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

Ottomanelli, Lisa; Lind, Lisa

doi:10.1080/10790268.2009.11754553

Cited by 186 publications

(221 citation statements)

References 79 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Heron-Delaney

Warren

Kenardy

2017

Injury

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Non-return to work following road traffic crash 2 Abstract Purpose: Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC.Method: Participants were 194 claimants (63.4% female) within a common-law "fault-based" system from the UQ SuPPORT cohort who were working prior to their RTC. Participants were assessed at 6 months on a variety of physical and mental health measures and RTW status was determined at 2 years post-RTC. RTW rate was 78.4%.Results: Univariate predictors of NRTW included being the driver or passenger, having a prior psychiatric diagnosis, high disability level, low mental or physical quality of life, predicted non-recovery, high pain, low function, high expectations of pain persistency, low expectations about RTW, having a psychiatric diagnosis, elevated depression or anxiety. The final multivariable logistic regression model included only two variables: disability level and expectations about RTW. Seventy-five percent of individuals who will not RTW by 2 years can be identified accurately at an early stage, using only these two predictors. Conclusion:The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW. Keywords: Motor Vehicles; Traffic Accidents; Return to Work; Mental Health; HealthNon-return to work following road traffic crash 3 Predictors of non-return to work 2 years post-injury in road traffic crash survivors: results from the UQ SuPPORT studyThe annual cost of road traffic crashes (RTCs) in Australia is estimated at $27 billion 1 and Australia reports spending 3.6% of its gross domestic product on RTCs 2 . The World Health Organization 3 anticipates that RTC injuries will be the third leading cause of disabilityadjusted life years lost (DALYs) by 2020. One of the major factors contributing to these costs is non-return to work (NRTW) following injury. NRTW is also problematic because working is associated with better health, self-esteem and social connectedness 4,5 , as well as improved quality of life and overall longevity 6 .Previous research on return to work (RTW) rates and predictors in RTC cohorts have produced varied results, most likely due to the differences in the nature of injuries in the samples assessed, the variance in severity of injury (mild through to catastrophic), the timeframe for follow-up, the compensation scheme and other sociocultural factors that vary across countries, such as the health care system. Rates of RTW range from 42%-69% at 9 to 12 months post-RTC for more serious inju...

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Section: Discussionmentioning

confidence: 99%

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

Heron-Delaney

Warren

Kenardy

2017

Injury

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“…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 …”

Section: Literature Search Proceduresmentioning

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.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

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

Cited by 186 publications

References 79 publications

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

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

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

Traumatic Cervical Spinal Cord Injury and Income and Employment Status

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