Prediction of employment status one year post-discharge from rehabilitation following traumatic spinal cord injury: an exploratory analysis of participation and environmental variables.

Abstract

OBJECTIVE: To identify the extent to which early participation and environmental variables, when assessed at discharge from hospital, add to injury and demographic variables in the prediction of employment following traumatic spinal cord injury. DESIGN: Prospective study in which participants were assessed on a range of injury, demographic, participation and environmental measures at discharge from inpatient rehabilitation and then followed up 12 months later to assess their employment status. SUBJECTS: A cohort of 72 eligible patients discharged from hospitals' rehabilitation units. RESULTS: Using injury, demographic and contextual variables as predictors, 94% of not employed and 65% of employed cases (87% overall) could be correctly classified. The contextual variables made a significant contribution to improving predictive power, beyond that achieved by use of the more restricted set of injury and demographic variables. Three variables made significant, independent contributions at the third and final step of a sequential logistic regression: Functional Independence Measure score at discharge, high-skill pre-injury occupation, and perceived community integration (CIM score, at discharge). CONCLUSION: To assist in raising employment achievements post-injury, attention should be given during rehabilitation to factors beyond the traditional patient injury and demographic variables, as well as considering community integration support services when developing vocational rehabilitation service plans.