Relationship between employment and quality of life and self-perceived health in people with spinal cord injury: an international comparative study based on the InSCI Community Survey

Escorpizo R 1 , Naud S 2 , Post MWM 3 , Schwegler U 4 , Engkasan J 5 , Halvorsen A 6 Show all authors , Geraghty T 7 , Sadowsky C 8

Affiliations 

  • 1 The University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA. reuben.escorpizo@med.uvm.edu
  • 2 The University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA
  • 3 Centre of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
  • 4 Swiss Paraplegic Research, Nottwil, Switzerland
  • 5 Universiti Malaya, Lumpur, Malaysia
  • 6 Clinic of Rehabilitation, Department of Spinal Cord Injuries, St Olavs hospital, Trondheim University Hospital, Trondheim, Norway
  • 7 Division of Rehabilitation, Princess Alexandra Hospital, and The Hopkins Centre, Metro South Health and Griffith University, Brisbane, Australia
  • 8 Kennedy Krieger Institute / Johns Hopkins School of Medicine, Baltimore, MD, USA
Spinal Cord, 2024 Mar;62(3):110-116.
PMID: 38160224 DOI: 10.1038/s41393-023-00953-8

Abstract

STUDY DESIGN: Cross-sectional study.

OBJECTIVES: Work-related disability is common in persons with spinal cord injury (SCI). The aims of this study are to examine the associations of employment with self-perceived health (SPH) and quality of life (QoL) across 22 countries and to explore the covariates around employment and SPH and QoL.

SETTING: Community.

METHODS: We analyzed 9494 community-dwelling persons with SCI aged 18-65. We performed an adjusted regression and path analysis. The independent variable was 'employment' and the dependent variables were two single items: QoL (very poor to very good) and SPH (excellent to poor). Covariates included the Gross Domestic Product (GDP), education, time since SCI, age, gender, years of employment after SCI, SCI level (paraplegia, tetraplegia), and completeness of SCI.

RESULTS: Participants' mean age was 47, 74% were male, and 63% had paraplegia. We found an association between employment and QoL and SPH. While the magnitude of the effect of employment on QoL did not differ across GDP quartiles, its perceived effect on QoL was found to be significant in the highest GDP quartile. Employment was predictive of good SPH in two GDP quartiles (Q1 and Q4), but significant across all quartiles when predicting poor perceptions, with the magnitude of effect varying significantly.

CONCLUSIONS: Employment is closely related to QoL and SPH depending on the GDP. We may positively influence the QoL and SPH in the SCI population to promote better employment outcomes by considering the infrastructure and economy.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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