{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:36:32Z","timestamp":1780378592305,"version":"3.54.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015995","name":"Nord universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015995","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite mild disability, people with multiple sclerosis (PwMS) often face work-related challenges and reduced employment. Their experiences regarding work challenges are understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To explore experienced work challenges and possibilities for sustained employment among employed PwMS with mild to moderate disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In-depth interviews with 26 employed PwMS analyzed using systematic text condensation guided by Goffman's theories on self and social interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three categories were developed: (1) unspoken work challenges, (2) the cumulative impact of mild MS symptoms on work challenges, and (3) disability and work challenges influence \u201cwho I am at work\u201d. Communication about work challenges was often limited even when MS was disclosed. Most participants experienced difficulties related to cumulation and interplay of symptoms and work challenges, resulting in reduced work capacity, hours and negative thoughts about themselves, confidence and perceived prospects for job retention. Feeling capable in handling work tasks were believed to facilitate sustained employment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mildly disabled PwMS often trivialized and avoided addressing work challenges to maintain self-concept, social order and role at work, even after MS was disclosed. Recognizing and addressing mild symptoms and work challenges while maintaining self-concept, sense of capability and acceptance at work, may facilitate sustained employment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fresc.2025.1677114","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:31:44Z","timestamp":1762929104000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mild multiple sclerosis challenges shape work experiences, affect self-concept, and are often trivialized despite disclosure"],"prefix":"10.3389","volume":"6","author":[{"given":"Maria","family":"Grytvik Hartvedt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt","family":"Normann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Sivertsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Christin","family":"Arntzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1177\/1352458517694432","article-title":"New insights into the burden and costs of multiple sclerosis in Europe","volume":"23","author":"Kobelt","year":"2017","journal-title":"Mult Scler"},{"key":"B2","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1177\/13524585231164295","article-title":"Employment status, productivity loss, and associated factors among people with multiple sclerosis","volume":"29","author":"Rodriguez Llorian","year":"2023","journal-title":"Mult Scler"},{"key":"B3","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1186\/s12889-019-6907-x","article-title":"Economic burden of multiple sclerosis in a population with low physical disability","volume":"19","author":"Garc\u00eda-Dom\u00ednguez","year":"2019","journal-title":"BMC Public Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"936","DOI":"10.3109\/09638288.2015.1070295","article-title":"Work-related problems in multiple sclerosis: a literature review on its associates and determinants","volume":"38","author":"Raggi","year":"2016","journal-title":"Disabil Rehabil"},{"key":"B5","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1177\/1352458518781971","article-title":"Estimating MS-related work productivity loss and factors associated with work productivity loss in a representative Australian sample of people with multiple sclerosis","volume":"25","author":"Chen","year":"2019","journal-title":"Mult Scler"},{"key":"B6","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s10926-022-10084-1","article-title":"Work barriers and job adjustments of people with multiple sclerosis: a systematic review","volume":"33","author":"Vitturi","year":"2023","journal-title":"J Occup Rehabil"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1007\/s10198-018-0971-5","article-title":"The economic impact of multiple sclerosis to the patients and their families in Norway","volume":"19","author":"Svendsen","year":"2018","journal-title":"Eur J Health Econ"},{"key":"B8","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/s0003-9993(03)00614-2","article-title":"The cost and benefits of employment: a qualitative study of experiences of persons with multiple sclerosis","volume":"85","author":"Johnson","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1177\/1359105317691587","article-title":"Employment and multiple sclerosis: a meta-analytic review of psychological correlates","volume":"24","author":"Dorstyn","year":"2019","journal-title":"J Health Psychol"},{"key":"B10","volume-title":"Disability, Work and Inclusion: Mainstreaming in All Policies and Practices","year":"2022"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1258737","DOI":"10.3389\/fresc.2023.1258737","article-title":"Feasibility of a new intervention addressing group-based balance and high-intensity training, physical activity and employment in individuals with multiple sclerosis: a pilot randomized controlled trial","volume":"4","author":"Arntzen","year":"2023","journal-title":"Front Rehabil Sci"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2055217319852717","DOI":"10.1177\/2055217319852717","article-title":"Perception of stigma in patients with primary progressive multiple sclerosis","volume":"5","author":"P\u00e9rez-Miralles","year":"2019","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"B13","doi-asserted-by":"publisher","first-page":"102046","DOI":"10.1016\/j.msard.2020.102046","article-title":"Workplace