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Keihanian F, Homaie Rad E, Samadi Shal S, Pourreza N, Eramsadati LK, Hosseini Malekroudi SM, Khodadadi-Hassankiadeh N. Return to work after traumatic spinal fractures and spinal cord injuries: a retrospective cohort study. Sci Rep 2023; 13:22573. [PMID: 38114786 PMCID: PMC10730843 DOI: 10.1038/s41598-023-50033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
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.
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Affiliation(s)
- Fateme Keihanian
- Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran
| | - Simin Samadi Shal
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Nooshin Pourreza
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | | | - Naema Khodadadi-Hassankiadeh
- Guilan Road Trauma Research Center, Poursina Hospital, Trauma Institute, Guilan University of Medical Sciences, Namjoo St, Rasht, Iran.
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Raha SS, Yip S, Ho C, Olayinka O, Peláez-Ballestas I, Rame-Montiel AK, MacIsaac R, Henderson R, Kovacs Burns K, Bakal J, Charbonneau R, Kamran R, Loyola-Sanchez A. Novel Application of the World Health Organization Community-Based Rehabilitation Matrix to Understand Services' Contributions to Community Participation for Persons With Traumatic Spinal Cord Injury: A Mixed-Methods Study. Am J Phys Med Rehabil 2023; 102:815-822. [PMID: 36917031 DOI: 10.1097/phm.0000000000002220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
PURPOSE The aim of the study is to use the World Health Organization community-based rehabilitation matrix for understanding services' contributions to foster community participation for people with traumatic spinal cord injury. METHODS This study used a convergent mixed-methods design with a quantitative arm describing the frequency with which services contributed to 22 of the community-based rehabilitation-matrix elements and a qualitative arm involving document reviews and stakeholder interviews. Results were integrated following Onwuegbuzie and Teddlie's method (i.e., quan + QUAL). RESULTS Twenty of the 22 (91%) of the World Health Organization community-based rehabilitation elements were addressed by traumatic spinal cord injury services. Five types of services were identified. Integrated results showed that the strengths of traumatic spinal cord injury services were as follows: (1) comprehensiveness; (2) essential medical services publicly funded; (3) numerous social protections available; and (4) highly active community-based organizations. Identified opportunities to improve these services were as follows: (1) increase specificity for traumatic spinal cord injury and (2) increase communication and integration among services. CONCLUSIONS Services available for people with traumatic spinal cord injury in the province studied address most of the elements of the World Health Organization community-based rehabilitation matrix. However, lack of cohesion between services could create gaps that hinder community participation. Addressing these gaps could improve the quality of life and outcomes of people with traumatic spinal cord injury.
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Affiliation(s)
- Srijan S Raha
- From the Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (SSR, SY, CH, OO, AL-S); Cumming School of Medicine, University of Calgary, Calgary, Canada (SSR); Faculty of Science, University of British Columbia, Vancouver, Canada (SY); Alberta Health Services, Edmonton, Canada (CH, KKB, AL-S); Hospital General de México "Dr. Eduardo Liceaga," México City, Mexico (IP-B); Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada (AKR-M); Spinal Cord Injury Alberta, Edmonton, Canada (RM); Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH, RC); Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH); School of Public Health, University of Alberta, Edmonton, Canada (KKB); Provincial Research Data Services, Alberta Health Services, Edmonton, Canada (JB); Alberta Health Services, Calgary, Canada (RC); Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (RC); and Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada (RK)
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Timothy E, Bourke J, Dunn J, Martin R, Nunnerley J. United and flexible: a collaborative approach to early vocational rehabilitation on a spinal unit. A realist study. Spinal Cord Ser Cases 2023; 9:33. [PMID: 37443167 PMCID: PMC10344866 DOI: 10.1038/s41394-023-00587-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
STUDY DESIGN Qualitative study using realist review. OBJECTIVES To conceptualise how Early Intervention Vocational Rehabilitation (EIVR) functions within inpatient multidisciplinary contexts during spinal cord injury (SCI) rehabilitation. SETTING New Zealand Spinal Unit. METHODS People with newly acquired SCI and members of their rehabilitation team were observed in a range of rehabilitation sessions, team meetings and therapeutic interactions. Participants were also interviewed to explore how EIVR functioned alongside the multidisciplinary team (MDT). Interviews and observations were transcribed, coded and analysed using realist methods. RESULTS We identified three primary contexts which influenced how EIVR was delivered within the MDT: (1) a united approach, (2) a flexible approach, and (3) a hesitant approach. These contexts generated four work-related outcomes for people with SCI; enhanced work self-efficacy, strengthened hope for work, maintained work identity, and the less desirable outcome of increased uncertainty about work. CONCLUSIONS To optimise work outcomes for people after SCI, it is important to consider how EIVR is delivered and integrated within the wider MDT. Such an understanding can also inform the establishment of new EIVR services in different settings. Results suggest that unity, flexibility and clarity between EIVR services and the wider MDT are essential foundations for supporting people with SCI on their journey to employment. SPONSORSHIP This research was funded by Health Research Council NZ grant in partnership with Canterbury District Health Board.
