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

Abstract

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.

Promoting factors and barriers to participation in working life for people with spinal cord injury

“…The importance of a new and diverse strategy for professional re-integration has already been emphasised in a meta-analysis [35]. However, this partly contrasts with the fact that less than half of those affected think about returning to work in rehabilitation immediately after the event that led to SCI [36]. The process of returning to social and community participation was identified as occurring in three main stages: withdrawal; re-emergence into society; and stability.…”

Can targeted job-information for adults with spinal cord dysfunction be effectively delivered online? A pilot study

“…Research indicates a sub-optimal return-to-work rate among adults with spinal cord injury or dysfunction (SCI/D), despite many being capable of engaging in paid employment. [1][2][3] The complexity of unemployment is highlighted by Australian economic data which demonstrates a steady decline in labor-force participation rates over the last 10 years for workingage adults with physical disabilities, despite sustained economic growth. 4 This underutilization of people with SCI/D of working age contributes to significant personal costs for the injured individual and their family in addition to economic costs associated with long-term care and lost productivity.…”

Models of Care Delivery from Rehabilitation to Community for Spinal Cord Injury: A Scoping Review

“…In fact, it is well-known that the return-to-work rate after SCI has been low. 70,71 Therefore, while this has not been identified as an optimal attribute to existing models of care internationally, future development of SCI models of care should include support for vocational rehabilitation as an area of focus.…”