Impact of a spinal cord injury in employment: a cross-sectional study in a Portuguese population

Abstract

Background: Patients who have sustained a spinal cord injury (SCI) frequently face a fundamental change in their employment situation, as the demands of their previous job often exceed their remaining physical abilities. Aim: To study which factors associated with the SCI may influence the employment status. Design: Descriptive cross-sectional study. Setting and population: Seventy-three individuals who had sustained a SCI, admitted in our Rehabilitation Center in 2015. Intervention: Not applicable. Methods: Besides clinical information, a telephone questionnaire was applied in 2019 to the patients, in order to identify demographic and injury-related status, functionality (FIM, SCIM-III, nFAC scales), and work-related information. The data was analyzed in SPSS Statistics® version 26, using χ2 test for categorical variables and t test for independent samples between continuous and categorical variables. Results: The employment rate after SCI was 27.8%. The need of a caregiver showed a significant relationship with not being employed (p<0.001), consisting in an independent determinant for employment (OR 5.38). Return-to-work was associated with higher functional scores, lower mean age values (p<0.001), previous higher education level (p<0.001), and pre-injury intellectual job (p=0.009). Conclusion and clinical rehabilitation impact: The employment rate and factors influencing return-to-work were in line with those available in literature. Additionally, we consider that the “need of a caregiver” is essential in the evaluation of a SCI patient, as it gives a clearer understanding of the patients’ work ability (participation domain), in contrast with functional scores, best suited in the activity domain of the International Classification of Functioning Disability and Health.