Stigma, Discrimination and Disclosure of the Diagnosis of Multiple Sclerosis in the Workplace: A Systematic Review

Abstract

The objective of the study was to describe and analyze the stigma, discrimination and the disclosure of the diagnosis of Multiple Sclerosis (MS) in the workplace. The protocol was registered in PROSPERO (CRD42022320437). We systematically searched four scientific databases with key search terms. We included any original peer-reviewed articles reporting the stigma or discrimination experienced at work due to MS or the disclosure of the diagnosis of MS in the workplace. No time limits were set for the search. An appraisal of the individual study quality was performed with the JBI critical appraisal checklist. Overall, 26 studies were deemed to fulfil all the eligibility criteria. The total number of participants in this review was 9571. The prevalence of people with MS who experience some degree of stigma in the workplace can be as high as 79.2%. Those who report greater feelings of discrimination are more likely to be unemployed. The prevalence of employers’ and co-workers’ awareness of the diagnosis varies from 31.7 to 90.2%. The main reason for non-disclosure is the fear of being discriminated against. The psychosocial work environment needs to be taken into consideration as part of public and individual policies to promote the health of patients with MS.

Longitudinal determinants of employment status in people with relapsing-remitting multiple sclerosis

“…In particular, a lack of understanding in colleagues and line managers on the subject of MS was perceived as an issue. This finding relates to a recent systematic review by Vitturi and colleagues ( Vitturi et al, 2022 ) in which they suggest that stigma and discrimination can discourage people with disabilities from pursuing employment or maintaining it. Additionally, perceived stigma and/or discrimination may prevent employees from disclosure of their MS diagnosis which in turn may hinder the usage of appropriate accommodations in the work setting.…”

“…In addition, contextual factors such as the work environment might contribute to employment outcomes in MS ( Vijayasingham and Mairami, 2018 , Vitturi et al, 2022 ). A recent meta-analysis highlighted the need of further research analysing the impact of a supportive and inclusive work environment specifically ( Dorstyn et al, 2019 ).…”

Determinants of social participation in people with disability

“…Understanding and addressing the unique work barriers faced by people with disabilities is crucial for creating inclusive and supportive work environments that promote their employment opportunities and job retention. Kusznir Vitturi et al [ 12 ] provides a detailed systematic review of the work barriers and job adjustments experienced by people with Multiple Sclerosis (MS), highlighting the diverse challenges faced by individuals with MS in the workplace, including job characteristics, work environment factors, social relationships, negative work events, and emphasizes the importance of tailored job adjustments, such as workload management, flexible work schedules, workplace adaptations, and vocational rehabilitation services, to promote better work outcomes. Also in another review Kusznir Vitturi et al [ 13 ] conducted a comprehensive analysis of the potential impact of various factors, including demographic variables, disease severity, and types of work barriers, on the occupational outcomes of people with MS.…”

Disability discrimination in hiring: A systematic review

“…While there is an emerging evidence base focusing on disability-related discrimination, the vast majority of research has focused on wheelchair users, followed by individuals who experience mental conditions, and those with sensory impairments. There is very limited research on invisible conditions such as autism, ADHD, multiple sclerosis, and cancer, despite evidence of stigma and discrimination in various settings (for example, see Fujisawa and Hagiwara 2015;Lebowitz 2016;Turnock, Langley, and Jones 2022;Vitturi et al 2022). Extending the focus of experimental studies to other conditions is necessary to understand differential locations of disadvantage and delineate the mechanisms through which groups with different conditions and impairments end up occupationally disadvantaged (Chatzitheochari, Velthuis, and Connelly 2022).…”