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Objectives: The aim of the study is to examine labor market participation of individuals with spinal cord injury living in Switzerland over the past decade and in relation to the general population., Design: This is a descriptive study, using longitudinal panel data from the 2012, 2017, and 2022 community surveys of the Swiss Spinal Cord Injury Cohort Study and general population data from the Swiss Labor Force Survey., Results: Employment rates among spinal cord injury responders were 56% in 2012, 61% in 2017, and 64.6% in 2022. Employment gaps between the spinal cord injury and the Swiss general population samples decreased from 22.5% (2012) to 15.4% (2022). This decrease was particularly evident for females, middle-aged individuals, and people with tetraplegia but contrasted with increased employment gaps in Southwestern Switzerland., Conclusions: By identifying increased employment rates among spinal cord injury responders along with decreased employment gaps in relation to the general population, our study indicates improved opportunities for persons with impairments in the Swiss labor market over the past decade. While there is still room to improve the labor market participation prospects among the Swiss spinal cord injury population, particular efforts at the regional level are required to ensure equal labor market participation opportunities for all individuals with spinal cord injury living in Switzerland., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: This study aims to examine the change in mental health from the clinical to community setting in persons with spinal cord injury and to identify the role of psychosocial resources for this transition., Design: Longitudinal survey self-report data from N = 240 persons with spinal cord injury from the Swiss Spinal Cord Injury Cohort study., Results: Latent profile analysis identified three profiles for each the clinical and the community setting: low, medium, and high mental health load. Latent transition analysis revealed that persons with spinal cord injury were most likely to stay in the same profile from discharge of initial rehabilitation to community, followed by a decrease from a high mental health load to a medium mental health load and an increase from a low mental health load to a medium mental health load. Individuals staying in the low mental health load profile showed significantly higher levels of psychosocial resources compared to individuals increasing to the medium mental health load profile, whereas individuals who stayed in the high mental health load profile showed lower levels of psychosocial resources compared to individuals decreasing to the medium mental health load profile., Conclusions: This study highlights a positive role of psychosocial resources on mental health transitions, underlining the need for strengthening psychosocial resources beyond initial rehabilitation., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Examining changes in participation frequency (productive, leisure, and social activities) from pre-spinal cord injury/disorder to at least 2 yrs post-spinal cord injury/disorder and identifying sociodemographic and spinal cord injury/disorder characteristics associated with significant shifts in participation frequency., Design: The study used a longitudinal design, using data from the Swiss Spinal Cord Injury Cohort study. Pre-spinal cord injury/disorder participation frequency was assessed retrospectively 12 wks after spinal cord injury/disorder and prospectively 1 and at least 2 yrs after spinal cord injury/disorder. Linear mixed-effects model trees were used to identify subgroups with participation changes and related sociodemographic and spinal cord injury/disorder characteristics., Results: The study involved 550 individuals (median age at spinal cord injury/disorder onset: 53 yrs, 30% female, 63.9% with traumatic etiology, and 5.6 yrs since onset). Pronounced decrease was observed prominently in productive activities. Education and age at spinal cord injury/disorder onset served as initial variables to split the tree at first level for each of the participation dimensions., Conclusions: This research identified participation dimensions most susceptible to changes during the initial years after spinal cord injury/disorder and pinpointed subgroups displaying clinically meaningful longitudinal variations across productive, leisure, and social activities. These findings have the potential to enhance the efficiency of rehabilitation programs, leading to improvements in long-term participation levels for individuals with spinal cord injury/disorder., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Context/objective: Perceived job quality is a key indicator of sustainable work among persons with spinal cord injuries (PwSCI). This study aimed at (a) describing three indicators of perceived job quality ( i.e. job satisfaction, job performance, and work stress) among working PwSCI, and (b) identifying whether and how different person-job match dimensions ( i.e. interest congruence, demands-abilities fit, needs-supplies fit, and effort-reward imbalance) as well as sociodemographic and health-related factors ( e.g. age, sex, SCI-related characteristics, pain problems, and depressive symptoms) are associated with perceived job quality., Design: Cross-sectional, self-report survey., Setting: Community., Participants: 549 working-age PwSCI who participated in the 2017 community survey of the Swiss Spinal Cord Injury Cohort study and reported being engaged in paid work., Outcome Measures: Job satisfaction, job performance, and work stress., Results: Higher interest congruence, better needs-supplies fit and lower effort-reward imbalance, as well as female sex, were associated with higher job satisfaction, while higher effort-reward imbalance, poorer demands-abilities fit (underqualification), and - surprisingly - better needs-supplies fit were associated with higher work stress. Moreover, underqualification, worse needs-supplies fit as well as pain, depressive symptoms, and language region were associated with lower job performance., Conclusion: Integrating individuals in jobs that match their abilities, interests and needs, and which adequately reward their efforts may contribute to better job quality among PwSCI. Beyond that, common secondary health conditions and comorbidities such as pain and depressive symptoms should receive particular attention in interventions that aim to promote job quality and ultimately sustainable work in the SCI population.

