Meaningful Work, Self-Stigma, and Psychological Health of Persons with Visual Impairment

Background and purpose: Across the globe, persons with disabilities continue to exhibit disproportionately lower labour force participation rates and job retention (Vornholt et al., 2018), as well as poorer quality of life and psychological wellbeing compared to the general population (Kagan, Itzick, & Tal-Katz, 2018). Paid work is a key and critical life domain. However, not only does employment status per se matters. Rather, it is the subjective work experience that accounts for variations in psychological outcomes for persons with disabilities (Zhu et al., 2019). Meaningful work has been shown to positively correlate with psychological health. However, persons with disabilities are often renegaded to perform menial work tasks, which may be indicative of discriminatory practices. On the other hand, studies also show that persons with disabilities may internalise existing discriminatory beliefs on disability (e.g., ableism) and lead to enhanced levels of self-stigma. Yet, there is little understanding on the relationship between meaningful work and psychological health. Furthermore, there is little theoretical understanding on the relationship between meaningful work, self-stigma theory, and psychological health. As such, this study examines the associations between meaningful work, self-stigma, and psychological health. We hypothesise that (1) meaningful work is positively associated with psychological health, and (2) meaningful work is negatively associated with self-stigma; (3) self-stigma is negatively associated with psychological health, and (4) self-stigma mediates the relationship between meaningful work and psychological health in persons with disabilities.

Methods: This is a cross-sectional quantitative study. A survey comprising measures on meaningful work, self-stigma, and psychological health, was administered in Hong Kong via purposeful sampling. Meaningful work comprises four sub-domains including capacity optimisation, social embeddedness, reciprocal complementarity, and personal growth (Chui et al., 2019). A total of 302 persons with visual impairment completed the survey. Descriptive, linear, and mediation analyses were performed to test the four hypotheses.

Findings: Results show that meaningful work was positively associated with psychological health (F(8, 293) = 6.36, p < .001), that meaningful work was negatively associated with self-stigma (a = -0.11, t(293) = -5.77, p < .001), that self-stigma was negatively associated with psychological health, (b = -0.38, t(293) = -7.39, p < .001), and that self-stigma mediated the relationship between meaningful work and psychological health (z = 4.55, p < 0.001).

Conclusion and implications: To foster a more inclusive society for people of all abilities, it is insufficient simply to take ‘labour force participation’ is a marker for inclusion. The relationship between work and psychological health can be better explained by a more nuanced approach toward what we understand to be meaningful work to persons with disabilities. Meaningful work appears to be a promising protective factor to lower self-stigma amongst persons with disabilities, as well as promote psychological health amongst persons with disabilities. Findings provide insights and advances theoretical understanding on meaningful work and self-stigma theory in the context of disabilities. Implications for social work practice are discussed.