Determinants of sustainable work participation after spinal cord injury in The Netherlands

Work participation of persons with spinal cord injury (SCI) is lower compared to the overall Dutch population, with determinants largely unknown.

To identify the determinants of sustainable work participation for persons with SCI.

A cross-sectional multicenter study was conducted in eight Dutch rehabilitation centers. Persons with first inpatient rehabilitation, discharged between 2015 and 2022, and a work participation goal were invited to complete a survey. Statistical analyses compared groups based on having paid work (yes/no), work functioning (good/lower), past sick leave (occasional/frequent), and expected sick leave (occasional/frequent). Variables that significantly differed were added in logistic regression analyses, and goodness of fit of the model was estimated using Nagelkerke pseudo R-square.

In total, 175 persons responded (69.7% male, 51.1 ± 12.8 years, time since injury 4.2 ± 2.7 years). The paid work model accounted for 24.5% of the variance (p < .001). The work functioning model accounted for 48.1% (p < .001), with work ability as a significant contributor. The model for past sick leave accounted for 23.5% (p = .009). The model for expected sick leave accounted for 36.4% (p < .001), with work ability as a significant contributor.

Lower self-reported work ability was associated with a higher chance of lower work functioning and expected frequent sick leave. Implications for rehabilitationA lower self-reported workability was associated with a higher chance of lower work functioning and expected frequent sick leave for the next year.The Work Ability Index - Single Item (WAS) can be considered for use in the clinical setting to assess work functioning and sick leave expected in the next year.A low WAS value should be discussed with the patient, and if needed with the vocational rehabilitation team and/or the employer to enable adequate intervention(s).