Early vocational rehabilitation after spinal cord injury: A survey of service users

Article type: Research Article

Authors: Snell, Deborah L.^{a; *} | Hackney, Jonathan J.^b | Maggo, Jasjot^b | Martin, Rachelle A.^{b; c} | Nunnerley, Joanne L.^{a; b} | Bourke, John A.^{b; d; e} | Hall, Andrew^f | Derrett, Sarah^e | Dunn, Jennifer A.^a

Affiliations: [a] Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand | [b] Burwood Academy of Independent Living, Christchurch, New Zealand | [c] Department of Medicine, University of Otago Wellington, Wellington South, New Zealand | [d] Menzies Health Institute, Griffith University, Queensland, Australia | [e] Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand | [f] New Zealand Spinal Trust, Christchurch, New Zealand

Correspondence: [*] Address for correspondence: Deborah Snell, Associate Professor, Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch 8140, New Zealand. Tel.: +64 3 3836871; E-mail: debbie.snell@otago.ac.nz.

Abstract: BACKGROUND:Early vocational rehabilitation following spinal cord injury (SCI) improves return to work (RTW) outcomes, but there is limited information about who benefits from such interventions, why and in what contexts. OBJECTIVE:We aimed to describe demographic and clinical characteristics and RTW outcomes of adults with SCI who received early vocational rehabilitation. We sought to identify key mechanisms of early vocational rehabilitation. METHODS:This is a cross-sectional survey of people with SCI recruited from the New Zealand Spinal Trust Vocational Rehabilitation Service, who had sustained an SCI within the previous five years. RESULTS:Of the 37 people who responded to the survey, 54% returned to paid work (90% of whom retained their pre-injury employment). Those in autonomous roles returned to work faster with greater odds of returning to their pre-injury employer and role. Participants highlighted the importance of feeling hopeful about RTW while still in the spinal unit as a key mechanism of effect within the early vocational intervention. CONCLUSIONS:Findings suggested key mechanisms of early vocational intervention could be framed by models of hope. However, for gains to be optimised, continuity of support beyond the acute stage was suggested as an area for future research.

Keywords: Spinal cord injury, early vocational rehabilitation, return to work, hope

DOI: 10.3233/JVR-211166

Journal: Journal of Vocational Rehabilitation, vol. 55, no. 3, pp. 323-333, 2021