Barriers to employment among those with spinal cord dysfunction: A comparison of participants with SCI and MS
Krause J, Cao Y, Jarnecke M
Medical University of South Carolina, Charleston, SC, United states
Objective: The employment rates for those with spinal cord injury (SCI) and multiple sclerosis (MS) are both consistently estimated at less than 50%. These rates substantially trail that of persons without disabilities (73%). We must better understand factors that serve as barriers of employment, as this has rarely been systematically studied and we know of no studies comparing those with SCI and MS. Our purpose is to identify the employment rates and barriers to employment among those with SCI and MS.
Design/methods: Self-report assessments were obtained by mail and web for SCI participants (n = 2447) and compared with responses from MS participants (n = 1324). All participants were between 18-64 years of age. SCI cohorts included 1227 participants from the Southeastern SCI Model System or a Midwestern rehabilitation hospital; and 1220 from one of two statewide surveillance systems (South Carolina, Minnesota). Five-point rating scales were obtained for 30 items on barriers. Employment status was assessed at onset, three months, one year, and currently (retrospective recall).
Results: The pattern of employment differed as a function of diagnosis, as those with SCI reported the lowest employment rate at three months postinjury with increases noted thereafter. In contrast, those with MS had declining employment rates with the peak at three months and decreasing over time. There were both similarities and differences in endorsement of barriers to employment. The 3 most prominent barriers based on agreement percentages by both groups included: not having the proper education and training, not having the proper resources, and inability to do the same type of work as before disability onset. The SCI participants were more likely than MS participants to endorse not being able to do the same types of jobs, lack of accessibility, and not having the needed education. In contrast, those with MS were more likely to report fatigue, memory problems, stress from working, difficulty retaining jobs.
Conclusions: The pattern of employment rates differed substantially between those with SCI and MS. While there are many commonalities between groups for barriers, some items are quite different. This helps to highlight the differences between SCI and MS and assist in developing programs to address these barriers and promote better employment outcomes
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