles. Disability and unemployment at an early age decrease lifetime productivity and increase the burden on both families and public health. Identifying characteristics that predict change and developing targeted interventions could increase the level of participation in preferred activities, including employment, among individuals living with MS. This pilot study provided an opportunity to apply this analytic technique to MS data, and yielded useful results on which we will base future research.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.