Factors associated with sustaining work with chronic spinal cord injury: a scoping review

Abstract

Work participation remains challenging for people with spinal cord injury (SCI), as reflected in lower employment rates compared to the general population. To promote work participation for people with SCI, practitioners and policymakers need a better understanding of the factors associated with sustaining work in the long term. This study aimed to identify such factors. Materials and methods: Scoping review synthesizing quantitative and qualitative research published between 2000 and 2021. The databases searched were PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. Results: Initially, 1221 articles were identified. Three quantitative studies investigating socio-demographic and injury-related factors and eight qualitative studies exploring mainly personal and environmental facilitators and barriers to working in the long term were retained. The results of the quantitative studies showed the importance of time since injury, age and education. The qualitative findings emphasized the positive influence of self-advocacy, managing health behaviours and a supportive work environment. Main barriers were time organization and societal attitudes.

Factors related to sustainable employment of people with acquired brain injury or spinal cord injury: The employer's perspective

“…The aspects raised by the employers interviewed in connection with sustainable employment largely coincide with the findings of existing international studies that look at the period of vocational rehabilitation or working with ABI or SCI in general (21,22). In addition, these studies also found that many aspects that our study identified as important for a sustainable work ability are initiated and established during the vocational reintegration phase.…”

“…For people with SCI, the importance of self and health management and adaptations in the work environment, as well as support from work colleagues, is emphasized. Barriers to sustainable work ability relate to difficulties in work organization and social discrimination (21). Specific, though not surprising, the interviewees focused strongly on performance as a critical factor to sustained employment and the challenges associated with discrepancies in performance expectations between employers and employees, what was also pointed out by Gilbride et al (26).…”

Facilitators and Barriers to Sustainable Employment After Spinal Cord Injury or Acquired Brain Injury: The Person's Perspective

“…They also overlap with key determinants of a successful RTW (31)(32)(33)(34)(35)(36)(37), indicating that some of the factors that are important for RTW remain significant in the long run. For example, being understood and supported by others at work and in private life is important for both RTW and sustaining employment as found by previous research (6,7). However, as shown in our study and previously reported, support at the workplace tends to diminish over time 1 .…”

“…Sustaining work reflects a major challenge for people with a disability, as evidenced by premature withdrawals from the labor market and a significantly decreasing employment rate over the life course (1)(2)(3). While return to work (RTW) is a primary goal of vocational integration services, many affected persons face problems in maintaining their jobs after initial RTW and tend to drop out from the labor market in the long run (3)(4)(5)(6)(7). By contrast to the predictors of a successful RTW, factors that determine labor market dropouts and a sustainable employment over time are hardly investigated in the literature.…”

“…For individuals with spinal cord injury (SCI) and persons with acquired brain injury (ABI), achieving a sustainable employment after RTW is particularly challenging (6,7,11). While SCI impairs the spine and ABI the brain, both conditions strongly limit functional abilities that are critical in today's labor market: mobility, cognitive functioning, work and social life (12)(13)(14).…”