Factors related to engagement in employment after spinal cord injury in Australia: A cross-sectional study.

OBJECTIVE To explore the association between socio-demographic, health, functional independence and environmental variables with engagement in paid work, for people with spinal cord injury (SCI). DESIGN Self-reported, cross-sectional Australian data from a large international SCI survey. SETTING Community-based. PARTICIPANTS 1,189 working age people with SCI (18-67 years), or aged >67 years and engaged in paid employment. Respondents were community-based and at least 1-year after injury. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Employment and work integration variables. Bayesian penalized regression was used to determine associations between 23 predictor variables and engagement in paid work. RESULTS Most participants (87%) were employed pre-injury, with 39% in paid employment at the time of the survey. Participants who attained a Master/doctoral degree (OR = 3.01, 95% CrI = 1.63, 5.44) and those married (OR = 1.68, 95% CrI = 1.13, 2.49) were more likely to be engaged in paid work. Females (OR = 0.55, 95% CrI = 0.37, 0.81), people receiving a disability pension (OR = 0.17, 95% CrI = 0.13, 0.24) and older participants (OR = 0.75, 95% CrI = 0.63, 0.90) were less likely to be in paid work. Working participants identified hardships including problems completing their work (60%) and accessing the workplace (32%); as well as unmet needs relating to assistive devices required for completing their work (50%). CONCLUSIONS Findings from the current study can assist in directing resources to subgroups within the SCI population who need greater assistance or intervention related to employment outcomes, including through vocational rehabilitation services/programs. Unmet needs and workplace issues expressed by employed individuals identify gaps in work integration and satisfaction that could affect employment sustainability that need to be addressed. TRIAL REGISTRATION Not applicable.