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Karcz K, Trezzini B, Escorpizo R, Finger ME. Factors associated with sustaining work with chronic spinal cord injury: a scoping review. Disabil Rehabil 2022; 44:7723-7738. [PMID: 34781795 DOI: 10.1080/09638288.2021.1988736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Work participation remains challenging for people with spinal cord injury (SCI), as reflected in lower employment rates compared to the general population. To promote work participation for people with SCI, practitioners and policymakers need a better understanding of the factors associated with sustaining work in the long term. This study aimed to identify such factors. MATERIALS AND METHODS Scoping review synthesizing quantitative and qualitative research published between 2000 and 2021. The databases searched were PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Initially, 1221 articles were identified. Three quantitative studies investigating socio-demographic and injury-related factors and eight qualitative studies exploring mainly personal and environmental facilitators and barriers to working in the long term were retained. The results of the quantitative studies showed the importance of time since injury, age, and education. The qualitative findings emphasized the positive influence of self-advocacy, managing health behaviors, and a supportive work environment. Main barriers were time organization and societal attitudes. CONCLUSIONS Future interventions should address the identified factors to promote working in the long term of people with SCI. Policymakers should adapt and enforce legal standards that address environmental and social barriers to creating supportive work environments for persons with SCI.Implications for rehabilitationPeople with spinal cord injury (SCI) experience difficulties in maintaining employment.Personal factors identified as crucial for working in the long term, such as self-advocacy and self-management of health behaviors, should be strengthened by future interventions.People with SCI should be offered a supportive work environment with work accommodations and flexible working hours to facilitate their labor market participation.
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Affiliation(s)
- Katarzyna Karcz
- Participation, Integration and Social Epidemiology Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Bruno Trezzini
- Participation, Integration and Social Epidemiology Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Reuben Escorpizo
- Participation, Integration and Social Epidemiology Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
| | - Monika E Finger
- Participation, Integration and Social Epidemiology Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Perceived Clinical Barriers to Employment for Males with Spinal Cord Injury in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084747. [PMID: 35457614 PMCID: PMC9029978 DOI: 10.3390/ijerph19084747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 01/27/2023]
Abstract
Return to work is a challenging aspect of community integration for individuals with disabilities. The reintegration of individuals with spinal cord injury (SCI) is multifactorial; hence, regional challenges need to be investigated in the context of their clinical attributes and perceptions. A total of 121 male participants above 18 years of age with diagnosis of SCI and living at home were included in this cross-sectional survey. The study was conducted at a tertiary care rehabilitation facility in Saudi Arabia. The most common reported clinical barriers to employment were mobility, bladder incontinence, spasticity, musculoskeletal pain, and neuropathic pain. Bladder incontinence and musculoskeletal pain were the most common perceived clinical barriers for individuals with paraplegia and tetraplegia, respectively. A significant difference was observed for bowel incontinence as a reported barrier (p = 0.024) among adults less than thirty years of age in comparison with those older than thirty years. Spasticity as a barrier was reported more among patients who were older than thirty years (54.0%) compared to those younger than thirty years of age (37.9%) (p = 0.077). Twenty-two (23.7%) participants with paraplegia reported transfers as a perceived barrier to employment, which was significant (p = 0.014), and it was also reported as a significant barrier (p = 0.001) in individuals with tetraplegia (56%). This study shows that clinical conditions associated with SCI are considered potential barriers to employment by individuals with SCI. In terms of priority, the perceived barriers between individuals with tetraplegia and paraplegia were mostly different. This shows the need to consider relevant secondary health care conditions in goal setting while planning for employment in individuals with SCI.
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Sturm C, Bökel A, Korallus C, Geng V, Kalke YB, Abel R, Kurze I, Gutenbrunner CM. Promoting factors and barriers to participation in working life for people with spinal cord injury. J Occup Med Toxicol 2020; 15:37. [PMID: 33334363 PMCID: PMC7745479 DOI: 10.1186/s12995-020-00288-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is still difficult for people with physical impairments to be and remain equally integrated into the labour market. For this reason, the question of occupational activity has explicitly been examined by the German Spinal Cord Injury Survey (GerSCI) in order to identify barriers and facilitators for labour market participation. METHODS Cross-sectional explorative observational study. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). Using survey data from persons recruited at eight specialised SCI-centres in Germany. PARTICIPANTS 1.479 persons with Spinal Cord Injury (SCI) aged 18 years and older. RESULTS In a self-disclosure questionnaire, persons with SCI show themselves as a professionally well-educated and highly motivated group with most of them aiming at gainful employment and considering themselves fit for work. Many changeable and non-changeable factors have been found, which showed a high correlation with the return to work after acquired SCI. CONCLUSION Education and pain belong to the most critical factors and thereby possible approaches to increase the level of employment, which is essential and highly relevant not only for earning money but also for self-confidence and social integration. SCI has many dimensions in itself; support also should be multidimensional. Study results might help to improve participation.
