Barriers to sustained return-to-work reported by those returning to work post traumatic spinal cord injury rehabilitation

Aim: The first aim of this cross-sectional survey was to assess the reasons given by people with traumatic spinal cord injury (tSCI) for leaving a job that they had secured after sustaining injury. The second aim was to examine the extent to which these reasons were compatible with a previously-developed framework for understanding organizational behaviors such as leaving a position of employment. Method: Thirty tSCI patients who left a position of employment which had been secured following the injury were interviewed, and asked to report the factors associated with their withdrawal from that position of employment. Results: A large number of factors were reportedly involved in the withdrawals. These factors mirrored were those which have been identified as influencing organizational behavior among the general workforce (characteristics of the individual, of the job, and of the wider environment). The ratio of factors involved was, respectively, 8:8:1. Within the environmental factors, micro-level factors were more prevalent than macro-level factors (in the ratio of 2:1). Conclusions: As many of the individual, job, and health-related reasons are essentially immutable, the environmental factors offer more promise for the development of preventive interventions to minimize unnecessary job loss. Prominent among these environmental factors targeted in interventions would be the workplace-related factor of social support.