Return to work after spinal cord injury

Abstract

Objective: To describe predictors of return to work after spinal cord injury (SCI), in particular the physical intensity of the pre-injury job. Study design: Survey. Setting: Patients' home. Methods: We interviewed 234 persons with a spinal cord injury (SCI) between 18 and 65 years of age and who were gainfully employed at the time of the injury. Possible predictors were tested with logistic regression analyses. Results: After the SCI, only 37% of the persons were gainfully employed. People with heavy and strenuous physical work pre-injury regained work in only 25%, respectively 21%. Being male (Odds Ratio (OR) 3.70), light to moderate physical job pre-injury (OR 3.16), high Barthel Index (OR 2.76), high educational level (OR 2.12) and education post-injury (OR 2.14) were signi®cant predictors for returning to gainful work after injury. Many unemployed persons thought they were capable of working. Conclusions: Only a minority returned to gainful employment after SCI even to a physically less demanding job. In addition to intensive inpatient re-education, long-term support in job seeking is very important, including switching to a less demanding job. Spinal Cord (2000) 38, 51 ± 55

Barriers and facilitators to employment after spinal cord injury: underlying dimensions and their relationship to labor force participation

“…Education is widely acknowledged to be a primary facilitator of labor force participation after SCI. 1,[16][17][18][19] Similarly, the majority of participants reported they indeed felt capable of working and were motivated to work. For instance, 60% of the participants agreed with the statements that they were capable of working and that work was worth the effort.…”

Participation and satisfaction after spinal cord injury: results of a vocational and leisure outcome study

“…[9][10][11][12][13] Preceding their SCI, this study group was very active and spent on average more than 40 working hours a week preinjury. It concerned a relatively high number of self-employed workers and persons who extended their regular jobs with jobs on the side in evening hours.…”

“…[6][7][8] Working rates for people with SCI vary from 31 to 48% in recent studies. [9][10][11][12][13] Factors related to the success of vocational reintegration are age, education level, realistic expectations, preinjury type of job, type of lesion and disease-specific problems and disabilities. 2,4,9,[14][15][16] For those people unable to reintegrate in work, participation in nonvocational activities must also be considered as a successful rehabilitation outcome.…”

Vocational reintegration following spinal cord injury: expectations, participation and interventions

“…3,[8][9][10][11][12][13][14] Factors related to the success of vocational reintegration include several personal and injury-related variables, such as age, type of lesion and Barthel score, and work-related variables, such as educational level, preinjury type of work and social security system. [1][2][3][8][9][10][11][12][13][14][15][16][17] Only few studies focused on the relation between vocational outcome and more subjective indicators such as work interests and values, educational and vocational plans and societal attitudes. 9,14 Nevertheless, the role of the individual patient seems very important in the process to successful job reintegration.…”

“…1,15,16,18 According to Wade, interventions at the level of participation include actions to maximise the behavioural repertoire of the patient and provide suitable opportunities for social interaction, such as educational and employment services. 19 Recommendations to improve vocational outcome are tailor-made educational and vocational counselling, contact with peer groups, changing employer perceptions, improving transport and equal access and reducing financial disincentives to working.…”