Unemployment and inequality are growing concerns that disproportionately affect people with disabilities. We compared unemployment rates and barriers to labor market participation for persons with spinal cord injury (SCI) as an exemplary case of disability with different socioeconomic positions and from a cross-national perspective across 20 countries worldwide. We showed that persons with SCI have much higher unemployment rates than the general population. While this situation is many times worse for those in low-income groups, persons with SCI in high-income groups are often in a position comparable to the general population. The main barriers to entering the labor market are health status, the impossibility of finding suitable jobs, and the lack of information about employment opportunities. This is the first study that quantifies the extent of inequality in the labor market for persons with SCI. Across the 20 countries analyzed, facing disability has a much higher impact on those in low-income groups. This reality is explained by the fact that people in lower-income groups face many more barriers to entering the labor market than those in higher-income groups., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Due to activity limitations and physical environmental barriers, low remunerative employment is a challenging issue for people with spinal cord injury (SCI) and relevant rehabilitation personnel. Since work opportunities in digital fields have continued to emerge, this study aims to report and discuss the possibility of using digital working as a strategy for increasing remunerative employment in people with SCI., Case Presentation: We report live experiences of four people with SCI in Thailand who have digital works with different types of jobs (image segmentation and identification for artificial intelligence development, online merchant, online streamer, cryptocurrency investor), different required digital skills (basic or intermediate digital skills), different employment statuses (employee or owner), and different incomes (from 50 to 200 USD/month). We also discuss advantages and potential risks of digital working for people with SCI and propose a model for care providers to facilitate safe digital work as a means of increasing remunerative opportunities for people with SCI., Conclusion: There is increasing interest in becoming involved in various types of digital work among people with SCI. Digital working could overcome many of the physical barriers; however, it also potentially introduces some potential economic and health risks for people with SCI. To minimize those risks, healthcare providers of people with SCI should prepare to develop the appropriate knowledge and attitudes regarding digital working and to learn how to properly facilitate digital working to increase remunerative employment in people with SCI., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)

Study Design: Cross-sectional study., Objectives: Work-related disability is common in persons with spinal cord injury (SCI). The aims of this study are to examine the associations of employment with self-perceived health (SPH) and quality of life (QoL) across 22 countries and to explore the covariates around employment and SPH and QoL., Setting: Community., Methods: We analyzed 9494 community-dwelling persons with SCI aged 18-65. We performed an adjusted regression and path analysis. The independent variable was 'employment' and the dependent variables were two single items: QoL (very poor to very good) and SPH (excellent to poor). Covariates included the Gross Domestic Product (GDP), education, time since SCI, age, gender, years of employment after SCI, SCI level (paraplegia, tetraplegia), and completeness of SCI., Results: Participants' mean age was 47, 74% were male, and 63% had paraplegia. We found an association between employment and QoL and SPH. While the magnitude of the effect of employment on QoL did not differ across GDP quartiles, its perceived effect on QoL was found to be significant in the highest GDP quartile. Employment was predictive of good SPH in two GDP quartiles (Q1 and Q4), but significant across all quartiles when predicting poor perceptions, with the magnitude of effect varying significantly., Conclusions: Employment is closely related to QoL and SPH depending on the GDP. We may positively influence the QoL and SPH in the SCI population to promote better employment outcomes by considering the infrastructure and economy., (© 2023. The Author(s), under exclusive licence to International Spinal Cord Society.)

