Return to work after spinal cord injury: factors related to time to first job

Abstract

Study design: Cross-sectional survey. Objectives: To investigate factors related to length of time between spinal cord injury (SCI) onset and start of first post-injury employment. Setting: Persons living with SCI in the community who are members of a disability support organization. Methods: Participants were randomly selected from the membership list of a non-governmental voluntary organization. They met the following four criteria: traumatic SCI, minimum of 15 years of age at the time of survey, a minimum of 2 years after SCI and had been employed for some time since SCI. The main outcome measure was time (in years) from injury onset to beginning first post-injury job. Results: Participants averaged 4.9 years (s.d. 5.1) from the time of SCI to their first post-injury job, with a range of 3 months to 20 years. Fifty percent of the participants who eventually returned to work had done so by 4 years. Return to pre-injury employer and employment were associated with early return, whereas having less years in education and being older at the time of injury were associated with longer time to return to work. Conclusion: Rehabilitation team need to consider return to employment as a realistic goal even many years after SCI. Perhaps a focus on returning more people to their pre-injury employer and employment with added focus and input from rehabilitation team for those with lower education status and older age at time of injury might expedite the process of reintegration.

Psychological variables associated with employment following spinal cord injury: a meta-analysis

“…5,48 However, consideration also needs to be given to the period of time between an individual's discharge from the in-patient spinal injury rehabilitation unit and employment. 6 For some people, the psychological impact of a SCI is chronic, hence there may be a considerable delay before employment goals are achieved. 3,6,8,49 There is a need then, for future research to examine referral pathways and, in particular, to explore barriers to the use of vocational services for people with SCI.…”

“…6 For some people, the psychological impact of a SCI is chronic, hence there may be a considerable delay before employment goals are achieved. 3,6,8,49 There is a need then, for future research to examine referral pathways and, in particular, to explore barriers to the use of vocational services for people with SCI.…”

“…[3][4][5] A time lag of 4.9 years (standard deviation (s.d.) ¼ 5.1) between injury onset and successful employment has also been identified, 6 suggesting that any clear vocational potential in this group is not immediately realized. 5,7 Researchers have now turned their attention to psychological factors and attributes as moderators of the post-SCI employment process, 4,8,9 with injury and demographic characteristics considered to explain only a modest amount of variance in employment status.…”

“…1, 43 In addition, details on the occupational positions obtained, pre-and post SCI, would help to identify the type of vocational retraining required during rehabilitation, including opportunities for higher education. 4 Time since injury is another critical variable for employment, 6 yet few studies reported this detail. Additional sub-group analyses might include the differential effects of employment (that is, part-time vs full-time employment) on the examined psychological indices, 51 and the impact of gender on vocational interests and engaged work roles.…”

Return-to-work intentions during spinal cord injury rehabilitation: an audit of employment outcomes

“…1 Returning to work for the pre-injury employer is one of the most significant factors relating to both employment following SCI and time taken to return to work. 19,20 Studies have found that a 'fast track' exists whereby individuals with SCI who return to work for their pre-injury company, whether in the same role or a new role, return to work significantly faster than those who find employment with a new company. This key piece of information should have a crucial role in future attempts to improve employment outcomes post-SCI.…”