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Affiliation(s)
- Emily Timothy
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand.
| | - John Bourke
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine | Te Tari Hāparapara me te Whaiora Ua-kāhiwi, University of Otago, Christchurch, New Zealand
| | - Rachelle Martin
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- Rehabilitation Teaching and Research Unit | Te Whare Whakamatūtū, University of Otago, Wellington, New Zealand
| | - Jo Nunnerley
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine | Te Tari Hāparapara me te Whaiora Ua-kāhiwi, University of Otago, Christchurch, New Zealand
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Bhattarai M, Smedema SM, Hoyt WT, Bishop M. The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study. Health Qual Life Outcomes 2022; 20:148. [PMID: 36310168 PMCID: PMC9620601 DOI: 10.1186/s12955-022-02059-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Quality of life is considered the most overarching psychosocial adaptation outcome following the rehabilitation of persons with spinal cord injury. Literature suggests that the quality of life of persons with spinal cord injury is determined by many personal and psychological factors, including mindfulness. This study aimed to identify the direct and indirect effect of mindfulness on the quality of life of persons living with spinal cord injury. METHODS Participants consisted of 231 members of three spinal cord injury organizations in the United States: United Spinal Association, North American Spinal Cord Injury Consortium, and Paralyzed Veterans of America-Wisconsin Chapter. The participants completed a set of standardized self-report questionnaires in an online Qualtrics survey. A hierarchical regression analysis was performed to identify the contribution of mindfulness to quality of life, controlling for sociodemographic and injury-related factors. A serial mediation analysis was performed to examine the indirect effect of mindfulness on quality of life. RESULTS In the hierarchical regression analysis, sociodemographic and injury-related factors (i.e., age, gender, race, marital status, education, employment, level and completeness of injury, comorbidities, frequency of hospitalization, pain intensity, and functional limitation) and mindfulness explained 59% variance on quality of life of the participants with spinal cord injury. Mindfulness uniquely contributed to the higher quality of life above and beyond sociodemographic and injury-related variables. In the serial mediation analysis, pain and functional limitation did not significantly mediate the relationship between mindfulness and quality of life. However, the indirect effects of mindfulness on functional limitation and quality of life through pain were significant. CONCLUSION The findings underscore the vital role of mindfulness in improving the quality of life of persons with spinal cord injury. Implications of these findings for future research and clinical practice are discussed.