difficulties, health-related quality of life, and perception of stigma from the perspective of patients with multiple sclerosis","volume":"41","author":"Maurino","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"B14","first-page":"59","article-title":"Barriers to and facilitators of employment among Americans with multiple sclerosis: results of a qualitative focus group study","volume":"82","author":"Bogenschutz","year":"2016","journal-title":"J Rehabil"},{"key":"B15","doi-asserted-by":"publisher","first-page":"158","DOI":"10.7224\/1537-2073.2018-087","article-title":"Effect of multiple sclerosis on daily activities, emotional well-being, and relationships: the global vsMS survey","volume":"22","author":"Bass","year":"2020","journal-title":"Int J MS Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"9452","DOI":"10.3390\/ijerph19159452","article-title":"Stigma, discrimination and disclosure of the diagnosis of multiple sclerosis in the workplace: a systematic review","volume":"19","author":"Vitturi","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1331746","DOI":"10.3389\/fpubh.2024.1331746","article-title":"Disclosing or concealing multiple sclerosis in the workplace: two sides of the same coin-insights from a Swedish population-based survey","volume":"12","author":"Dervish","year":"2024","journal-title":"Front Public Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3276","DOI":"10.1080\/09638288.2020.1741698","article-title":"The notion of \u201cinvisibility\u201d in people\u2019s experiences of the symptoms of multiple sclerosis: a systematic meta-synthesis","volume":"43","author":"Parker","year":"2021","journal-title":"Disabil Rehabil"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1111\/hex.13093","article-title":"\u2018It struck at the heart of who I thought I was\u2019: a meta-synthesis of the qualitative literature examining the experiences of people with multiple sclerosis","volume":"23","author":"Desborough","year":"2020","journal-title":"Health Expect"},{"key":"B20","doi-asserted-by":"crossref","DOI":"10.1037\/sah0000599","volume-title":"The Experience of Stigma and Concealment in Multiple Sclerosis","author":"Maguire","year":"2024"},{"key":"B21","volume-title":"InterViews: Learning the Craft of Qualitative Research Interviewing","author":"Brinkmann","year":"2015"},{"key":"B22","volume-title":"Qualitative Inquiry and Research Design: Choosing Among Five Approaches","author":"Creswell","year":"2017"},{"key":"B23","volume-title":"Philosophies of Social Science: The Classic and Conteporary Readings","author":"Delanty","year":"2003"},{"key":"B24","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/s1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1212\/wnl.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1080\/21679169.2024.2385325","article-title":"The meaning and feasibility of engaging in physical activity while being employed in people with mild to moderate disability due to multiple sclerosis: a qualitative study","volume":"27","author":"Grytvik Hartvedt","year":"2024","journal-title":"Eur J Physiother"},{"key":"B27","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1177\/1403494812465030","article-title":"Systematic text condensation: a strategy for qualitative analysis","volume":"40","author":"Malterud","year":"2012","journal-title":"Scand J Public Health"},{"key":"B28","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman","year":"1968"},{"key":"B29","volume-title":"Interaction Ritual: Essays in Face-to-face behavior","author":"Goffman","year":"2005"},{"key":"B30","volume-title":"The Presentation of Self in Everyday Life","author":"Goffman","year":"1969"},{"key":"B31","doi-asserted-by":"publisher","first-page":"S67","DOI":"10.1177\/0022146510383495","article-title":"The social construction of illness: key insights and policy implications","volume":"51","author":"Conrad","year":"2010","journal-title":"J Health Soc Behav"},{"key":"B32","volume-title":"The Goffman Reader","author":"Goffman","year":"1997"},{"key":"B33","first-page":"70","article-title":"Feltarbeid i egen kultur: innenfra, utenfra eller begge deler?[Fieldwork in thei own culture: from within, from outside or both?]","volume-title":"Metodisk Feltarbeid: Produksjon og Tolkning av Kvalitative Data","author":"Paulgaard","year":"1997"},{"key":"B34","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"B35","article-title":"Lov om folketrygd LOV-1997-02-28-19","year":"1997"},{"key":"B36","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1007\/s00415-005-0765-4","article-title":"Factors influencing work retention for people with multiple sclerosis: cross-sectional studies using qualitative and quantitative methods","volume":"252","author":"O'Connor","year":"2005","journal-title":"J Neurol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1177\/1352458514525869","article-title":"An empowerment model of workplace support following disclosure, for people with MS","volume":"20","author":"Kirk-Brown","year":"2014","journal-title":"Mult Scler"},{"key":"B38","doi-asserted-by":"publisher","first-page":"a949","DOI":"10.1136\/bmj.a949","article-title":"Why use theories in qualitative research?","volume":"337","author":"Reeves","year":"2008","journal-title":"Br Med J"}],"container-title":["Frontiers in Rehabilitation Sciences"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2025.1677114\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:31:47Z","timestamp":1762929107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fresc.2025.1677114\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":38,"alternative-id":["10.3389\/fresc.2025.1677114"],"URL":"https:\/\/doi.org\/10.3389\/fresc.2025.1677114","relation":{},"ISSN":["2673-6861"],"issn-type":[{"value":"2673-6861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"article-number":"1677114"}}