Multiple sclerosis (MS) is a central nervous system disorder that impacts more than 400,000 people in the U.S. The disease results in multiple functional impairments that are diverse and varied across individuals. Additonally, MS has a profound impact on community participation which, like other rehabilitation outcomes, cannot be explained on the basis of functional limitations alone. The purpose of this study was to develop and evaluate a model of community participation for people living with MS using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework. The model focused on the roles that personal factors have as predictors of community participation, while also serving as mediators and moderators for the relationship between activity limitation and participation. Results from the hierarchical regression analysis indicated that demographic characteristics (i.e. MS type), personal factors (i.e. core self-evaluations (CSE), MS self-management, resilience, and social skills), and activity limitations accounted for 64% of the variance in participation. Further, mediation analysis indicated that CSE mediated the relationship between activity limitation and community participation. Finally, moderation analysis indicated an interaction effect between educational attainment and MS self-management. Implications for future research in rehabilitation and clinical application are discussed.

In 2010, we proposed a personal factor classification which was published in this journal. Since then, the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) and the biopsychosocial model were increasingly incorporated into the German Social Law Code for participation and rehabilitation, implying that personal factors are indispensable for individual assessments. For the present study, we aimed to come up with an updated version of the personal factors classification based on current research. To achieve this goal, we employed a qualitative approach to re-examine the basic structure, consistency, and selection of categories in the classification from our 2010 study, to amend and supplement the categories to reflect best practice personal factor classifications. Our findings indicate that the basic structure remained largely unchanged, with relatively minor changes, including the deletion of 5 categories from our 2010 classification, 10 categories revised in format or content, and 13 new categories. We believe our revised classification to be useful for supporting users in systematically, comprehensively, and transparently reporting influences on specific aspects of individuals’ life and living background on their functioning and participation, thus facilitating an equitable allocation of disability benefits.

Multiple sclerosis (MS) is a chronic, typically progressive immune-mediated disease characterized by inflammation and demyelination in the central nervous system (CNS), and is associated with a wide range of neurological, physical, and psychosocial effects. For people living with MS, access to relevant, timely, and accessible health information and resources may contribute to effective illness management, psychosocial health, and quality of life (QOL). In this study, we sought to increase understanding of the specific types of information most wanted by people with MS, as well as the sources and effects of this information. Specifically, we surveyed 748 adults with MS about (a) the sources from which they obtain information about MS, (b) the type of information that is most important in terms of improving their QOL, and (c) specific topics about which they would like to have more information, services, or resources. Content analysis of the qualitative results demonstrated the diversity of information sources accessed by people with MS and the importance of providing information through different formats and media. The participants prioritized information related to new MS medications and treatments, physical and mental health and wellness, and local opportunities for support. Implications for practicing rehabilitation counselors are discussed.

The success of a lobectomy procedure for adult-onset epileptic seizure (AOES) would depend on the quality of the patient’s relationship with the health care provider. This ethnographic multiple case study explored patient and health professional relationship contexts following surgery for seizure activity reduction treatment. We interviewed five Australian men (aged 34–59) with a history of AOES and neurosurgery regarding the quality of their relationship with health care providers. Interpretive phenomenological analysis (IPA) of the data yielded three interrelated relationship themes of Timeliness (promptness of necessary care), Support (availability, understanding, and empathy), and Responsibility (adaptive communication, self-care, and decision-making ownership). Self-directed relationship resourcing enhanced subjective well-being in the patients.

This article reports on women’s experiences of career change following a breast cancer diagnosis and explores whether their illness represents the driving force to pursue previously unfulfilled career ambitions. The participants were four women who had been diagnosed with breast cancer and had changed career direction after their treatment. Data were conducted through in-depth interviews and were analyzed using Interpretative Phenomenological Analysis (IPA). Four themes prominent throughout each women’s narrative were identified: (i) a pre-diagnosis, unhappiness at work, (ii) a sense of stepping off the treadmill, (iii) a sharp focus upon their “self,” and subsequently (iv) a flourishing “work-life.” Further research is needed to investigate how common these findings are among women with breast cancer.

This study aimed to understand state-level variation in participation in the State/Federal Vocational Rehabilitation (State VR) System in the United States among transition-aged youth (persons under the age of 22 years at application for State VR services) with traumatic brain injury (TBI) in Federal Fiscal Year 2016. A weighted least squares regression analysis was conducted to determine the relationship of state-level population size, unemployment rate, and per-capita income to the number of State VR closures in each state for transition-aged youth with TBI. Population size and per-capita income significantly predicted closures, while there was no relationship between closures and unemployment rate. Research is needed that further explores and explains state-level disparities in participation among transition-aged youth with TBI.