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Affiliation(s)
- Muna Bhattarai
- grid.264756.40000 0004 4687 2082School of Nursing, Texas A&M University, 8447 Riverside Pkwy, 77807-3260 Bryan, TX USA
| | - Susan Miller Smedema
- grid.14003.360000 0001 2167 3675Department of Rehabilitation Psychology & Special Education, University of Wisconsin–Madison, Madison, WI USA
| | - William T. Hoyt
- grid.14003.360000 0001 2167 3675Department of Counseling Psychology, University of Wisconsin–Madison, Madison, WI USA
| | - Malachy Bishop
- grid.14003.360000 0001 2167 3675Department of Rehabilitation Psychology & Special Education, University of Wisconsin–Madison, Madison, WI USA
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Bloom J, McLennan V, Dorsett P. Results from phase one of an early intervention vocational rehabilitation trial for people with spinal cord injury conducted in Queensland, Australia. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The Back2Work Early Intervention Vocational Rehabilitation (EIVR) program was developed in response to the low employment rate of people with spinal cord injuries (SCI) and their lack of access to early, specialised vocational rehabilitation (VR). The program has been delivered by qualified rehabilitation counsellors to hospital patients with newly acquired SCI since 2016. OBJECTIVE: The objective of the study was to evaluate the effectiveness and consumer perspective of the Back2Work EIVR Program. METHODS: The program was evaluated using a mixed-methods, longitudinal, prospective design. RESULTS: Data analysis revealed a return to work rate (RTW) of 43% by 12 months post-discharge. Qualitative data indicated positive participant experiences with the program, emphasising the hopefulness brought about by early vocational support. CONCLUSIONS: The Back2Work program has a positive impact on participants’ RTW outcomes, through the provision of early specialist vocational rehabilitation interventions. This includes building a positive culture around RTW after SCI and engagement with employers to maximise the likelihood of timely and sustainable re-employment. The RTW outcomes and emergent themes will help inform service development in the field of early vocational rehabilitation after SCI.
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Affiliation(s)
- Julia Bloom
- School of Health Sciences and Social Work, Griffith University, Queensland, QLD, Australia
- Menzies Health Institute Queensland, Brisbane, QLD, Australia
| | - Vanette McLennan
- School of Health Sciences and Social Work, Griffith University, Queensland, QLD, Australia
- Menzies Health Institute Queensland, Brisbane, QLD, Australia
| | - Pat Dorsett
- School of Health Sciences and Social Work, Griffith University, Queensland, QLD, Australia
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Martin RA, Nunnerley JL, Young T, Hall A, Snell DL, Hackney JJ, Bourke JA, Derrett S, Dunn JA. Vocational wayfinding following spinal cord injury: In what contexts, how and why does early intervention vocational rehabilitation work? JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early intervention vocational rehabilitation (EIVR) is used to optimize return to work (RTW) outcomes for people following spinal cord injury (SCI). However, theoretical clarity is required about how EIVR works, for whom and under what circumstances. OBJECTIVE: To develop a theoretical understanding of how people respond to EIVR following SCI and the contexts in which mechanisms of intervention effect are likely to be activated. METHODS: Realist research methods were used to analyze interviews with 30 participants who had received EIVR following SCI. RESULTS: We conceptualized the reporting of our analyses using a travel metaphor, encapsulating the types and degree of wayfinding support participants required to think about, plan and action their vocational aspirations. Developing, maintaining and enacting hope, supporting self-identity and vocational identity, and focusing on environmental context adaptations required to enact vocational aspirations, appear to be critical mechanisms of intervention effect within EIVR. CONCLUSIONS: Various contexts and mechanisms of EIVR contribute to successful negotiation, achievement and sustainability of RTW outcomes for people following SCI. These theoretical understandings can refine EIVR service provision within SCI rehabilitation and inform how EIVR can improve RTW outcomes for people with acquired neurological conditions in other rehabilitation contexts.
