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

Authors

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

DOI:

https://doi.org/10.2340/jrm.v53.59

Keywords:

health, spinal cord injuries, employment

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.

Lay abstract
The data source for this study was the Finnish Spinal Cord Injury Study (FinSCI), which collected extensive information from people with spinal cord injury about their health and employment status. A total of 452 responders from the FinSCI survey were included in the current study. The employment rate in the FinSCI study population was low (26.5%) and the majority of those not in work (73.5%) were receiving a disability pension. The analysis of health factors showed that all health aspects were better in the employed group compared with the group who were not working. Physical Health, Ability to Participate in Social Roles and Activities, less severe injury, and young age were associated with likelihood of work participation. This study provides up-to-date self-reported data for the spinal cord injury population and health professionals, helping to identify health-related problems that could be barring employment.

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References

Krause JS, Bozard JL. Natural course of life changes after spinal cord injury: a 35-year longitudinal study. Spinal Cord 2012; 50: 227-231.

https://doi.org/10.1038/sc.2011.106 DOI: https://doi.org/10.1038/sc.2011.106

Escorpizo R, Smith EM, Finger ME, Miller WC. Work and employment following spinal cord injury. 2018 [cited 2021 May 15] Available from: https://scireproject.com/wp-content/uploads/S6-Work-Employment-Chapter-_RE_AC_MF_RE-MQ-Apr-11-2019.pdf.

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.

https://doi.org/10.1007/s11136-009-9477-z DOI: https://doi.org/10.1007/s11136-009-9477-z

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.

https://doi.org/10.1080/10790268.2009.11754553 DOI: https://doi.org/10.1080/10790268.2009.11754553

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.

https://doi.org/10.3233/WOR-162381 DOI: https://doi.org/10.3233/WOR-162381

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.

https://doi.org/10.1016/j.apmr.2020.05.027 DOI: https://doi.org/10.1016/j.apmr.2020.05.027

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.

https://doi.org/10.1038/sc.2012.18 DOI: https://doi.org/10.1038/sc.2012.18

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.

https://doi.org/10.1007/s11136-014-0622-y DOI: https://doi.org/10.1007/s11136-014-0622-y

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.

https://doi.org/10.1016/j.jclinepi.2010.04.011 DOI: https://doi.org/10.1016/j.jclinepi.2010.04.011

Lidal IB, Huynh TK, Biering-Sørensen F. Return to work following spinal cord injury: a review. Disabil Rehabil 2007; 29: 1341-1375.

https://doi.org/10.1080/09638280701320839 DOI: https://doi.org/10.1080/09638280701320839

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.

https://doi.org/10.1038/sc.2011.181 DOI: https://doi.org/10.1038/sc.2011.181

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.

https://doi.org/10.2340/16501977-2539 DOI: https://doi.org/10.2340/16501977-2539

Coulter A. Measuring what matters to patients. BMJ 2017 Feb [cited 2021 Apr 10]; 2017; 356: 816-816. Available from: https://www.bmj.com/content/356/bmj.j816.

https://doi.org/10.1136/bmj.j816 DOI: https://doi.org/10.1136/bmj.j816

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.

https://doi.org/10.1179/204577211X13207446293695 DOI: https://doi.org/10.1179/204577211X13207446293695

Finnish Centre for Pensions. 2021 [cited 2021 Apr 11]. Available from: https://www.etk.fi/.

WHO. International Classification of Functioning, Disability and Health (ICF) Geneva: World Health Organization; 2001.

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.

https://doi.org/10.1097/PHM.0000000000000647 DOI: https://doi.org/10.1097/PHM.0000000000000647

PROMIS (Patient-Reported Outcomes Measurement Information System) Slides Introducing HealthMeasures. [cited 2021 Apr 11]. Available from: https://www.healthmeasures.net/explore-measurement-systems/promis/intro-to-promis.

