Article

OBJECTIVES: To identify different employment trajectories in individuals with
spinal cord injury (SCI) after discharge from initial rehabilitation and to
determine predictors of different trajectories from demographic, injury,
functional, and psychological characteristics. DESIGN: Prospective cohort study
with baseline measurement at the start of active rehabilitation, a measurement at
discharge, and follow-up measurements at 1, 2, and 5 years after discharge.
SETTING: Eight rehabilitation centers with SCI units in The Netherlands.
PARTICIPANTS: People with acute SCI (N=176), aged between 18 and 60 years at
baseline, who completed at least 2 follow-up measurements. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: Employment was defined as having paid work for
>/= 12 h/wk. RESULTS: Using latent class growth mixture modeling, 3 distinct
employment trajectories were identified: (1) no employment group (22.2%), that
is, participants without employment pre-SCI and during 5-year follow-up; (2) low
employment group (56.3%), that is, participants with pre-SCI employment and a
low, slightly increasing probability of employment during 5-year follow-up; and
(3) steady employment group (21.6%), that is, participants with continuous
employment pre-SCI and within 5-year follow-up. Predictors of steady employment
versus low employment were having secondary education (odds ratio, 4.32; 95%
confidence interval, 1.69-11.02) and a higher FIM motor score (odds ratio, 1.04;
95% confidence interval, 1.01-1.06) at discharge. CONCLUSIONS: Distinct
employment trajectories after SCI were identified. More than half of the
individuals with SCI had a low employment trajectory, and only one-fifth of the
individuals with SCI had a steady employment trajectory. Secondary education and
higher functional independence level predicted steady employment.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS