Health-related factors for work participation in persons with spinal cord injury in Finland

Kaarina Eskola, Eerika Koskinen, Heidi Anttila, Susanna Tallqvist, Paula Bergman, Mauri Kallinen, Harri Hämäläinen, Anna-Maija Kauppila, Anni Täckman, Aki Vainionpää, Jari Arokoski, Marketta Rajavaara, Sinikka Hiekkala, Kaarina Eskola, Eerika Koskinen, Heidi Anttila, Susanna Tallqvist, Paula Bergman, Mauri Kallinen, Harri Hämäläinen, Anna-Maija Kauppila, Anni Täckman, Aki Vainionpää, Jari Arokoski, Marketta Rajavaara, Sinikka Hiekkala

Abstract

Objective: To explore work participation and the health-related factors affecting work participation among the Finnish Spinal Cord injury (FinSCI) study population (n = 884).

Methods: A cross-sectional explorative observational study in the FinSCI community survey applying Patient-Reported Outcomes Measurement Information System (PROMIS®) forms on Social Health and Global Health. Analyses of socio-demographic and injury-related data were performed.

Results: Employment among the study population (n = 452) was 26.5%. Physical, Mental, Social and General Health were better in the employed group compared with work-age persons not working. Logistic regression showed that work participation was related to all health domains, but Physical Health and Ability to Participate in Social Roles and Activities in Social Health were the strongest indicators of likelihood of being at work. Paraplegia and young age were associated with increased likelihood of work participation.

Conclusion: The first national survey among people with spinal cord injury in Finland shows low level of employment. The results suggest that pain, physical function, and ability to participate in social roles should be monitored by health and vocational professionals when assessing a person's likelihood of being in work.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Sum variables of the 3 Patient-Reported Outcomes Measurement Information System (PROMIS®) Social Health measures in working responders and individually determined working aged persons of the Finnish Spinal Cord Injury study (FinSCI) (n = 452). Likert-scale on Satisfaction with Participation in Discretionary Social Activities and Satisfaction with Social Roles and Activities: 1 = Not at all, 2 = A little bit, 3 = Somewhat, 4 = Quite a bit, 5 = Very much. Likert-scale on Ability to Participate in Social Roles and Activities: 1 = Always, 2 = Usually, 3 = Sometimes, 4 = Rarely, 5 = Never.