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Affiliation(s)
- Christian Sturm
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany.
| | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
| | | | - Yorck B Kalke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany
| | - Rainer Abel
- SCI Unit, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Ines Kurze
- Department for Paraplegia and Neuro-Urology, Centre of Spinal Cord Injuries and Diseases, Bad Berka, Germany
| | - Christoph M Gutenbrunner
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hanover, Germany
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Cotner BA, Ottomanelli L, Keleher V, Dirk L. Scoping review of resources for integrating evidence-based supported employment into spinal cord injury rehabilitation. Disabil Rehabil 2018; 41:1719-1726. [PMID: 29485303 DOI: 10.1080/09638288.2018.1443161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Individual placement and support (IPS), an evidence-based supported employment (SE) program, has helped Veterans with spinal cord injury (SCI) receiving care in the Veterans Health Administration to obtain work. To facilitate integration of IPS into SCI rehabilitation, resources are needed. A scoping review was conducted to identify tools and resources suitable for providers of SCI care. METHODS Applying a modified version of Arksey and O'Malley's framework, a scoping review of literature on SE tools or resources was conducted. The original review focused on resources published between 2002 and 2015 and available in English. Prior to publication an updated review through 2017 was conducted. RESULTS From 1822 tools and resources identified in the initial review, 24 met criteria for inclusion and were evaluated by an advisory panel of experts, who selected 16 tools that addressed five topics: IPS in SCI (n = 2) orientation to SCI (n = 3); IPS SE (n = 7), job accommodations (n = 2), and benefits planning (n = 2). The updated review yielded no tools or resources that met inclusion criteria. CONCLUSION Despite few resources to guide implementation of IPS in SCI, 16 essential resources were identified that, combined into a toolkit, may facilitate translation of IPS in SCI from research to clinical care. Implications for rehabilitation The toolkit consists of 16 essential resources and is currently available online to all persons involved in spinal cord injury rehabilitation to educate them about this effective means of assisting persons with spinal cord injury to find employment and to facilitate translation of individual placement and support in spinal cord injury from research to clinical care. While expert-informed, the toolkit is being field tested with both clinical and vocational providers to facilitate the adoption of individual placement and support by spinal cord injury rehabilitation programs. The revised version will be made available online.
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Affiliation(s)
- Bridget A Cotner
- a VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR) , James A. Haley Veterans' Hospital , Tampa , FL , USA.,b Department of Anthropology , University of South Florida , Tampa , FL , USA
| | - Lisa Ottomanelli
- a VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR) , James A. Haley Veterans' Hospital , Tampa , FL , USA.,c Department of Rehabilitation and Mental Health Counseling , University of South Florida , Tampa , FL , USA
| | - Virginia Keleher
- a VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR) , James A. Haley Veterans' Hospital , Tampa , FL , USA
| | - Lynn Dirk
- a VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR) , James A. Haley Veterans' Hospital , Tampa , FL , USA
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Cotner BA, Ottomanelli L, O’Connor DR, Trainor JK. Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury. Disabil Rehabil 2017; 40:1273-1279. [DOI: 10.1080/09638288.2017.1294209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bridget A. Cotner
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, Tampa, FL, USA
- Department of Anthropology, University of South Florida, Tampa, FL, USA
| | - Lisa Ottomanelli
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, Tampa, FL, USA
- Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL, USA
| | - Danielle R. O’Connor
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, Tampa, FL, USA
| | - John K. Trainor
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans’ Hospital, Tampa, FL, USA
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Reinhardt JD, Post MWM, Fekete C, Trezzini B, Brinkhof MWG. Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study. PLoS One 2016; 11:e0166955. [PMID: 27875566 PMCID: PMC5119900 DOI: 10.1371/journal.pone.0166955] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022] Open
Abstract
Objectives We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. Methods We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistical Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. Results 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR = 1.73, 95% CI 1.33–2.25) and participants with paraplegia (OR = 1.78, 95% CI 1.40–2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours per week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. Conclusions LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints on higher LMP or both.
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Affiliation(s)
- Jan D. Reinhardt
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
- Institute for Disaster Management and Reconstruction, Sichuan University and Hong Kong Polytechnic University, Chengdu, China
- * E-mail:
| | - Marcel W. M. Post
- Swiss Paraplegic Research, Nottwil, Switzerland
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | | | - Bruno Trezzini
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
| | - Martin W. G. Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland
- University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland
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