Study Design: Longitudinal, population-based survey., Objective: To examine change in labour market participation (LMP) of people with spinal cord injury (SCI) living in Switzerland and to identify predictors of increase, decrease and stability in LMP between 2012 and 2017., Setting: Community., Methods: Longitudinal information on LMP (i.e., weekly workload) was obtained from 311 gainfully employed, working-age individuals who participated in the Swiss Spinal Cord Injury Cohort Study (SwiSCI) community survey in 2012 and were still of working age at the time of completing the 2017 questionnaire. Statistical preselection of the predictors of change in LMP was carried out by implementing the least absolute shrinkage and selection operator (LASSO) in a multinomial logistic regression model. The final set of predictors was selected by comparison of several multinomial logistic regression models., Results: Out of 311 participants, almost half (43%) changed their LMP between 2012 and 2017, 48 increased their weekly workload, 49 reduced and 37 participants left the labour market prematurely. Age at time of the survey, years of education, having children, intention to change weekly workload, high satisfaction with daily routine, extra-time needs for transportation and managing support were associated with change in LMP., Conclusions: Modifiable factors like education and satisfaction with daily routine should receive particular attention in the context of job retention strategies. More longitudinal research focusing on key employment transitions and trajectories over the life course of persons with SCI is needed to complement, validate and extend our findings., (© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.)

Study Design: Longitudinal community survey., Objectives: To determine subgroups in social participation of individuals living with spinal cord injury (SCI)., Setting: Community., Methods: Data were collected in 2012 and 2017 as part of the community survey of the Swiss Spinal Cord Injury cohort. Participation was assessed using the 33-item Utrecht Scale of Evaluation of Rehabilitation-Participation evaluating frequency of, restrictions in and satisfaction with productive, leisure, and social activities. Linear mixed-effects model trees were used to distinguish subgroups in participation associated with sociodemographic and lesion characteristics., Results: In all, 3079 observations were used for the analysis, of which 1549 originated from Survey 2012, 1530 from Survey 2017, and 761 from both surveys. Participants were mostly male (2012: 71.5%; 2017: 71.2%), aged on average 50 years (2012: 52.3; 2017: 56.5), with an incomplete paraplegia (2012: 37.5%; 2017: 41.8%) of traumatic origin (2012: 84.7%; 2017: 79.3%). There was limited within-person variation in participation over the 5-year period. Participation varied with age, SCI severity, education, financial strain, number of self-reported health conditions (SHCs), and disability pension level. Among modifiable parameters, the number of SHCs and disability pension level emerged as the most frequent partitioning variables, while education was most informative for participation in productive, leisure, and social activities., Conclusions: Long-term rehabilitation management and clinical practice should target people most prone to decreased participation in major life domains. Our study indicates that the alleviation of SHCs, engagement in further education, or adjusting disability pension level are promising areas to improve participation of persons living with SCI.

Study Design: Longitudinal, population-based survey., Objective: To examine determinants of between-person differences in labor market participation of individuals with spinal cord injury (SCI) living in Switzerland and their potential importance for policy., Setting: Community., Methods: Longitudinal information on labor market participation (i.e., paid work or not) was obtained from 1198 and 1035 individuals of working-age participating in the 2012 and 2017 SwiSCI community survey, respectively. Determinants of between-person variation in labor market participation were examined using mixed effects logistic regression, controlling for within-person variation. Employment rates were predicted using counterfactual data for modifiable determinants., Results: The employment rate was 56% for the 2012 and 61% for the 2017 survey. Labor market participation was affected mostly by static (sex, nationality, SCI severity), temporal (age), dynamic (education level, functional independence, chronic pain), and policy-related (general pension, disability pension level) determinants. Counterfactual (what-if) predictions indicated the highest improvement of employment rates for strategies that increase functional independence (up to 6% increase), foster education (5%), reduce chronic pain (2%), or promote a shift to partial disability pensions (15%)., Conclusions: Between-person variation in labor market participation of persons with SCI is influenced by various temporal, static, dynamic, and policy-related determinants. Our results suggest that policy strategies aimed at enhancing the employment rate of the Swiss SCI population may particularly invest in programs promoting functional independence, education, and partial pension levels that are more adequate for ensuring sustainable employment.

