Returning to Work After Spinal Cord Injury Are we "Investing in Regression"?

Authors

  • José Luís Mesquita Serviço de Medicina Física e de Reabilitação - Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.
  • Anabela Ferreira Serviço de Reabilitação de Adultos 1 - Centro de Medicina de Reabilitação de Alcoitão, Alcoitão, Portugal
  • Filipa Faria Serviço de Reabilitação de Adultos 1 - Centro de Medicina de Reabilitação de Alcoitão, Alcoitão, Portugal

DOI:

https://doi.org/10.25759/spmfr.462

Keywords:

Employment, Return to Work, Spinal Cord Injuries

Abstract

Introduction: A successful return to work following spinal cord injury has well documented physical and psychological health benefits. Nevertheless, the percentage of people returning to work actually decreased over the years. This study aims to identify the impact of injury severity, functional impairment, time since injury onset, level of education and the need to readapt the job on returning to work following SCI.
Methods: A telephone interview was conducted with individuals with spinal cord injury admitted to a rehabilitation center during 2015. Fifty one patients agreed to participate, corresponding to individuals aged between 15 and 66 years, with injuries that occurred between 1976 and 2015 who were professionally active prior to injury. Each participant was asked about their level of education, current employment, need of changing employer or entering vocational rehabilitation and period of time until returning to work. Information was collected from discharge summaries on injury etiology, American Spinal Injury Association Impairment Scale and Functional Independence Measure.
Results: About half of the patients (n=26; 51%) returned to work after injury. It was found that individuals who return to work have a higher level of education (p=0.02). Keeping the same employer is also a facilitating factor, allowing a quicker return (p=0.002). On the other hand, individuals who do not return to work do not have more severe neurological injuries (p=0.21) or lower levels of functional independence (p=0.13) than those who remain professionally active. Also, those who have lived with the injury longer do not have higher rates of return to work (p=0.36).
Conclusion: Despite the progressive development of multidisciplinary care in the rehabilitation of spinal cord injury patients, return to work is a complex and undefined process. Its success does not seem to be fully determined by the impact of motor, sensory, autonomic and psychosocial dysfunction. Thus, expectations are created in individualized vocational rehabilitation, which must be enhanced by measures to facilitate reentering labor market.

References

Ottomanelli L, Lind L. Review of critical factors related to employment after spinal cord injury: implications for research and vocational services. J Spinal Cord Med 2009; 32: 503–31.

Franceschini M, Pagliacci MC, Russo T, Felzani G, Aito S, Marini C, et al. Occurrence and predictors of employment after traumatic spinal cord injury: the GISEM study. Spinal Cord 2012; 50: 238–42. doi: 10.1038/sc.2011.131.

Boschen KA, Tonack M, Gargaro J. Long-term adjustment and community reintegration following spinal cord injury. Int J Rehabil Res. 2003; 26:157–164.

Manns PJ, Chad KE. Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury. Qual Health Res. 2001; 11:795– 811.

Schönherr MC, Groothoff JW, Mulder GA, Schoppen T, Eisma WH. Vocational reintegration following spinal cord injury: expectations, participation and interventions. Spinal Cord. 2004;42:177-84. doi: 10.1038/sj.sc.3101581.

Guttmann L. Rehabilitation and the paraplegic. J Coll Gen Pract. 1964; 8: 36– 42.

Decreto-Lei n.o 290/2009, de 12 de outubro, alterado pela Lei n.o 24/2011, de 16 de junho, pelo Decreto-Lei n.o 131/2013, de 11 de setembro e pelo Decreto-Lei n.o 108/2015, de 17 de junho, que o republica.

Guttmann L. Statistical survey on one thousand paraplegics. Proc R Soc Med. 1954; 47: 1099–103.

Munro D. Rehabilitation of patients totally paralyzed below waist with special reference to making them ambulatory and capable of earning their own livings. N Engl J Med. 1954; 250: 4–14.

Chapin M, Kewman D. Factors affecting employment following spinal cord injury: a qualitative study. Rehabil Psychol. 2001; 46: 400–16.

Kennedy P, Lude P, Taylor N. Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples. Spinal Cord. 2006; 44: 95–105.

Kennedy P, Sherlock O, McClelland M, Short D, Royle J, Wilson C. A multi-centre study of the community needs of people with spinal cord injuries: the first 18 months. Spinal Cord. 2010; 48: 15–20. doi: 10.1038/sc.2009.65.

Young A, Murphy G. Employment status after spinal cord injury (1992–2005): a review with implications for interpretation, evaluation, further research, and clinical practice. Int J Rehabil Res. 2009; 32:1–11.

Trenaman L, Miller W, Escorpizo R. Interventions for improving employment outcomes among individuals with spinal cord injury: a systematic review. Spinal Cord. 2014;52: 788–94. doi: 10.1038/sc.2014.149.

Bloom J, Dorsett P, McLennan V. Investigating employment following spinal cord injury: outcomes, methods, and population demographics. Disabil Rehabil. 2019;41:2359-68. doi: 10.1080/09638288.2018.1467968.

Krause JS, Terza JV, Erten M, Focht KL, Dismuke CE. Prediction of postinjury employment and percentage of time worked after spinal cord injury. Arch Phys Med Rehabil. 2012; 93: 373–5.

Ramakrishnan K, Mazlan M, Julia PE, Abdul Latif L. Return to work after spinal cord injury: factors related to time to first job. Spinal Cord. 2011; 49: 924-7. doi: 10.1038/sc.2011.16.

