Article

OBJECTIVES: To examine the employment situation and predictors of return to work
for individuals with spinal cord injury 5 years after discharge from inpatient rehabilitation. DESIGN: Prospective cohort study. SUBJECTS: A total of 114
subjects who were employed before the injury and who completed a 5-year
follow-up. METHODS: Work was defined as having paid work >/= 1 h/week or >/= 12
h/week. Predictors of return to work were identified using logistic regression
analysis. Demographic, injury-related, pre-injury work factors and self-efficacy
were measured at the start of rehabilitation and at discharge. RESULTS: Return to
work rates for >/= 1 and >/= 12 h/week were 50.9% and 42.6%, respectively. Median
time to return to work was 13 months. Compared with before injury, participants
worked for fewer hours per week and had occupations of lower physical intensity.
The majority had a supplementary income. Those who returned to work were
financially better-off than those who did not. Only 40% of participants received
return to work support. A high/middle level occupation was associated with higher
odds of return to work >/= 1 h/week (odds ratio (OR) = 2.39, 95% confidence
interval (95% CI) = 1.07-5.30). Low physical intensity of pre-injury occupation
was significantly associated with higher odds of return to work >/= 1 h/week (OR
= 3.01, 95% CI = 1.31-6.91) and >/= 12 h/week (OR = 2.67, 95% CI = 1.18-5.96).
After adjustment for potential confounders, these associations were no longer
significant. CONCLUSION: Return to work after spinal cord injury was relatively
high in this study, but entailed considerable changes in the employment
situation, especially reduced working hours and less physically intense
occupations. Rehabilitation interventions should enhance the skills and
qualifications of individuals with physically-demanding pre-injury work in order
to improve access to suitable jobs after spinal cord injury. Interventions should
focus not only on return to work, but also on the quality of employment,
including opportunities to pursue full-time work.

Langue : ANGLAIS