Factors associated with labor 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 Apr;58(4):411-422. doi: 10.1038/s41393-019-0380-3. Epub 2019 Nov 14.

Abstract

Study design: Cross-sectional study using data from the 2012 community survey of the Swiss Spinal Cord Injury Cohort Study.

Objectives: To identify associations between selected factors related to the social background, health, functional independence, and the environment of persons with spinal cord injury (SCI) and their labor market participation.

Setting: Community-based, Switzerland.

Methods: Labor market participation (i.e., involvement in paid work or not) was determined for a sample of 966 persons with traumatic SCI who were of employable age at the time of the survey. Applying an exploratory approach, potential predictors of labor market participation were selected based on the literature and using a bidirectional stepwise variable selection approach. Descriptive statistics were calculated and weighted bootstrapped multiple logistic regressions were applied to describe the associations between the selected predictor variables and labor market participation, controlling for sociodemographic and SCI-related characteristics.

Results: A total of 568 (58.8%) of the participants were involved in paid work at the time of the survey. From the 17 selected predictor variables, general functional independence and Swiss citizenship showed a significant positive association, and chronic pain a negative association with involvement in paid work.

Conclusions: Beyond previously established sociodemographic and injury-related risk factors such as female gender, low education, and high lesion severity, functional independence, chronic pain, and nationality proved crucial for labor market participation. These factors should receive particular attention in medical and vocational strategies striving for a sustainable work integration of persons with SCI.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Employment / statistics & numerical data*
  • Female
  • Functional Status*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Sex Factors
  • Socioeconomic Factors*
  • Spinal Cord Injuries / epidemiology*
  • Spinal Cord Injuries / rehabilitation
  • Switzerland / epidemiology
  • Young Adult