References

    1. Krause JS, Bozard JL. Natural course of life changes after spinal cord injury: a 35-year longitudinal study. Spinal Cord 2012; 50: 227–231.
    1. Escorpizo R, Smith EM, Finger ME, Miller WC. Work and employment following spinal cord injury. 2018. [cited 2021 May 15] Available from: .
    1. Krahn GL, Suzuki R, Horner-Johnson W. Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status. Qual Life Res 2009. ; 18: 575–584.
    1. Ottomanelli L, Lind L. Review of critical factors related to employment after spinal cord injury: implications for research and vocational services. J Spinal Cord Med 2009; 32: 503–531.
    1. Leiulfsrud AS, Ruoranen K, Ostermann A, Reinhardt JD. The meaning of employment from the perspective of persons with spinal cord injuries in six European countries. Work (Reading, MA) 2016; 55: 133–144.
    1. Post MW, Reinhardt JD, Avellanet M, Escorpizo R, Engkasan JP, Schwegler U, et al. . Employment among people with spinal cord injury in 22 countries across the world: results from the International Spinal Cord Injury Community Survey. Arch Phys Med Rehabil 2020; 101: 2157–2166.
    1. Eyh S, Nick E, Stirnimann D, Ehrat S, Miche F, Peter C, et al. . Self-efficacy and self-esteem as predictors of participation in spinal cord injury – an ICF-based study. Spinal Cord 2012; 50: 699–706.
    1. Tucker CA, Cieza A, Riley AW, Stucki G, Lai JS, Bedirhan Ustun T, et al. . Concept analysis of the Patient Reported Outcomes Measurement Information System (PROMIS®) and the International Classification of Functioning, Disability and Health (ICF). Qual Life Res 2014; 23: 1677–1686.
    1. Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, et al. . The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol 2010; 63: 1179–1194.
    1. Lidal IB, Huynh TK, Biering-Sørensen F. Return to work following spinal cord injury: a review. Disabil Rehabil 2007; 29: 1341–1375.
    1. Marti A, Reinhardt JD, Graf S, Escorpizo R, Post M. To work or not to work: labour market participation of people with spinal cord injury living in Switzerland. Spinal Cord 2012; 50: 521–526.
    1. Tallqvist S, Anttila H, Kallinen M, Koskinen E, Hämäläinen H, Kauppila A-M, et al. . Health, functioning and accessibility among spinal cord injury population in Finland: Protocol for the FinSCI study. J Rehabil Med 2019; 51: 273–280.
    1. Coulter A. Measuring what matters to patients. BMJ 2017. Feb [cited 2021 Apr 10]; 2017; 356: 816–816. Available from: .
    1. Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. . International standards for neurological classification of spinal cord injury (Revised 2011). J Spinal Cord Med 2011; 34: 535–546.
    1. Finnish Centre for Pensions. 2021. [cited 2021 Apr 11]. Available from: .
    1. WHO . International Classification of Functioning, Disability and Health (ICF) Geneva: World Health Organization; 2001.
    1. Gross-Hemmi MH, Post MW, Ehrmann C, Fekete C, Hasnan N, Middleton JW, et al. . Study Protocol of the International Spinal Cord Injury (InSCI) Community Survey. Am J Phys Med Rehabil 2017; 96: 23–34.
    1. PROMIS (Patient-Reported Outcomes Measurement Information System) Slides Introducing HealthMeasures. [cited 2021 Apr 11]. Available from: .
    1. Hays RD, Bjorner J, Revicki DA, Spritzer K, Cella D. Development of physical and mental health summary scores from the Patient Reported Outcomes Measurement Information System (PROMIS) global items. Qual Life Res 2009; 18: 873–880.
    1. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007; 30: 459–467.
    1. The national PROMIS-centre administered by Finnish Institute for health and welfare . PROMIS measures in Finnish. [Internet]. 2021. Apr 7 [Cited 2021 Apr 11] Available from: .
    1. PROMIS . Global Health. A brief guide to the PROMIS© Global Health instruments. 2017. Jun 3 [cited 2021 Apr 11]. Available from: .
    1. PROMIS . Resource Center. Analysis of PROMIS Global01 and 09 questions [Internet]. 2021. [Cited 2021 Apr 11]. Available from: .
    1. PROMIS . A brief guide to the PROMIS Satisfaction with Social Roles and Activities instruments. [Internet] 2014. Oct 22 [Cited 2021 Apr 11] Available from: .
    1. PROMIS . A brief guide to the PROMIS® Profile instruments for adult respondent. [Internet] 2021. Apr 9 [Cited 2021 Apr 11] Available from: .
    1. PROMIS . A brief guide to the PROMIS® Satisfaction with Participation in Discretionary Social Activities v1.0 instruments. [Internet] 2018. March 22 [Cited 2021 Apr 11] Available from: .
    1. PROMIS . Satisfaction with Participation in Discretionary Social Activities. A brief guide to the PROMIS Satisfaction with Participation in Discretionary Social Activities v1.0 instruments.. 2015. Aug 7 [cited 2021 Apr 11]. Available from: .
    1. Biering-Sorensen F, DeVivo MJ, Charlifue S, Chen Y, New PW, Noonan V, et al. . International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting. Spinal Cord 2017; 55: 759–764.
    1. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis: a global perspective. 7th edn. Upper Saddle River, NJ: Prentice Hall; 2010.
    1. George D, Mallery P. SPSS for Windows step by step: a simple guide and reference 18.0 update. 11th edn. Boston: Allyn & Bacon; 2011.
    1. Official Statistics of Finland: Labour Force Survey. 2021. May 25 [cited 2021 May 31]. Available from: .
    1. Botticello AL, Chen Y, Tulsky DS. Geographic variation in participation for physically disabled adults: the contribution of area economic factors to employment after spinal cord injury. Soc Sci Med 2012; 75: 1505–1513.
    1. Burns SM, Boyd BL, Hill J, Hough S. Psychosocial predictors of employment status among men living with spinal cord injury. Rehabil Psychol 2010; 55: 81–90.
    1. Lin M-R, Hwang H-F, Yu W-Y, Chen C-Y. A prospective study of factors influencing return to work after traumatic spinal cord injury in Taiwan. Arch Phys Med Rehabil 2009; 90: 1716–1722.
    1. Machacova K, Lysack C, Neufeld S. Self-rated health among persons with spinal cord injury: What is the role of physical ability? J Spinal Cord Med 2011; 34: 265–272.
    1. Schwegler U, Fellinghauer CS, Trezzini B, Siegrist J. Factors associated with labour market participation of persons with traumatic SCI in Switzerland: analyzing the predictive power of social background, health, functional independence, and the environment. Spinal Cord 2020; 58: 411–422.
    1. Roels EH, Reneman MF, Stolwijk-Swuste J, van Laake-Geelen CC, de Groot S, Aiaansen JJE, et al. . Relationships between type of pain and work participation in people with long-standing spinal cord injury: results from a cross-sectional study. Spinal Cord 2018; 56: 453–460.
    1. Alschuler KN, Jensen MP, Sullivan-Singh SJ, Borson S, Smith AE, Molton IR. The association of age, pain, and fatigue with physical functioning and depressive symptoms in persons with spinal cord injury. J Spinal Cord Med 2013; 36: 483–491.
    1. Marti A, Boes S, Lay V, Escorpizo R, Reuben Escorpizo PT, Trezzini B. The association between chronological age, age at injury and employment: Is there a mediating effect of secondary health conditions? Spinal Cord 2016; 54: 239–244.
    1. Jetha A, Dumont FS, Noreau L, Leblond J. A Life course perspective to spinal cord injury and employment participation in Canada. Topics Spinal Cord Inj Rehabil 2014; 20: 310–320.

Source: PubMed

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