van Dinter Renée, Veenhuysen Anouk L C, Roels Ellen H, van Laake-Geelen Charlotte C M, Maas Ellen M, van Nes Ilse J W, Osterthun Rutger, Stolwijk-Swuste Janneke M, Post Marcel W M, Reneman Michiel F
Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.
Disabil Rehabil. 2025 Jul;47(15):3914-3920. doi: 10.1080/09638288.2024.2433665. Epub 2024 Nov 30.
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 ( < .001). The work functioning model accounted for 48.1% ( < .001), with work ability as a significant contributor. The model for past sick leave accounted for 23.5% ( = .009). The model for expected sick leave accounted for 36.4% ( < .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).
与荷兰总体人群相比，脊髓损伤（SCI）患者的工作参与度较低，其决定因素大多未知。
确定脊髓损伤患者可持续工作参与的决定因素。
在荷兰的八个康复中心进行了一项横断面多中心研究。邀请2015年至2022年间首次住院康复出院且有工作参与目标的患者完成一项调查。统计分析根据是否有带薪工作（是/否）、工作功能（良好/较低）、过去病假情况（偶尔/频繁）以及预期病假情况（偶尔/频繁）对各组进行比较。将有显著差异的变量纳入逻辑回归分析，并使用Nagelkerke伪R平方估计模型的拟合优度。
共有175人做出回应（男性占69.7%，年龄51.1±12.8岁，受伤后时间4.2±2.7年）。带薪工作模型解释了24.5%的方差（P<0.001）。工作功能模型解释了48.1%（P<0.001），工作能力是一个重要因素。过去病假模型解释了23.5%（P=0.009）。预期病假模型解释了36.4%（P<0.001），工作能力是一个重要因素。
自我报告的工作能力较低与工作功能较低以及预期频繁病假的可能性较高相关。
康复启示
自我报告的工作能力较低与工作功能较低以及下一年预期频繁病假的可能性较高相关。
工作能力指数单项（WAS）可考虑在临床环境中用于评估下一年的工作功能和预期病假情况。
应与患者讨论低WAS值，如有必要，与职业康复团队和/或雇主讨论，以便进行适当干预。
