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Citation
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Ferdiana A, Post MW, Hoekstra T, van der Woude L, van der Klink JJ, Bültmann U. Arch. Phys. Med. Rehabil. 2014; 95(11): 2040-2046. |
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Affiliation
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Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. |
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Abstract
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OBJECTIVE: 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 centres with SCI units in the Netherlands. PARTICIPANTS: A total of 176 people with acute SCI, aged between 18 and 60 years at baseline, who completed at least two follow-up measurements. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: Employment was defined as having paid work for ≥12 hours/week.
RESULTS: Using latent class growth mixture modeling, three distinct employment trajectories were identified: 1) no employment group (22.2%), i.e., participants without employment pre-SCI and during 5-year follow-up; 2) low employment group (56.3%), i.e., 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%), i.e., participants with continuous employment pre-SCI and within 5-year follow-up. Predictors of steady employment versus low employment were having secondary education (OR=4.32, 95% CI 1.69-11.02) and a higher Functional Independence Measure motor-score (OR=1.04, 95% CI 1.01-1.06) at discharge.
CONCLUSION: Distinct employment trajectories following SCI were identified. More than half of individuals with SCI had a low employment trajectory, and only one-fifth of individuals with SCI had a steady employment trajectory. Secondary education and higher functional independence level predicted steady employment.
Language: en |