Review of Critical Factors Related to Employment After Spinal Cord Injury: Implications for Research and Vocational Services

Abstract

Background/Objective: Employment rates after spinal cord injury (SCI) vary widely because of discrepancies in studies' definition of employment and time of measurement. The objective of this study was to provide a comprehensive summary of the literature on employment rates, predictors of employment, and the benefits and barriers involved. Methods: A search using the terms spinal cord injury and employment in the databases PubMed, PsycINFO, and MEDLINE. The search included a review of published manuscripts from1978 through 2008. Results: A total of 579 articles were found and reviewed to determine the presence of reported employment rates. Of these, 60 articles were found to include a report of employment rates for individuals with SCI. Results indicated that, in studies that examined paid employment, the average rate of any employment after SCI was approximately 35%. Conclusions: Characteristics associated with employment after SCI include demographic variables, injuryrelated factors, employment history, psychosocial issues, and disability benefit status. It is recommended that researchers studying employment after SCI use common outcome measures such as competitive employment rates, duration of employment, and job tenure. Empirical evidence is lacking in regard to the most effective methods of vocational rehabilitation among this population. Evidence-based supported employment practices seem to be the most applicable model for assisting persons with SCI in restoring meaningful employment. Controlled studies are needed to test this assumption.

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study

“…RTW is important, in terms of reducing financial burden for the individual, their family and society as well as the associated benefits of better health, social connectedness and quality of life [4][5][6] . The results may ultimately have significant implications for policy and practice.…”

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

“…The database searches were conducted by the first author (MK) with retrieved studies then examined by both authors (MK, DD) in accordance with meta-analysis guidelines. 19 An examination of available reviews 4,5,10,11,18 in addition to the reference list of included studies was also undertaken by the first author (MK) to identify any further articles that may have been missed in the initial database search. 19 …”

“…[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.…”

“…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. 8 Moreover, psychological factors are potentially modifiable through clinical intervention.…”

“…8 Moreover, psychological factors are potentially modifiable through clinical intervention. In their systematic review, Ottomanelli and Lind 4 reported positive role models and degree of motivation as significant contributors to post-injury employment. Qualitative research additionally indicates that engagement in a valued occupation can enhance an individual's perception of self-worth, including one's ability, competencies and capabilities.…”