Pflaum JS, Reed KS. Barriers and facilitators to employment after spinal cord injury: underlying dimensions and their relationship to labor force participation. Spinal Cord. 2011; 49: 285–91. doi: 10.1038/sc.2010.110.

Hay-Smith EJ, Dickson B, Nunnerley J, Anne Sinnott K. "The final piece of the puzzle to fit in": an interpretative phenomenological analysis of the return to employment in New Zealand after spinal cord injury. Disabil Rehabil. 2013;35:1436-46. doi: 10.3109/09638288.2012.737079.

Chan SK, Man DW. Barriers to returning to work for people with spinal cord injuries: a focus group study. Work. 2005; 25:325–8.

Roels EH, Aertgeerts B, Ramaekers D, Peers K. Hospital- and community- based interventions enhancing (re)employment for people with spinal cord injury: a systematic review. Spinal Cord. 2016;54:2-7. doi: 10.1038/sc.2015.133.

Ville I, Winance M. To work or not to work? The occupational trajectories of wheelchair users. Disabil Rehabil. 2006;28:423-36. doi: 10.1080/096382 80500192561.

Fadyl JK, McPherson KM. Understanding decisions about work after spinal cord injury. J Occup Rehabil. 2010;20:69-80. doi: 10.1007/s10926-009-9204-1.

Middleton JW, Johnston D, Mupthy G, Ramakrishnan K, Savage N, Harper R, et al. Early access to vocational rehabilitation for spinal cord injury inpatients. J Rehabil Med. 2015; 47:626–31. doi: 10.2340/16501977-1980.

Krause JS, DeVivo MJ, Jackson AB. Health status, community integration, and economic risk factors for mortality after spinal cord injury. Arch Phys Med Rehabil. 2004; 85: 1764–73.

Gollwitzer PM, Sheeran P. National Cancer Institute Implementation intentions. Health Behavior Constructs: Theory, Measurement and Research 2008, Cancer control and population sciences. Bethesda: National Institutes of Health; 2008.

Kennedy P, Hamilton LR. The needs assessment checklist: a clinical approach to measuring outcome. Spinal Cord. 1999; 37: 136–9.

Pflaum C, McCollister G, Strauss DJ, Shavelle RM, DeVivo MJ. Worklife after traumatic spinal cord injury. J Spinal Cord Med. 2006; 29: 377–86.

Krause JS, Terza JV. Injury and demographic factors predictive of disparities in earnings after spinal cord injury. Arch Phys Med Rehabil. 2006; 87: 1318–26.

Tomassen PC, Post MW, van Asbeck FW. Return to work after spinal cord injury. Spinal Cord. 2000;38:51-5.

Krause JS. Employment after spinal cord injury. Arch Phys Med Rehabil. 1992; 73:163–9.

Krause JS. Years to employment after spinal cord injury. Arch Phys Med Rehabil. 2003; 84:1282–9.

Trezzini B, Schwegler U, Reinhardt JD; for the SwiSCI Study Group. Work and wellbeing-related consequences of different return-to-work pathways of persons with spinal cord injury living in Switzerland. Spinal Cord. 2018;56:1166-75. doi: 10.1038/s41393-018-0135-6.

Krause JS, Terza JV, Dismuke CE. Factors associated with labor force participation after spinal cord injury. J Vocat Rehabil. 2010; 33:89–99.

Jain NB, Sullivan M, Kazis LE, Tun CG, Garshick E. Factors associated with health-related quality of life in chronic spinal cord injury. Am J Phys Med Rehabil. 2007; 86:387–96.

Marti A, Escorpizo R, Schwegler U, Staubli S, Trezzini B. Employment pathways of individuals with spinal cord injury living in Switzerland: a qualitative study. Work. 2017; 58:99–110.

Kristof-Brown AL, Zimmerman RD, Johnson EC. Consequences of individuals’ fit at work: a meta-analysis of person-job, personorganization, person-group, and person-supervisor fit. Pers Psychol. 2005; 58:281–342.

Nützi M, Trezzini B, Medici L, Schwegler U. Job matching: an interdisciplinary scoping study with implications for vocational rehabilitation counseling. Rehabil Psychol. 2017; 62:45–68.

Better SR, Fine PR, Simison D, Doss GH, Walls RT, Mclaughlin DE. Disability benefits as disincentives to rehabilitation. Milbank Mem Fund Q. 1979; 57:412-27.

Walls RT, Masson C, Werner Tj. Negative incentives to vocational rehabilitation. Rehabil Lit. 1977; 38:143-50.

Burnham RS, Warren SA, Saboe LA, Davis LA, Russell GG, Reid DC. Factors predicting employment 1 year after traumatic spine fracture. Spine. 1996; 21: 1066–1101.

National Spinal Cord Injury Statistical Center. Spinal cord injury facts & figures at a glance. J Spinal Cord Med. 2008; 31: 357–8.

World Health Organization.International Classification of Functioning, Disability, and Health: ICF. Geneva: WHO; 2001.

Additional Files

Published

2023-11-17

How to Cite

1.
Mesquita JL, Ferreira A, Faria F. Returning to Work After Spinal Cord Injury Are we "Investing in Regression"?. SPMFR [Internet]. 2023 Nov. 17 [cited 2024 Sep. 19];35(3):81-90. Available from: https://spmfrjournal.org/index.php/spmfr/article/view/462

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Original Article

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