Study Design: Descriptive study of the second community survey of the Swiss Spinal Cord Injury Cohort Study (Survey 2017) conducted between 03/2017 and 03/2018., Objectives: To describe the methodology, recruitment results, characteristics of participants and non-participants, and non-response of the Survey 2017., Setting: Community., Methods: Description of the sampling strategy and sampling frame. Recruitment results and characteristics of participants and non-participants of the two Survey 2017 questionnaire modules were analyzed using descriptive statistics. Determinants of survey participation were examined using multivariable logistic regression, and the impact of non-response bias on survey results was evaluated using inverse-probability weighting., Results: Out of 3959 persons who met the eligibility criteria, 1530 responded to module 1 (response rate 38.6%) and 1294 to module 2 (response rate 32.7%) of the Survey 2017. Of the 4493 invited persons, 1549 had participated in the first SwiSCI community survey conducted in 2012/2013. Of these, 1332 were invited to the Survey 2017 and 761 participated in module 1 (response rate 58.9%) and 685 in module 2 (response rate 53.1%). The majority of module 1 participants were male (71.2%, 95% CI: 68.9, 73.5), with a median age of 57 (IQR: 46.0, 67.0) years and incomplete paraplegia (41.9%, 95% CI: 39.3, 44.5). Survey non-response was higher in the oldest age group, among females, and those with tetraplegia., Conclusions: The design of the Survey 2017 was successful in recruiting a substantial proportion of the SCI source population in Switzerland. To counteract survey non-response, survey weights may be applied to subsequent analyses., Sponsorship: none.

Objective: To compare pre- and post-injury job type distributions of individuals with spinal cord injury (SCI) living in Switzerland. Design: Cross-sectional, self-report survey. Setting: Community. Participants: Two hundred sixty-three individuals reporting a pre- and 677 a post-injury job title in the Swiss SCI Cohort Study community survey. Interventions: Not applicable. Outcome Measures: Job titles were elicited by free-text questions and classified using the International Standard Classification of Occupations (ISCO-08). Frequencies across ISCO-08 major groups were calculated and compared to Swiss labor market statistics for 1995 and 2011. Results: Compared to pre-SCI, Professionals (16.3% vs 31.2%) and Clerical Support Workers (11.7% vs 19.1%) were more prevalent and Crafts and Related Workers (26.5% vs 5.4%) less common post-injury. Except for Clerical Support Workers , these results reflect recent structural changes in the Swiss labor market. Conclusion: The higher post-SCI prevalence of jobs predominantly requiring cognitive and communication skills compared to rather physically oriented jobs mirrors structural changes in the labor market, except for clerical jobs. Future return-to-work strategies should not primarily target the clerical sector with its diminishing job opportunities, but promote vocational re-training towards jobs requiring higher education and assistive technology to return individuals with limited cognitive resources to physically oriented jobs.

Objectives: To describe the employment situation of individuals with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord Injury community survey, to compare observed and predicted employment rates, to estimate gaps in employment rates among people with SCI compared with the general population, and to study differences in employment between men and women., Design: Cross-sectional survey., Setting: Community., Participants: People of employable age (N=9875; 18-64 y) with traumatic or non-traumatic SCI (including cauda equina syndrome) who were at least 18 years of age at the time of the survey, living in the community, and able to respond to one of the available language versions of the questionnaire., Interventions: Not applicable MAIN OUTCOME MEASURES: The observed employment rate was defined as performing paid work for at least 1 hour a week, and predicted employment rate was adjusted for sample composition from mixed logistic regression analysis., Results: A total of 9875 participants were included (165-1174 per country). Considerable differences in sample composition were found. The observed worldwide employment rate was 38%. A wide variation was found across countries, ranging from 10.3% to 61.4%. Some countries showed substantially higher or lower employment rates than predicted based on the composition of their sample. Gaps between the observed employment rates among participants with SCI and the general population ranged from 14.8% to 54.8%. On average, employment rates were slightly higher among men compared with women, but with large variation across countries. Employment gaps, however, were smaller among women for most countries., Conclusions: This first worldwide survey among people with SCI shows an average employment rate of 38%. Differences between observed and predicted employment rates across countries point at country-specific factors that warrant further investigation. Gaps with employment rates in the general population were considerable and call for actions for more inclusive labor market policies in most of the countries investigated., (Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To develop and pretest a comprehensive occupation- and health condition-specific job matching tool for vocational rehabilitation of persons with spinal cord injury. Materials and methods: The study design involved qualitative and quantitative steps. First, an interdisciplinary scoping review covering return-to-work, organizational and vocational psychology research was conducted to devise a conceptual job matching framework. Then, the occupation- and health condition-specific tool content was determined based on a database analysis of jobs performed by persons with spinal cord injury and focus groups with affected persons. Finally, a tool prototype was developed and pretested in a simulation exercise with vocational rehabilitation professionals. Results: The study yielded a tool prototype with matching profiles that structure the demands and characteristics of 415 occupations as well as spinal cord injury-related needs and limitations into a stable, a modifiable, and a needs-supplies dimension of person-job match. Vocational rehabilitation professionals perceived the prototype as helpful for determining target jobs for vocational retraining and for goal-oriented intervention planning. Conclusions: By comprehensively assessing the person-job match of individuals with spinal cord injury, the tool facilitates determining suitable target jobs and interdisciplinary intervention planning in vocational rehabilitation and is thus likely to promote sustainable return to work.Implications for rehabilitationJob matching is crucial for a sustainable work reintegration of persons with disabilities. However, the majority of existing job matching tools lack applicability for return to work because they are (1) not occupation-specific or rely on outdated occupational information, (2) not health condition-specific, and (3) not comprehensive with regard to the relevant aspects for determining a person-job match.Persons with spinal cord injury are a case in point for the need of job matching tools that comprehensively address occupation- and health condition-specific information.The present study responded to the shortcomings of existing job matching tools and uses vocational rehabilitation of persons with spinal cord injury as a case in point for developing a job matching tool that is both occupation- and health condition-specific at the same time.The developed tool was perceived as promising for determining suitable target jobs for vocational retraining of persons with spinal cord injury and for goal-oriented intervention planning in an interdisciplinary vocational rehabilitation setting. The tool's underlying conceptual framework may also serve as a blueprint for developing job matching tools for other types of disabilities.

