Factors Related to Engagement in Employment After Spinal Cord Injury in Australia: A Cross-sectional Study

Factors affecting return to work after spinal cord injury in Japan: a cross-sectional study

STUDY DESIGN

Survey.

OBJECTIVES

This study aimed to investigate the rate of return to work among individuals with spinal cord injuries in Japan and identify factors associated with their return.

SETTING

Returning to work is difficult for people with spinal cord injuries, although it contributes to their personal quality of life and society. Previous studies have examined various factors inhibiting return to work, but none have examined social participation.

METHODS

Questionnaires were sent to individuals of working age with spinal cord injuries. Their employment status, marital status, neurological status, activities of daily living, enjoyment of sports and/or hobbies post-injury, and whether they lived with family were examined using the visual analog scale for pain.

RESULTS

Among the 134 respondents, 61 (46%) were employed at the time of the survey. Multivariate logistic regression analysis revealed that mild paralysis and enjoyment of sports and/or hobbies were significant factors associated with return to work. Among those employed, 27% secured jobs through private job introductions, highlighting the role of social connections in facilitating employment.

CONCLUSIONS

Besides mild paralysis, social participation in sports and/or hobbies was significantly associated with a return to work. As social connections can provide opportunities to obtain jobs, providing spaces for interaction through sports and hobbies, can create a conducive environment for returning to work.

A national cross-sectional survey on community spinal cord injury individuals profiles, health-related quality of life and support services in China: implications for healthcare and rehabilitation

BACKGROUND

Spinal cord injury (SCI) results in severe, permanent functional changes and has become a global health priority due to its high incidence, cost, and disability rate. Current national epidemiological data on SCI in China are limited and outdated. This study aimed to provide a comprehensive, national cross-sectional investigation of SCI epidemiology in China.

METHODS

This cross-sectional study included 3055 SCI participants aged 8 to 78 years, conducted from May to September 2023. Data collected encompassed demographic characteristics, employment status, etiology, years lived with disability (YLD), family structure, caregiving status, income, health insurance, paralysis type, and health-related quality of life (HRQoL). Descriptive statistics analyses were used to assess demographic and injury characteristics. Group differences were assessed using t-tests, one-way ANOVA and Chi-square tests. Significant factors were examined using multivariate regression analysis.

RESULTS

The majority (88.9%) of respondents were aged 15 to 59 years, with a male-to-female ratio of 2.36:1. Car accidents caused 45.4% of tetraplegia cases, falls caused 35.9% of paraplegia cases, and myelitis was the leading cause of non-traumatic SCI. Among paraplegia participants, 65.5% had complete SCI, while 53.1% of tetraplegia participants had incomplete SCI. Functional improvement was reported by 9.58% of participants. Half (50.3%) of the respondents were unemployed, and 75% had incomes below the national average. HRQoL was significantly lower in the SCI population compared to controls, mainly influenced by injury site, income, age and etiology (p < 0.05).

CONCLUSIONS

SCI participants in China exhibit low HRQoL and reemployment rates. Accessible community and vocational rehabilitation programs, alongside robust public medical services, are essential for enhancing reemployment and HRQoL among SCI participants, reducing the overall disease burden.

Relationship between employment and quality of life and self-perceived health in people with spinal cord injury: an international comparative study based on the InSCI Community Survey

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

Work-related disability is common in persons with spinal cord injury (SCI). The aims of this study are to examine the associations of employment with self-perceived health (SPH) and quality of life (QoL) across 22 countries and to explore the covariates around employment and SPH and QoL.

SETTING

Community.

METHODS

We analyzed 9494 community-dwelling persons with SCI aged 18-65. We performed an adjusted regression and path analysis. The independent variable was 'employment' and the dependent variables were two single items: QoL (very poor to very good) and SPH (excellent to poor). Covariates included the Gross Domestic Product (GDP), education, time since SCI, age, gender, years of employment after SCI, SCI level (paraplegia, tetraplegia), and completeness of SCI.