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Affiliation(s)
- Rachelle A. Martin
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington South, New Zealand
| | - Joanne L. Nunnerley
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Deborah L. Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - John A. Bourke
- Burwood Academy Trust, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, QL, Australia
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jennifer A. Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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Dunn JA, Hackney JJ, Martin RA, Tietjens D, Young T, Bourke JA, Snell DL, Nunnerley JL, Hall A, Derrett S. Development of a Programme Theory for Early Intervention Vocational Rehabilitation: A Realist Literature Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:730-743. [PMID: 34524575 DOI: 10.1007/s10926-021-10000-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
Purpose Little is currently known about how early intervention vocational rehabilitation (EIVR) works for people with newly acquired neurological conditions such as traumatic brain injury, acquired brain injury and spinal cord injury. This study aims, from a realist framework, to identify relevant literature and develop an initial programme theory to understand how EIVR might work for people experiencing acquired neurological disability. Realist reviews are ideally placed to address the identified knowledge gap as they assist in gaining a deeper understanding of how the intervention works, for whom it works best, and the contexts that promote the activation of desired outcomes. Methods We used a seven-step iterative process to synthesise literature using a realist approach. The steps included: development of initial programme theory, literature search, article selection, extracting and data organising, synthesis of evidence and programme theory refinement. We performed a literature search using the following databases: Cinahl, Embase, EMcare, Medline, PsychInfo and Scopus. Articles were selected if they contributed to the knowledge describing what is EIVR and how it works in newly acquired neurological conditions. Data were extracted and synthesised to develop a programme theory for EIVR. Results Following screening of 448 references, 37 documents were eligible for data extraction. We developed a refined programme theory of EIVR consisting of three contexts (prioritisation of exploring work options, return to work discussed as an option, and workplace support), nine mechanisms (ensuring rehabilitation teams' culture, fostering hope, exploring options, optimising self-efficacy, maintaining worker identity, staying connected, setting goals, engaging employer, and flexing roles) and three outcomes (confidence in ability to work, psychological adjustment, and engagement in solution focussed options). Conclusions This appears to be the first paper to explore how EIVR works, for whom and in what situations. We have produced a programme theory that may provide an initial understanding of EIVR following acquired neurological conditions.
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Affiliation(s)
- Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.
| | | | - Rachelle A Martin
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Donna Tietjens
- Wellington Medical and Health Sciences Library, University of Otago, Wellington, Wellington, New Zealand
| | | | - John A Bourke
- Burwood Academy Trust, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Deborah L Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Joanne L Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
- Burwood Academy Trust, Christchurch, New Zealand
| | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Sarah Derrett
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Snell DL, Hackney JJ, Maggo J, Martin RA, Nunnerley JL, Bourke JA, Hall A, Derrett S, Dunn JA. Early vocational rehabilitation after spinal cord injury: A survey of service users. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-211166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early vocational rehabilitation following spinal cord injury (SCI) improves return to work (RTW) outcomes, but there is limited information about who benefits from such interventions, why and in what contexts. OBJECTIVE: We aimed to describe demographic and clinical characteristics and RTW outcomes of adults with SCI who received early vocational rehabilitation. We sought to identify key mechanisms of early vocational rehabilitation. METHODS: This is a cross-sectional survey of people with SCI recruited from the New Zealand Spinal Trust Vocational Rehabilitation Service, who had sustained an SCI within the previous five years. RESULTS: Of the 37 people who responded to the survey, 54% returned to paid work (90% of whom retained their pre-injury employment). Those in autonomous roles returned to work faster with greater odds of returning to their pre-injury employer and role. Participants highlighted the importance of feeling hopeful about RTW while still in the spinal unit as a key mechanism of effect within the early vocational intervention. CONCLUSIONS: Findings suggested key mechanisms of early vocational intervention could be framed by models of hope. However, for gains to be optimised, continuity of support beyond the acute stage was suggested as an area for future research.