Study Design: Cross-sectional study using data from the 2012 community survey of the Swiss Spinal Cord Injury Cohort Study., Objectives: To identify associations between selected factors related to the social background, health, functional independence, and the environment of persons with spinal cord injury (SCI) and their labor market participation., Setting: Community-based, Switzerland., Methods: Labor market participation (i.e., involvement in paid work or not) was determined for a sample of 966 persons with traumatic SCI who were of employable age at the time of the survey. Applying an exploratory approach, potential predictors of labor market participation were selected based on the literature and using a bidirectional stepwise variable selection approach. Descriptive statistics were calculated and weighted bootstrapped multiple logistic regressions were applied to describe the associations between the selected predictor variables and labor market participation, controlling for sociodemographic and SCI-related characteristics., Results: A total of 568 (58.8%) of the participants were involved in paid work at the time of the survey. From the 17 selected predictor variables, general functional independence and Swiss citizenship showed a significant positive association, and chronic pain a negative association with involvement in paid work., Conclusions: Beyond previously established sociodemographic and injury-related risk factors such as female gender, low education, and high lesion severity, functional independence, chronic pain, and nationality proved crucial for labor market participation. These factors should receive particular attention in medical and vocational strategies striving for a sustainable work integration of persons with SCI.

Purpose: To discuss the representation and organization of information describing persons' lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health, using spinal cord injury as a case in point for disability., Methods: The scientific literature was reviewed, discussion rounds conducted, and qualitative secondary analyses of data carried out using an iterative inductive-deductive approach., Results: Conceptual considerations are explicated that distinguish the personal factors perspective from other components of the International Classification of Functioning, Disability and Health. A representation structure is developed that organizes health-related concepts describing the internal context of functioning. Concepts are organized as individual facts, subjective experiences, and recurrent patterns of experience and behavior specifying 7 areas and 211 concept groups., Conclusions: The article calls for further scientific debate on the perspective of personal factors in the light of the International Classification of Functioning, Disability and Health. A structure that organizes concepts in relation to a personal factors perspective can enhance the comprehensiveness, transparency and standardization of health information, and contribute to the empowerment of persons with disabilities. Implications for rehabilitation The present study collected data from scientific literature reviews, discussion rounds and qualitative secondary analyses in order to develop a representation and organization of information describing persons' lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health. The following representation structure for health-related information from a personal factors perspective was developed: (i) Individuals facts (i.e., socio-demographical factors, position in the immediate social and physical context, personal history and biography), (ii) subjective experience (i.e., feelings, thoughts and beliefs, motives), and (iii) recurrent patterns of experience (i.e., feelings, thoughts and beliefs) and behavior. With this study, we aim to stimulate further scientific discussion about the personal factors component in the International Classification of Functioning, Disability and Health, including its application and subsequent validation for potential implementation into clinical practice.

Background: Matching an individual's capabilities, interests and needs with corresponding job demands and characteristics is an established procedure in vocational rehabilitation (VR). Yet, a systematic exposition of specific factors affecting the determination and attainment of a person-job match in VR practice is currently missing., Objective: To examine factors, assessments and interventions related to job matching (JM) in VR of persons with spinal cord injury (SCI) by using a literature-based conceptual JM framework., Methods: Applying a qualitative descriptive design, data were collected by overt non-participant observations across the VR process of two individuals with SCI, representing major return-to-work scenarios (returning to the pre-injury job and preparing for vocational retraining)., Results: Person-related, job-related and environmental factors were identified that either played a direct or indirect role in determining and attaining a person-job match. The factors were evaluated by different work-related and medical assessments and were targeted by a number of JM-related interventions., Conclusions: While our conceptual framework may serve as a generic blueprint to facilitate JM approaches in VR practice, the specific factors identified in our study are particularly valuable for developing JM applications aimed at promoting sustainable return to work for persons with SCI.

Study Design: Observational study based on the 2012 community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI)., Objectives: To investigate work and wellbeing-related consequences of different return-to-work (RTW) pathways after SCI., Setting: Community-based., Methods: Using a subsample of 243 SwiSCI participants, we determined whether a respondent had returned to the pre-injury employer, started with a new employer or had not returned to gainful employment post-SCI. For each pathway, descriptive statistics were provided and work and wellbeing-related consequences were examined with regression analyses., Results: One hundred eleven (45.7%) participants had returned to their pre-injury employer, 80 (32.9%) had changed employers and 52 (21.4%) had never returned to paid work post-SCI. Although returning to the pre-injury employer was associated with a shorter RTW time and a higher current weekly work time compared with starting work with a new employer, no significant differences were found with regard to current employment status and post-SCI work duration. Concerning wellbeing-related outcomes (i.e., income, quality of life and life satisfaction), the two pathways did not differ., Conclusions: Although lasting RTW had beneficial wellbeing outcomes, the specific pathway initially taken (i.e., pre-injury vs. new employer) appeared less crucial. Although the two pathways seem equally viable, longitudinal data are required to corroborate the present findings, and future research needs to clarify the role of the client triage system and of vocational rehabilitation practices with regard to person-job match and its impact on job satisfaction and job performance.

Study Design: Descriptive qualitative and quantitative study using cross-sectional data from the Swiss Spinal Cord Injury Cohort Study (SwiSCI)., Objective: To determine the key demands and characteristics of occupations performed by individuals with spinal cord injury (SCI)., Setting: Swiss community., Methods: Job titles indicated by SwiSCI participants were linked to occupational titles from the Occupational Information Network (O*NET) and then frequency-analyzed across sociodemographic and injury-related factors. Subsequently, average O*NET relevance values ranging from 0 to 100 were calculated for the occupations' demands and characteristics, both in general and stratified by injury-related factors., Results: The 1549 study participants indicated a total of 717 job titles and were primarily employed in administrative and management occupations (22.1% and 16.4%, respectively). The participants' occupations predominantly required verbal abilities (average relevance [AR]=68.4) and complex problem solving skills (AR=55.8) and were characterized by conventional work tasks (AR=62.9) and social relationships (AR=58.6). Both the occupations' frequency distribution as well as the average relevance levels of their demands and characteristics differed by SCI severity., Conclusions: Individuals with SCI perform a broad range of occupations that are mainly characterized by cognitive and communicative demands, while physical demands are of minor importance. By informing the development of job matching profiles for vocational guidance, our study facilitates the determination of well-matching jobs for persons with SCI and may contribute to a more sustainable return to work of the affected persons.

Background: Labour market participation (LMP) represents a key goal of rehabilitation for individuals with spinal cord injury (SCI). To achieve this goal, Swiss SCI rehabilitation centres seek, together with their clients, viable follow-up solutions for returning to work after initial rehabilitation. However, the long-term outcomes of such vocational follow-up solutions have not been investigated so far, and there is a paucity of knowledge regarding the various types of employment pathways that persons with SCI living in Switzerland may experience., Objective: To examine long-term employment pathways as experienced by individuals with SCI living in Switzerland., Methods: A qualitative descriptive study design involving narrative interviews with individuals who completed vocational rehabilitation (VR) during their initial rehabilitation. Interviews were transcribed verbatim, and data analysed using an inductive thematic analysis approach., Results: The analysis of the 15 interviews revealed four employment pathways: the pathway of no paid work, the pathway of retraining, the pathway of job adaptation and the pathway of continuing work., Conclusions: Apart from three pathways leading towards paid employment, our results revealed one pathway that was characterized by permanent unemployment. Individuals facing a pathway of no paid work may benefit from more custom-made vocational follow-up solutions and prolonged job coaching after initial VR.