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.

https://doi.org/10.1007/s11136-009-9496-9 DOI: https://doi.org/10.1007/s11136-009-9496-9

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.

https://doi.org/10.1002/nur.20199 DOI: https://doi.org/10.1002/nur.20199

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: https://thl.fi/fi/web/toimintakyky/toimintakyvyn-arviointi/kansallinen-promis-keskus#Suomenkieliset%20PROMIS-mittarit_uusi.

PROMIS. Global Health. A brief guide to the PROMIS© Global Health instruments. 2017 Jun 3 [cited 2021 Apr 11]. Available from: https://www.healthmeasures.net/images/PROMIS/manuals/PROMIS_Global_Scoring_Manual.pdf.

PROMIS. Resource Center. Analysis of PROMIS Global01 and 09 questions [Internet]. 2021 [Cited 2021 Apr 11]. Available from: https://www.healthmeasures.net/resource-center/user-community/forum/promis/263-analysis-of-promis-global01-and-09-questions.

PROMIS. A brief guide to the PROMIS Satisfaction with Social Roles and Activities instruments. [Internet] 2014 Oct 22 [Cited 2021 Apr 11] Available from: http://www.healthmeasures.net/images/promis/manuals/PROMIS_Satisfaction_with_Participation_in_Social_Roles_Scoring_Manual.pdf.

PROMIS. A brief guide to the PROMIS® Profile instruments for adult respondent. [Internet] 2021 Apr 9 [Cited 2021 Apr 11] Available from: https://www.healthmeasures.net/images/PROMIS/manuals/Scoring_Manuals_/PROMIS_Adult_Profile_Scoring_Manual.pdf.

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: https://www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=176&Itemid=992.

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: https://www.healthmeasures.net/images/promis/manuals/PROMIS_Satisfaction_with_Participation_in_Discretionary_Social_Activities_Scoring_Manual.pdf.

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.

https://doi.org/10.1038/sc.2017.59 DOI: https://doi.org/10.1038/sc.2017.59

Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis: a global perspective. 7th edn. Upper Saddle River, NJ: Prentice Hall; 2010.

George D, Mallery P. SPSS for Windows step by step: a simple guide and reference 18.0 update. 11th edn. Boston: Allyn & Bacon; 2011.

Official Statistics of Finland: Labour Force Survey. 2021 May 25 [cited 2021 May 31]. Available from: https://tilastokeskus.fi/til/tyti/2021/04/tyti_2021_04_2021-05-25_tie_001_en.html.

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.

https://doi.org/10.1016/j.socscimed.2012.06.010 DOI: https://doi.org/10.1016/j.socscimed.2012.06.010

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.

https://doi.org/10.1037/a0018583 DOI: https://doi.org/10.1037/a0018583

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.

https://doi.org/10.1016/j.apmr.2009.04.006 DOI: https://doi.org/10.1016/j.apmr.2009.04.006

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.

https://doi.org/10.1179/107902610X12883422813660 DOI: https://doi.org/10.1179/107902610X12883422813660

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.

https://doi.org/10.1038/s41393-019-0380-3 DOI: https://doi.org/10.1038/s41393-019-0380-3

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.

https://doi.org/10.1038/s41393-017-0048-9 DOI: https://doi.org/10.1038/s41393-017-0048-9

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.

https://doi.org/10.1179/2045772312Y.0000000072 DOI: https://doi.org/10.1179/2045772312Y.0000000072

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.

https://doi.org/10.1038/sc.2015.159 DOI: https://doi.org/10.1038/sc.2015.159

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.

https://doi.org/10.1310/sci2004-310 DOI: https://doi.org/10.1310/sci2004-310

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Published

2022-02-03

How to Cite

Eskola, K., Koskinen, E., Anttila, H., Tallqvist, S., Bergman, P., Kallinen, M., … Hiekkala, S. (2022). Health-related factors for work participation in persons with spinal cord injury in Finland. Journal of Rehabilitation Medicine, 54, jrm00255. https://doi.org/10.2340/jrm.v53.59

Issue

Vol. 54 (2022)

Section

Original Report

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Copyright (c) 2022 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

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