TY - JOUR
T1 - Employment Trajectories After Spinal Cord Injury
T2 - Results From a 5-Year Prospective Cohort Study
AU - Ferdiana, Astri
AU - Post, Marcel W.
AU - Hoekstra, Trynke
AU - van der Woude, Luccas H.
AU - van der Klink, Jac J.
AU - Bultmann, Ute
N1 - Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2014/11
Y1 - 2014/11
N2 - 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 >= 12h/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. (C) 2014 by the American Congress of Rehabilitation Medicine
AB - 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 >= 12h/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. (C) 2014 by the American Congress of Rehabilitation Medicine
KW - Disabled persons
KW - Employment
KW - Prospective/Observational
KW - Rehabilitation
KW - Spinal cord injuries
KW - SECONDARY CONDITIONS
KW - 1ST JOB
KW - RETURN
KW - WORK
KW - REHABILITATION
KW - POSTDISCHARGE
KW - PREDICTORS
KW - RACE
KW - TIME
KW - AGE
U2 - 10.1016/j.apmr.2014.04.021
DO - 10.1016/j.apmr.2014.04.021
M3 - Article
C2 - 24832572
VL - 95
SP - 2040
EP - 2046
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 11
ER -