6 research outputs found
Reliability and content validity of the Disability Assessment Structured Interview (DASI): a tool to assess functional limitations in claimants
Objective The aim of this study is to investigate
the reliability and validity of the Disability Assessment
Structured Interview (DASI). The DASI is a semi-structured
interview for assessing long-term functional limitations
concerning the work disability assessment of
claimants. Methods A randomized controlled trial was
conducted. Patients applying for a work-disability pension
after 21 months of sick leave were independently interviewed
and examined either by two physicians who had
completed a DASI training period (n = 32) or by two
physicians from a control group (n = 30) without any
DASI training. Agreement percentages within both groups
of physicians, eligibility for a disability benefit, and differences
between the groups in terms of the scores given on
the work-limitation items from the Functional Ability List
(FAL) were measured to investigate reliability and concurrent
validity. To determine the content validity, the
insurance physicians who completed DASI training
(n = 8) were asked to fill out a questionnaire concerning
their opinion of the DASI. Additionally, patients filled out
a questionnaire to measure their satisfaction as to the
behavioral aspects of the physicians. Results The groups
showed no important differences in agreement percentages
(mean percentage about 80%) and eligibility for a disability
benefit. In 9 out of 21 items the physicians of the control
group indicated fewer work limitations compared to physicians
using the DASI. All physicians agreed on the fact
that the DASI was an acceptable tool in daily practice, one
that provided a realistic picture of the patient and provided
sufficient information to assess functional limitations. In
addition, between the two groups, no differences were
found as to the satisfaction of patients concerning the
behavioral aspects of the physicians. Conclusion The DASI
is a tool with a reasonable to good inter-rater reliability and
content validity, and it appears to be acceptable to both
patients and physicians. It did not improve inter-observer
agreement beyond that of usual interview procedures used
in the Netherlands. The DASI would seem to be a worthwhile
tool for collecting self-reported information in order
to assess functional limitations in claimants.
Personality traits are not associated with changes in employment status over 3 years in persons with multiple sclerosis
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
Subjective cognitive impairment is related to work status in people with multiple sclerosis
Background: Unemployment is common among people with multiple sclerosis (pwMS) and has been associated with subjective cognitive difficulties, specifically in memory, attention, and executive functioning. However, longitudinal research on subjective cognitive difficulties and employment is scarce. Objective: We investigated whether subjective cognitive impairment (SCI), based on the clinical cut-off score of the MS Neuropsychological Screening Questionnaire (MSNQ), was associated with work status and negative work events (NWE) at baseline and after 2 years. Moreover, we investigated whether four MSNQ subdomains were related to work status and NWE. Methods: 287 participants (77.4% female, median age = 42 years) completed questionnaires on subjective cognitive functioning, depression, anxiety, and fatigue, and completed the Symbol Digit Modalities Test (SDMT). After baseline comparisons, logistic regression analyses were performed, with work status and NWE at baseline, and employment change and NWE change within 2 years after baseline as dependent variables. Independent variables included SCI and the MSNQ domains. Covariates anxiety, depression, fatigue, and SDMT were added. Results: SCI, depression and anxiety were associated with work status (Nagelkerke R2 = .286), but only SCI was associated with employment change (Nagelkerke R2 = .164). No predictors were associated with NWE at baseline or follow-up. In addition, no MSNQ subdomain was related to work status, employment change or NWE. Conclusion: Unemployed pwMS and pwMS with a deteriorated work status reported more cognitive difficulties after 2 years than employed pwMS or pwMS with a stable work status. In addition, depression, and anxiety were associated with work status
Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis:A 2-year longitudinal study
Background Cognitive functioning has been linked to employment outcomes in multiple sclerosis (MS) in cross-sectional studies. Longitudinal studies are however lacking and previous studies did not extensively examine executive functioning. Objectives We examined whether baseline cognitive functioning predicts a change in employment status after 2 years, while taking into account mood, fatigue and disability level. Methods A total of 124 patients with relapsing-remitting MS (pwMS) and 60 healthy controls were included. They underwent neurological and neuropsychological examinations and completed online questionnaires. PwMS were divided into a stable and deteriorated employment status group (SES and DES), based on employment status 2 years after baseline. We first examined baseline differences between the SES and DES groups in cognitive functioning, mood, fatigue and disability level. A logistic regression analysis was performed, with change in employment status (SES/DES) as dependent variable. Results The DES group included 22% pwMS. Group differences were found in complex attention, executive functioning, self-reported cognitive functioning, fatigue and physical disability. More physical disability (OR = 1.90, p = 0.01) and lower executive functioning (OR = 0.30, p = 0.03) were retained as independent predictors of DES (R2 = 0.22, p ≤ 0.001). Conclusions Baseline physical disability and executive functioning, but none of the other variables, moderately predicted a deterioration in employment status 2 years later