RESULTS

Participants' mean age was 47, 74% were male, and 63% had paraplegia. We found an association between employment and QoL and SPH. While the magnitude of the effect of employment on QoL did not differ across GDP quartiles, its perceived effect on QoL was found to be significant in the highest GDP quartile. Employment was predictive of good SPH in two GDP quartiles (Q1 and Q4), but significant across all quartiles when predicting poor perceptions, with the magnitude of effect varying significantly.

CONCLUSIONS

Employment is closely related to QoL and SPH depending on the GDP. We may positively influence the QoL and SPH in the SCI population to promote better employment outcomes by considering the infrastructure and economy.

Perceived vocational support needs and return-to-work outcomes in the first 12-months post-discharge in individuals with acquired brain injury and spinal cord injury: A retrospective cohort study

BACKGROUND

Return-to-work (RTW) is often viewed as an important outcome following acquired brain injury (ABI) and spinal cord injury (SCI), although not all individuals have vocational goals and many experience barriers to RTW.

OBJECTIVE

This study investigated the relationship between RTW and psychosocial functioning at 12-months post-discharge after ABI and SCI and examined patterns of RTW according to perceived need for and receipt of vocational support.

METHODS

A file audit was conducted for 69 participants with ABI (n = 44) and SCI (n = 25). Data on employment status and perceived vocational support at 3- and 12-months post-discharge, home and community participation, psychological distress, and health-related quality of life were extracted.

RESULTS

Individuals in paid employment at 12-months post-discharge (22%, n = 15) reported significantly better psychosocial functioning at this timepoint compared to those not employed (78%; n = 54). For those not employed, three subgroups were identified: 1) Did not perceive the need for or receive vocational support (50%; n = 27); 2) Perceived vocational support needs were unmet (19%; n = 10); and 3) Perceived and received vocational support (31%; n = 17). Psychological distress was highest for those who perceived and received vocational support but were not employed.

CONCLUSION

RTW was associated with better psychosocial functioning after acquired neurological injury. The findings highlight the need for clinicians to explore and revisit individuals' perceived need for and preferences for vocational support and monitor the psychological well-being of those with RTW goals that are not yet successful.

Return to work after traumatic spinal fractures and spinal cord injuries: a retrospective cohort study

This study aimed to determine the factors associated with return to work (RTW) after traumatic spinal fracture and spinal cord injury. It provided a predictive model for RTW among patients with spinal fractures and spinal cord injury and determined important factors influencing the time to RTW after injury. A retrospective cohort study was conducted in Poursina Tertiary Hospital, Guilan, Iran between May 2017 and May 2020. Patients aged 18 to 65 who were hospitalized with traumatic spinal fractures and spinal cord injuries were included. Demographic and clinical data were collected from the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR). A researcher-administered questionnaire was used through a telephone interview to obtain complementary data on social and occupational variables. Kaplan-Meier survival analysis was used to estimate the average time to RTW and the predictors of RTW were determined by multivariate Cox regression model. Of the 300 patients included, 78.6% returned to work and the average time to RTW was about 7 months. The mean age of the participants was 45.63 ± 14.76 years old. Among the study variables, having a Bachelor's degree (HR 2.59; 95% CI 1.16-5.77; P = 0.019), complications after injury (HR 0.47; 95% CI 0.35-0.62; P = 0.0001), full coverage health insurance (HR 1.73; 95% CI 1.10-2.72; P = 0.016), opium use (HR 0.48; 95% CI 0.26-0.90; P = 0.023), number of vertebral fractures (HR 0.82; 95% CI 0.67-0.99; P = 0.046), and length of hospital stay (HR 0.95; 95% CI 0.93-0.98; P = 0.001) were found to be significant in predicting RTW in Cox regression analysis. Our analysis showed that wealthier people and those with high job mobility returned to work later.