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Affiliation(s)
- Deborah L. Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - Jasjot Maggo
- Burwood Academy of Independent Living, Christchurch, New Zealand
| | - Rachelle A. Martin
- Burwood Academy of Independent Living, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington South, New Zealand
| | - Joanne L. Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
- Burwood Academy of Independent Living, Christchurch, New Zealand
| | - John A. Bourke
- Burwood Academy of Independent Living, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, Queensland, Australia
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jennifer A. Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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Nowrouzi-Kia B, Nadesar N, Sun Y, Ott M, Sithamparanathan G, Thakkar P. Prevalence and predictors of return to work following a spinal cord injury using a work disability prevention approach: A systematic review and meta-analysis. TRAUMA-ENGLAND 2021. [DOI: 10.1177/14604086211033083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Worldwide, spinal cord injuries are associated with diminished participation in the labor market. Inconclusive reporting and differences between workplace settings for individuals with spinal cord injury (SCI) make conceptualizing return to work rates among this population inherently challenging. The objectives of this study are to explore factors associated with return to work (RTW) following an SCI. Moreover, the factors were classified according to the work disability prevention framework. Finally, we conducted a meta-analysis of the prevalence of RTW following an SCI. Methods Original articles were identified through a literature search in four health databases. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the mapping and identification of records. Included studies contained primary studies that included the nature of the injury, antecedent factors associated with the injury, and study characteristics and RTW outcomes. Exclusion criteria for the studies included if there was no discussion of RTW outcomes, systematic reviews, and meta-analyses. Results A total of 461 full-text articles were assessed for eligibility, and eight studies were included and assessed using the Critical Appraisal Skills Programme checklist, Risk of Bias, and Newcastle–Ottawa Scale. Four studies identified personal system factors, four identified healthcare system factors, two identified compensation system factors, and one identified workplace system factors. Conclusions Attempts to optimize RTW among persons with SCI are inherently difficult due to the diversity of this client population. Findings from the studies included in this systematic review support the utility of interventions for facilitating RTW, such as vocational rehabilitation and workplace accommodations, while simultaneously acknowledging the limitations in identifying specific interventions as facilitatory or inhibitory throughout the process.
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Affiliation(s)
- Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - Nirusa Nadesar
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - Yingji Sun
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Markus Ott
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gobika Sithamparanathan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Priya Thakkar
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Bhattarai M, Smedema SM, Maneewat K. An Integrative Review of Factors Associated With Resilience Post-Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2020. [DOI: 10.1177/0034355220938429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to analyze factors associated with resilience among persons with spinal cord injury (SCI). An integrative review was conducted. Electronic databases including PubMed, ProQuest, Cumulative Index of Nursing and Allied Health Literature, and Web of Science were searched using relevant search terms and keywords. A total of two qualitative and nine quantitative studies were included in the review. Psychosocial factors such as social support, self-efficacy, spirituality, post-traumatic growth, life satisfaction, adaptive coping strategies, psychological strength, and being a role model were associated with higher resilience. Stress, anxiety, depression, external locus of control, and attachment avoidance correlated with lower resilience. Inconsistent results were reported for demographic and injury-related variables such as the age of the participants, gender, pain, and functional independence. The integrative review reported a number of factors associated with resilience in people with SCI. Rehabilitation counselors working with this population can design rehabilitation interventions targeting these variables to enhance the resilience of people with SCI. Consideration of cultural and contextual influences on resilience, as well as the design of effective interventions, are important directions for future research.
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Bloom J, Dorsett P, McLennan V. Vocational rehabilitation to empower consumers following newly acquired spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
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Roels EH, Reneman MF, New PW, Kiekens C, Van Roey L, Townson A, Scivoletto G, Smith E, Eriks-Hoogland I, Staubli S, Post MWM. International Comparison of Vocational Rehabilitation for Persons With Spinal Cord Injury: Systems, Practices, and Barriers. Top Spinal Cord Inj Rehabil 2020; 26:21-35. [PMID: 32095065 PMCID: PMC7015172 DOI: 10.1310/sci2601-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Employment rates among people with spinal cord injury or spinal cord disease (SCI/D) show considerable variation across countries. One factor to explain this variation is differences in vocational rehabilitation (VR) systems. International comparative studies on VR however are nonexistent. Objectives: To describe and compare VR systems and practices and barriers for return to work in the rehabilitation of persons with SCI/D in multiple countries. Methods: A survey including clinical case examples was developed and completed by medical and VR experts from SCI/D rehabilitation centers in seven countries between April and August 2017. Results: Location (rehabilitation center vs community), timing (around admission, toward discharge, or after discharge from clinical rehabilitation), and funding (eg, insurance, rehabilitation center, employer, or community) of VR practices differ. Social security services vary greatly. The age and preinjury occupation of the patient influences the content of VR in some countries. Barriers encountered during VR were similar. No participant mentioned lack of interest in VR among team members as a barrier, but all mentioned lack of education of the team on VR as a barrier. Other frequently mentioned barriers were fatigue of the patient (86%), lack of confidence of the patient in his/her ability to work (86%), a gap in the team's knowledge of business/legal aspects (86%), and inadequate transportation/accessibility (86%). Conclusion: VR systems and practices, but not barriers, differ among centers. The variability in VR systems and social security services should be considered when comparing VR study results.
