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

Ramakrishnan, Kumaran; Mazlan, Mazlina; Julia, P E; Latif, Lydia Abdul

doi:10.1038/sc.2011.16

Cited by 43 publications

(45 citation statements)

References 13 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…[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.…”

Section: Introductionmentioning

confidence: 95%

“…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.…”

Section: Study Limitationsmentioning

confidence: 99%

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

Kent

Dorstyn

2014

Spinal Cord

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Objectives: Spinal cord injury (SCI) research has highlighted links between psychological variables and employment outcome; however, there remains a need to consolidate the available heterogenous data. Methods: Meta-analytic techniques were used to examine and quantify differences in psychological functioning and employment status among adults with an acquired SCI. Fourteen observational studies (N ¼ 9, 868 participants) were identified from an electronic database search. Standardised mean difference scores between employed and unemployed groups were calculated using Cohen's d effect sizes. Additionally, 95% confidence intervals, fail-safe Ns, percentage overlap scores and heterogeneity statistics were used to determine the significance of d. Results: Moderate to large and positive weighted effects were noted across three broad psychological constructs: affective experience or feelings (d w ¼ 3.16), quality of life (d w ¼ 1.06) and life satisfaction (d w ¼ 0.70). However, the most compelling non-heterogeneous finding was associated with life satisfaction, a finding that was also not subject to publication bias. Inconsistent and weak associations between employment and individual measures of vocational attitude, self-efficacy, locus of control, adjustment and personality were also noted. Conclusion: Psychological factors and attributes are linked to employment post-SCI; however, the available data are limited in quantity. Longitudinal research is also needed to determine whether these variables can help to preserve employment over time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Study Limitationsmentioning

confidence: 99%

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

Kent

Dorstyn

2014

Spinal Cord

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Kennedy

Hasson

2015

Spinal Cord

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Study design: Single-centre, retrospective cohort study. Objectives: To analyse the return-to-work intentions during spinal cord injury (SCI) rehabilitation. Setting: Tertiary care, spinal cord injury rehabilitation unit, National Spinal Injuries Centre, Stoke Mandeville Hospital, Ayelsbury, UK. Methods: Employment outcomes were obtained from the Needs Assessment Checklist (NAC), for all patients admitted to the unit between February 2008 and October 2014. NAC1 is completed within 4 weeks post-mobilisation and NAC2 upon the patient moving to the pre-discharge ward. Data from 362 participants were analysed for return-to-work intentions, by gender, age and injury severity. Results: Seventy-six percent of the sample population was employed at the time of their injury. At NAC1, 22.4% of individuals had made plans to return to work, whereas 44.2% had not; at NAC2, 34.3% had made plans to return to work and 31.2% had not. This difference was found to be statistically significant. There were significant differences in return-to-work intentions by injury severity at NAC1 but not NAC2, and by age group at NAC2 but not NAC1. Conclusion: Less than half of those employed at the time of their injury had made plans to return to work before their discharge from the unit. The low proportion of individuals with SCI returning to work-just one in three-is concerning in view of the lost health and psychosocial benefits, and requires greater prominence during rehabilitation. Future research into effective employment interventions to improve employment outcomes in this population is required.

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Traumatic Cervical Spinal Cord Injury and Income and Employment Status

Jaffe,

Coyte,

Chan

et al. 2024

JAMA Netw Open

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ImportanceSpinal cord injury (SCI) causes drastic changes to an individual’s physical health that may be associated with the ability to work.ObjectiveTo estimate the association of SCI with individual earnings and employment status using national administrative health databases linked to income tax data.Design, Setting, and ParticipantsThis was a retrospective, national, population-based cohort study of adults who were hospitalized with cervical SCI in Canada between January 2005 and December 2017. All acute care hospitalizations for SCI of adults ages 18 to 64 years were included. A comparison group was constructed by sampling from individuals in the injured cohort. Fiscal information from their preinjury years was used for comparison. The injured cohort was matched with the comparison group based on age, sex, marital status, province of residence, self-employment status, earnings, and employment status in the year prior to injury. Data were analyzed from August 2022 to January 2023.Main outcomes and MeasuresThe first outcome was the change in individual annual earnings up to 5 years after injury. The change in mean yearly earnings was assessed using a linear mixed-effects differences-in-differences regression. Income values are reported in 2022 Canadian dollars (CAD $1.00 = US $0.73). The second outcome was the change in employment status up to 5 years after injury. A multivariable probit regression model was used to compare proportions of individuals employed among those who had experienced SCI and the paired comparison group of participants.ResultsA total of 1630 patients with SCI (mean [SD] age, 47 [13] years; 1304 male [80.0%]) were matched to patients in a preinjury comparison group (resampled from the same 1630 patients in the SCI group). The mean (SD) of preinjury wage earnings was CAD $46 000 ($48 252). The annual decline in individual earnings was CAD $20 275 (95% CI, −$24 455 to −$16 095) in the first year after injury and CAD $20 348 (95% CI, −$24 710 to −$15 985) in the fifth year after injury. At 5 years after injury, 52% of individuals who had an injury were working compared with 79% individuals in the preinjury comparison group. SCI survivors had a decrease in employment of 17.1 percentage points (95% CI, 14.5 to 19.7 percentage points) in the first year after injury and 17.8 percentage points (14.5 to 21.1 percentage points) in the fifth year after injury.Conclusions and RelevanceIn this study, SCI was associated with a decline in earnings and employment up to 5 years after injury for adults aged 18 to 64 years in Canada.

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

Cited by 43 publications

References 13 publications

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

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

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

Traumatic Cervical Spinal Cord Injury and Income and Employment Status

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