Prevalence and predictors of return to work following a spinal cord injury using a work disability prevention approach: A systematic review and meta-analysis

Abstract

Purpose Worldwide, spinal cord injuries are associated with diminished participation in the labor market. Inconclusive reporting and differences between workplace settings for individuals with spinal cord injury (SCI) make conceptualizing return to work rates among this population inherently challenging. The objectives of this study are to explore factors associated with return to work (RTW) following an SCI. Moreover, the factors were classified according to the work disability prevention framework. Finally, we conducted a meta-analysis of the prevalence of RTW following an SCI. Methods Original articles were identified through a literature search in four health databases. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the mapping and identification of records. Included studies contained primary studies that included the nature of the injury, antecedent factors associated with the injury, and study characteristics and RTW outcomes. Exclusion criteria for the studies included if there was no discussion of RTW outcomes, systematic reviews, and meta-analyses. Results A total of 461 full-text articles were assessed for eligibility, and eight studies were included and assessed using the Critical Appraisal Skills Programme checklist, Risk of Bias, and Newcastle–Ottawa Scale. Four studies identified personal system factors, four identified healthcare system factors, two identified compensation system factors, and one identified workplace system factors. Conclusions Attempts to optimize RTW among persons with SCI are inherently difficult due to the diversity of this client population. Findings from the studies included in this systematic review support the utility of interventions for facilitating RTW, such as vocational rehabilitation and workplace accommodations, while simultaneously acknowledging the limitations in identifying specific interventions as facilitatory or inhibitory throughout the process.

Impact of a spinal cord injury in employment: a cross-sectional study in a Portuguese population

“…Higher functional independence is a modifiable factor that positively influences employment opportunities after SCI. 15,16 Most of our results are in line with those in the literature, some of them with statistical significance. However, there are some data, like sex, which does not.…”

“…No characteristics of the SCI by itself showed statistical significance, although most patients who returned to work were paraplegic, had an incomplete lesion, and a non-traumatic etiology, as denoted in some studies. 5,13,16 Regarding functionality, higher mean scores were seen in patients who did return to work, in all three scales considered, as represented in the literature. 10 However, we cannot assume an association, as none showed a significant statistical difference.…”

Cognitive and Emotional Appraisal of Motivational Interviewing Statements: An Event-Related Potential Study

“…Participants in this study were injured workers classified into two readiness groups, i.e., PC and RD. The work disability prevention model stipulated that injured workers would make the return to work decisions based on the person, workplace, compensation, and health care system (Nowrouzi-Kia et al, 2021). Injured workers were revealed to have higher risks in developing psychological issues such as anxiety, depression, and posttraumatic stress disorder (Giummarra et al, 2018).…”

Evaluating the Effectiveness of Return-to-Work Interventions for Individuals with Work-Related Mental Health Conditions: A Systematic Review and Meta-Analysis

“…Hence, the possibility of resulting in statistically insignificant results thereby presents another limitation of this study. Additionally, another limitation could be that since many of the studies were completed in Europe using European samples, external validity to other countries may be limited [55]. To elaborate, in different countries, employers may have varying systems and accommodations for employees returning to work and in turn this may have an impact on how quickly employees return to work.…”