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Affiliation(s)
- Ellen H Roels
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
| | - Michiel F Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
| | - Peter W New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, and Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Victoria, Australia
| | - Carlotte Kiekens
- University Hospitals Leuven, Department of Physical and Rehabilitation Medicine, Leuven, Belgium
- KU Leuven - University of Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Lot Van Roey
- KU Leuven - University of Leuven, Department of Development and Regeneration, Leuven, Belgium
| | - Andrea Townson
- GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada
| | - Giorgio Scivoletto
- Spinal Unit and Spinal Rehabilitation (SpiRe) lab, IRCCS Fondazione S. Lucia, Rome, Italy
| | - Eimear Smith
- National Rehabilitation Hospital, Dun Laoghaire, Co. Dublin, Ireland
| | | | | | - Marcel W M Post
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
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Dorsett P, McLennan V. Exploring the ‘status quo’ in vocational rehabilitation and employment outcomes following spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-180995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pat Dorsett
- School of Human Services and Social Work, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Awards and updates. Spinal Cord Ser Cases 2018; 4:53. [DOI: 10.1038/s41394-018-0080-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 04/15/2018] [Indexed: 11/09/2022] Open
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Dorstyn D, Roberts R, Murphy G, Craig A, Kneebone I, Stewart P, Chur-Hansen A, Marshall R, Clark J, Migliorini C. Work and SCI: a pilot randomized controlled study of an online resource for job-seekers with spinal cord dysfunction. Spinal Cord 2018; 57:221-228. [PMID: 30262878 DOI: 10.1038/s41393-018-0200-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A prospective, parallel randomized controlled trial (RCT). OBJECTIVES To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D), and to determine the feasibility of proceeding to a full-scale RCT. SETTING A community cohort in Australia. METHODS Forty-eight adults (M = 42 years, SD = 10.95, 27 males) were randomized to receive 4-weeks access to the Work and SCI resource (n = 25) or to a wait-list control group (n = 23). The Work and SCI intervention involved six stand-alone learning modules which provided job-searching and career-planning information through text, videos, and interactive activities. Self-report measures were administered at baseline and after 4 weeks: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R), and Patient Health Questionnaire-9 (PHQ-9). RESULTS Online usage data identified high uptake of the Work and SCI resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance, whereas complete data revealed a significant interaction effect for optimism (LOT-R). CONCLUSION Further research to develop and enhance Work and SCI is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. SPONSORSHIP This project was funded by the auDA Foundation (project 16019).
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Affiliation(s)
- Diana Dorstyn
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia.
| | - Rachel Roberts
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Gregory Murphy
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Ashley Craig
- Northern Clinical School, Faculty of Medicine and Health, Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Peter Stewart
- PQSA - The Paraplegic and Quadriplegic Association of South Australia, Dulwich, SA, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Jillian Clark
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Christine Migliorini
- Department of Occupational Therapy, School of Primary Health Care, Monash University, Frankston, VIC, Australia
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Bloom J, Dorsett P, McLennan V. Investigating employment following spinal cord injury: outcomes, methods, and population demographics. Disabil Rehabil 2018; 41:2359-2368. [DOI: 10.1080/09638288.2018.1467968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
| | - Vanette McLennan
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
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