Staying Employed with a Physical Disability May Be Tough, But Resilience May Help

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

People with long-term physical disabilities have much lower employment rates than people without disabilities. People with conditions such as multiple sclerosis (MS) or spinal cord injury (SCI) may experience challenges such as limited mobility, pain, fatigue, difficulties with memory and concentration, depression, and anxiety, which can make it harder to find or keep a job. These individuals may also encounter discrimination or a lack of needed accommodations at work. While these experiences may be stressful or discouraging, past research has shown that people may be able to strengthen their inner resources to better cope with stress or uncertainty. In particular, resilience and self-efficacy are two inner resources that have been linked to higher quality of life for people with disabilities in past research. Resilience is a person’s ability to adapt to changes or stressful life events, and self-efficacy is a person’s confidence that they will succeed in reaching their goals. In a recent NIDILRR-funded study, researchers looked at the associations between demographic and disability factors, resilience, self-efficacy, and employment status in a sample of people with MS, SCI, muscular dystrophy (MD), and post-polio syndrome (PPS). They wanted to find out what factors were associated with being employed in this population. They also wanted to find out whether people who reported higher resilience or higher self-efficacy were more likely to be employed, after the differences in demographic and disability factors were accounted for.

Researchers at the University of Washington Rehabilitation Research and Training Center on Promoting Healthy Aging for Individuals with Long-Term Physical Disabilities reviewed survey responses from 882 people age 18-65 years with MS, SCI, MD, or PPS. The respondents were asked whether they were employed. They also answered questions about their demographics, such as their age and education level as well as how much they experienced various challenges related to their disability, including pain interference, anxiety, depression, sleep disruptions, mobility limitations, and difficulties with decision making and memory. Finally, the respondents indicated their level of agreement with 10 statements about their resilience, such as “I am able to adapt when changes occur,” and answered 6 questions about their self-efficacy in managing disability-related challenges, such as “How confident are you that you can keep your health condition or disability from interfering with your ability to deal with unexpected events”.

The researchers found that a third of the respondents reported working part-time or full-time, while the remaining two-thirds were unemployed. When the researchers looked at factors related to employment, they found that:

• Age and education were related to employment: On average, the employed respondents were about 4 years younger than the unemployed respondents. Most respondents had a college degree. However, those without college degrees were more likely to be unemployed: 11% of the employed respondents did not have a college degree while 27% of the unemployed respondents did not have a college degree.
• Disability challenges were generally not associated with unemployment: While respondents who were unemployed generally experienced more disability challenges, these challenges as a group were not strong predictors of employment. Only anxiety was a predictor of employment, and there were only small differences in anxiety between those who were employed and those were unemployed.
• Resilience was associated with employment but self-efficacy was not: After accounting for demographic and disability-related factors, the respondents reporting higher levels of resilience showed a higher probability of being employed than the respondents reporting lower resilience. However, there was no connection between disability management self-efficacy and employment status after accounting for demographic and disability-related factors.

The authors noted that self-efficacy in this study was measured by asking about general confidence in managing the daily challenges of living with a physical disability, and this specific type of self-efficacy may not be strongly related to employment status. However, a measure of work-related self-efficacy—confidence in one’s ability to secure a job or manage challenges on the job—may be more strongly related to job attainment and retention. Future research may be useful to evaluate the connections between employment and work-related self-efficacy.

According to the authors, resilience may be related to positive employment outcomes, even for individuals who experience significant daily challenges related to their disability. Resilience may aid these individuals to adapt to setbacks or stress and remain engaged in work-related activities. Vocational rehabilitation providers may wish to assess resilience in clients with long-term physical disabilities and consider implementing programs to help these individuals strengthen their resilience. Future research also may be useful to examine the impact of resilience during different stages of the employment process and following periods of employment and unemployment.

To Learn More

The Rehabilitation Research and Training Center on Promoting Healthy Aging for Individuals with Long-Term Physical Disabilities produced a collection of factsheets and research summaries for individuals with disabilities and practitioners. Among the collection:

• How to Bounce Back: What is resilience and how do people cope with disabilities as they age?
• Employment Concerns: What laws protect employees with disabilities and what programs and supports are available?
• How to Reduce Stress Through Mindfulness: What is mindfulness, what are some ways to practice mindfulness to reduce stress?

Working Well with a Disability is a six-week, peer facilitated workshop that considers health in the context of employment. Participants learn how to maintain life balance, manage stress, and improve their health in support of looking for or maintaining employment.

To Learn More About this Study

Ordway, A.R., Johnson, K.L., Amtmann, D., Bocell, F.D., Jensen, M.P, and Molton, I.R. (2019) The relationship between resilience, self-efficacy, and employment in people with physical disabilities. Rehabilitation Counseling Bulletin, 2019. This article is available from the NARIC collection under accession number J83673.