Abstract
To examine employment status amongst people with multiple sclerosis (pwMS) in Israel, identify predictors of employment status, and investigate factors contributing to absenteeism amongst employed individuals. This cross-sectional study included 119 pwMS (65 women, mean age, 40.1 years, mean disease duration, 10.0 years). Participants completed self-reported questionnaires assessing employment status, absenteeism, work-related difficulties, perceived fatigue, perceived mobility, bladder and bowel function, fear of falling, and psychological and cognitive factors. The level of disability and information processing speed were also evaluated. Statistical analyses included ANOVA, t-tests, and regression models. Almost half of the participants (49.6%) were fully employed, 29.4% were partially employed, and 21.0% were unemployed. Unemployed pwMS reported higher levels of fatigue, mobility challenges, bladder and bowel dysfunction, and fear of falling. Perceived fatigue, specifically the physical and cognitive subscales, distinguished fully employed from partially employed individuals and was the most significant predictor of absenteeism (52.7%) of employed participants reported missing work due to multiple sclerosis. No significant differences were observed in depression, anxiety, or cognitive function across employment groups. Fatigue emerged as a critical determinant of employment status and absenteeism in pwMS, in conjunction with physical and functional barriers. Interventions addressing fatigue, mobility, bladder issues, and workplace accommodations are essential for improving employment outcomes. Longitudinal research is warranted to explore causal relationships and guide comprehensive strategies for employment retention.