Article Details

Research Database: Article Details

Citation:  Ottomanelli, L., Lind, L. (2009). Review of critical factors related to Spinal Cord Injury: Implications of research and vocational services. Journal of Spinal Cord Medicine, 32 (5), 503-531.
Title:  Review of critical factors related to Spinal Cord Injury: Implications of research and vocational services
Authors:  Ottomanelli, L., Lind, L.
Year:  2009
Journal/Publication:  Journal of Spinal Cord Medicine
Publisher:  America Paraplegia Society
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Literature review

Structured abstract:

Background:  Compared to the general population unemployment rates of those with spinal cord injuries (SCI) has been reported in excess of 10-fold. Only an estimated 12% of those with spinal cord injuries return to their pre injury jobs. Data shows that many have a desire to return to employment.
Purpose:  The aim of the review is to examine the effect of SCI on employment characteristics such as rates of employment, characteristics associated with obtaining and sustaining employment, and benefits and barriers associated with work after SCI.
Intervention:  The literature search was conducted using the terms spinal cord injury (SCI) and employment in the databases PubMed, PsycINFO, and MEDLINE. This search included a review of published manuscripts dating back 30 years (1978–2008).
Findings:  Various definitions of employment are used by researchers in past studies which makes interpreting data difficult. Employment has been described as “working for pay”, “working for a living”, “employed or actively looking for work”, and “performance of significant, productive physical or mental work for pay or profit” In some studies reviewed no definition of employment was given. A review of the literature indicates that 11 key factors are associated with employability among persons with SCI. These include education, type of employment, disability severity, age, time since injury, sex, marital status and social support, vocational counseling, medical problems related to SCI, employer role, environment, and professional interests. Educational attainment is perhaps the strongest predictor of return to work for persons with SCI. Persons with college level educational backgrounds are most likely to return to work, whereas those with less than 12 years of education are at a disadvantage. Many researchers have found that age of onset of SCI significantly relates to return to work after SCI. Being younger at the time of injury is associated with the best employment outcomes, with poorer employment outcomes found as age of onset increases. The perception of barriers associated with employment differs between employed and unemployed persons with SCI. It has been found that, although employed persons with SCI tend to not perceive significant barriers to employment, 25% of individuals perceived lack of transportation and lack of Social Security benefits as the main barriers. For persons with SCI who were unemployed, 64% indicated lack of transportation, whereas 48% indicated having no time off for health-related concerns as being main perceived barriers to employment.
Conclusions:  Researchers should target a set of common guidelines when reporting SCI related employment data. Efforts directed at adapting evidence-based practices in vocational rehabilitation to effectively meet the needs of persons with SCI and other physical disabilities are critically important to maximize rehabilitation outcomes.

Disabilities served:  Spinal cord injury (SCI)