title: Return-to-work intentions during spinal cord injury rehabilitation: an audit of employment outcomes.
abstract: METHODS
  Single-centre, retrospective cohort study.
  
  
  OBJECTIVE
  To analyse the return-to-work intentions during spinal cord injury (SCI) rehabilitation.
  
  
  METHODS
  Tertiary care, spinal cord injury rehabilitation unit, National Spinal Injuries Centre, Stoke Mandeville Hospital, Ayelsbury, UK.
  
  
  METHODS
  Employment outcomes were obtained from the Needs Assessment Checklist (NAC), for all patients admitted to the unit between February 2008 and October 2014. NAC1 is completed within 4 weeks post-mobilisation and NAC2 upon the patient moving to the pre-discharge ward. Data from 362 participants were analysed for return-to-work intentions, by gender, age and injury severity.
  
  
  RESULTS
  Seventy-six percent of the sample population was employed at the time of their injury. At NAC1, 22.4% of individuals had made plans to return to work, whereas 44.2% had not; at NAC2, 34.3% had made plans to return to work and 31.2% had not. This difference was found to be statistically significant. There were significant differences in return-to-work intentions by injury severity at NAC1 but not NAC2, and by age group at NAC2 but not NAC1.
  
  
  CONCLUSIONS
  Less than half of those employed at the time of their injury had made plans to return to work before their discharge from the unit. The low proportion of individuals with SCI returning to work--just one in three--is concerning in view of the lost health and psychosocial benefits, and requires greater prominence during rehabilitation. Future research into effective employment interventions to improve employment outcomes in this population is required.
authors.affiliation: Department of Clinical Psychology, The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.|Oxford Institute of Clinical Psychology Training, University of Oxford, Oxford, UK.
authors.forename: P
authors.initials: P
authors.lastname: Kennedy
authors.affiliation: Department of Clinical Psychology, The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: L
authors.initials: L
authors.lastname: Hasson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D054869:Clinical Audit; D015331:Cohort Studies; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D062707:Return to Work / Q000523:psychology* / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D016896:Treatment Outcome; D014478:Unemployment / Q000523:psychology* / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult