Spinal Cord Injury: An Analysis of Medical and Social Costs

Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey.

Purpose: The purpose of this review was to synthesize the literature about spinal cord injury and employment, focusing on sample demographics, indicators of employment outcome, and the methods used. The review included literature from the previous decade; 2006-2017. Methods: A systematic quantitative literature review methodology was utilized, wherein papers' characteristics were extracted and categorized in a database according to their topics, employment outcome indicators, populations, locations, and methods. Frequency tables were generated and cross-tabulated to yield conclusions about the outcomes of the studies and the methods and samples used to yield these outcomes. Results: The review highlighted three key themes; the emergence of broader employment outcome measures that go beyond employment rate; a lack of consistency in the reporting of sample characteristics such as time since injury or ethnicity; and the relative lack of research focusing on people with newly acquired spinal cord injury. Conclusions: The literature review identified a number of limitations in the existing research including the lack of standardized reporting of employment outcomes and a need for increased consistency in reporting sample characteristics. In addition, there are gaps in the research about people with newly acquired spinal cord injury, particularly regarding the timing of interventions. Implications for Rehabilitation Spinal cord injury has the potential to disrupt a person's career across their lifespan. Employment rate is the gold standard for evaluating employment outcomes. Broader measures of employment, including job retention and hours worked, have potential in evaluating and improving the quality of employment outcomes for this population. Further research with people with newly acquired spinal cord injuries would better support the provision of vocational rehabilitation services earlier in a person's rehabilitation, potentially preserving jobs.

Investigating employment following spinal cord injury: outcomes, methods, and population demographics

PurposeWorldwide, spinal cord injuries are associated with diminished participation in the labor market. Inconclusive reporting and differences between workplace settings for individuals with spina...

Prevalence and predictors of return to work following a spinal cord injury using a work disability prevention approach: A systematic review and meta-analysis:

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.

Factors associated with sustaining work with chronic spinal cord injury: a scoping review.

The design was a narrative review. The objective of the study was to investigate the potential for early vocational rehabilitation (VR) interventions for people with spinal cord injury (SCI) in overcoming barriers in returning to work, and to pinpoint factors contributing to effectiveness in early VR intervention for this population. The setting was at Queensland, Australia. Synthesis of the findings of a literature search of online databases ProQuest and CINAHL, using keywords relating to the employment situation and VR of people with SCI. Themes were identified and analysed in accordance with the research objectives. Despite increasing government commitment to the workforce and social participation of people with disabilities, Australians living with SCI have significantly diminished employment outcomes compared with the general population. Current VR approaches usually do not commence until some months post discharge, potentially missing a window of opportunity to preserve pre-existing employment or assist in vocational decision making. The review found that there are opportunities for enhancing VR service provision following SCI, namely integrating the VR programme within the primary rehabilitation team thus facilitating early VR intervention. Emerging evidence shows promising results for early intervention in VR; however, questions remain regarding ideal intervention approaches, and it is clear that further empirical investigation is required to support the use of early intervention models post SCI. The study was sponsored by Motor Accident Insurance Commission (MAIC).

/pdf/integrated-services-and-early-intervention-in-the-vocational-1909uvpc5o.pdf

Integrated services and early intervention in the vocational rehabilitation of people with spinal cord injuries.

BACKGROUND:Emerging early intervention vocational rehabilitation (EIVR) services aim to improve employment outcomes after SCI. Beyond employment, EIVR services present an opportunity to support psychological resources, potentially promoting coping and adjustment. The construct of psychological empowerment represents several such resources, including hope, self-efficacy, and motivation. OBJECTIVE:To analyse the extant literature on employment after SCI published since 2006, to synthesise the support for and usefulness of the psychological constructs that underpin empowerment in the return to work process, particularly as they pertain to the early phases of rehabilitation. METHODS:A quantitative approach to systematic review, combined with a narrative synthesis of the literature. RESULTS:Hope, self-efficacy, and motivation were found to be related to RTW after SCI. Research gaps were identified, particularly relating to studies with newly-injured participants. The findings were contextualised within an empowerment framework. CONCLUSIONS:An empowerment model of EIVR could serve to both promote employment outcomes and support psychological wellbeing during early recovery from SCI. Further research is needed to develop this model, establish its use in practice, and explore the benefits of EIVR for a person’s psychological wellbeing.

Vocational rehabilitation to empower consumers following newly acquired spinal cord injury

ObjectiveThe aim of this article is to describe the development of a novel evidence-based model of early intervention vocational rehabilitation (EIVR) for people with spinal cord injury (SCI).MethodsAn extensive literature review and background study guided the collaboration of experienced practitioners and researchers in developing and evaluating the innovative Back2Work model of EIVR for people with SCI in Queensland, Australia. The program is undergoing longitudinal mixed-methods evaluation to the end of 2023.ResultsThe model is central to the successful implementation of the EIVR program, delivered by rehabilitation counsellors in the Queensland Spinal Injuries Unit. Back2Work includes a strong focus on maintaining and nurturing the pre-injury occupational bond between injured workers and employers, and aims to create a positive expectation for return to work (RTW) and increase the rate and timeliness of RTW after SCI.ConclusionsThe Back2Work program has become an integrated component of the multidisciplinary rehabilitation team, with positive early results in RTW outcomes and additional benefits in participants' sense of well-being and hope.What is known about the topic?Vocational intervention after SCI has traditionally been delivered after hospital discharge and considered outside the scope of early intervention approaches. Emerging evidence suggests EIVR, commencing before hospital discharge, can encourage hope and a positive expectancy for employment after SCI, and is showing promising outcomes in supporting people's quality of life and vocational goals.What does this paper add?This article details the process and product of developing and evaluating a novel EIVR model for people with SCI. The model underpins the Back2Work EIVR program being trialled in the Queensland Spinal Injuries Unit, an example of this emerging field of practice within the primary rehabilitation setting.What are the implications for practitioners?The Back2Work program is based on an innovative and evidence-based model of EIVR for people with SCI. The collaborative and empirically driven process of developing, implementing and evaluating the model will be of interest to researchers and practitioners looking to advance practices in vocational rehabilitation after serious injury.

Back2Work: a new model of early vocational rehabilitation for people with spinal cord injury.

BACKGROUND:
Emerging vocational rehabilitation services for people with spinal cord injury seek to fill the gap between hospital and community services, and preserve jobs before they are lost. This is consistent with the longstanding notion within disability management and workers’ compensation of ‘occupational bonding’, or the relationship between the person and their employer. Despite the importance of this factor, there is little research underpinning the concept of occupational bonding specifically.

OBJECTIVE:
To analyse the extant literature about vocational rehabilitation after spinal cord injury to summarise the evidence for the concept of occupational bonding after SCI.

METHODS:
A systematic review combined with a narrative synthesis of the literature.

RESULTS:
Evidence supported workplace-based social support, particularly from the employer, as being a key facilitator of return to work. There was also evidence of an intrinsic, values-based component describing the person’s bond to the world of work in general.

CONCLUSION:
Reinforcing the employer and co-workers during return to work after a lengthy absence could facilitate employment outcomes. The person’s intrinsic bond to the world of work may also be reinforced by the vocational rehabilitation professional during the often lengthy rehabilitation period following a spinal cord injury.

Occupational bonding after spinal cord injury: A review and narrative synthesis

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