In particular access to a life that can be considered normal and "outside of the person" or their injury is an important predictor of satisfaction with life for individuals with spinal cord injury (Richards, et. al, 1999). Occupational status is a tremendous element of personal satisfaction. Racial disparities have been identified in employment and job placement patterns among individuals with spinal cord injuries, however these differences are found by some researchers to mirror the patterns that exist among the population at large (Meade, Lewis, Jackson & Hess, 2004). Studies conducted show that racial disparities in employment rates and job placement are found to be similar before and after injury, and in one study no differences were found in the types of jobs held by African-Americans and whites with spinal cord injuries one year post injury (Meade, Lewis, Jackson & Hess, 2004). This is not to say however that job placement strategies should not focus on racial inequalities. On the contrary, the minority population is still found to be under-represented particularly with regard to disabled people in general, thus rehabilitative efforts should still focus on this population at large (Mead, et. al, 2004).

RECOMMENDATIONS and APPLICATIONS to the FIELD of REHABILITATION

Krause (2003) notes that counselors and rehabilitation specialists should work with individuals to help them understand a timeline of return to work, as well as to help them identify realistic work and educational goals that fit with their interests and abilities after their injury.

Further research conducted by Krause, Sternberg, Maides & Lottes (1998) confirms that rehabilitation professionals need to "find creative means to identify and neutralize barriers to employment" for individuals suffering from a spinal cord injury, particularly women and minority group victims. In addition the role of the rehabilitation or employment specialist should include helping people with SCI's to find meaningful vocations when they are injured, particularly if they are not able to return to their pre-injury position or one similar to it.

Most of the individuals that are readily able to find employment post injury are younger and Caucasian, and had completed in general more years of education (Krause, et. al, 1998). All of these factors must be considered when evaluating job placement strategies.

In addition rehabilitation and counseling professionals should make special efforts to "maximize employability after SCI among people with biographic characteristics that place them at the greatest risk for unemployment" (Krause & Anson, 1996). This includes men, individuals over the age of 50 and those with educations that equal less than twelve years.

One cannot argue that individuals suffering from a spinal cord injury require unique and specialized assistance in order to find meaningful employment after injury. The majority of evidence available suggests that special attention need be paid to the minority population in order to help women and minorities find employment after their industry. Rehabilitation and employment specialists should also work on providing educational and job training opportunities for people with spinal cord injuries.

Further it is vital that employers and rehabilitative specialists work to maintain an ongoing relationship with individuals after they are placed. Ongoing support will be needed to ensure an individuals changing needs are met in the workplace, specifically if the individual with a spinal cord injury is subject to chronic or further debilitating illnesses that are secondary to their injury.

Job placement strategies for this population should focus on returning spinal cord injury victims to the workforce in a field that is similar to one they were working in prior to their injury, or in a field that they are interested in pursuing. Much like the traditional applicant, and individual with a spinal cord injury is much more likely to thrive in an environment that supports their personal interests, skills and abilities.

The most challenging population to work with...

However the first step toward helping facilitate job placement among this population is understanding the specific challenges and risk factors that can be attributed to this group, which have been identified above.
Individuals with spinal cord injuries can have positive job placement experiences when they work in a supportive environment and with people that understand the unique challenges they face both personally and professionally. Job placement strategies are most likely to be successful when they take into consideration the whole person, and the unique challenges both physically and mentally they face.

Special emphasis need be given to minority populations and those who have been injured the longest, with the least amount of education. These populations seem to be particularly at risk with regard to job placement opportunities after injury. Spinal cord victims who were not employed at the time of their injury are more likely to face an uphill battle when seeking meaningful employment than those who were employed. However, the body of evidence available does indicate that many positive opportunities exist for persons with spinal cord injuries, and that finding meaningful employment can improve the overall quality of life and life satisfaction reported by persons with SCI. Thus it remains a vital and critical issue.

References

Anderson, CJ & Vogel, LC. (2002, Jun). "Employment outcomes of adults who sustained spinal cord injuries as children or adolescents." Arch Phys Med Rehabil. 83(6): 791-801

Dudgeon, BJ; Gerrard, BC, Jensen, MP, Rhodes, LA & Tyler, EJ. (2002, Feb). "Physical disability and the experience of chronic pain." Arch Phys Med Rehabil. 83(2): 229-35

Gibson, KL. (2003, July). "Caring for a patient who lives with a spinal cord injury."

Nursing 33(7): 36-41.

Gerhart, KA; Koziol-McLain J; Lowenstein, SR & Whiteneck, CG. (1994, Apr). "Quality of life following spinal cord injury: knowledge and attitudes of emergency care providers." Ann Emerg Med 23(4): 807-12. PMID: 8161051

Groah, SL; Stiens, SA; Gittler, MS; Kirschblum, SC & McKinley, WO. (2002, Mar).

Arch Phys Med Rehabilitation. 83 (3 Suppl 1): S82-9, S90-8

Jackson, AB; Dijkers, M; Devivo, MJ & Poczatek, RB. (2004, Nov). "A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. " Arch Phys Med Rehabil. 85(11): 1740-8. PMID: 15520968

Krause, JS & Anson, CA. (1996, Aug). "Employment after spinal cord injury: relation to selected participant characteristics." Arch Phys Med Rehabil. 77(8): 737-43.

Krause, JS. (2003, Sep). "Years to employment after spinal cord injury." Arch Phys Med

Rehabil. 84(9): 1282-9. PMID: 13680562 (PubMed).

Krause, JS, Kewman, D; DeVivo, MJ; Maynard, F; Coker, J; Roach, MJ & Ducharme, S.

1999, Nov). "Employment after spinal cord injury: An analysis of cases from the Model Spinal Cord Injury Systems." Arch Phys Med Rehabil. 80(11): 1492-500.

Krause, JS; Sternberg, M; Maides, J; Lottes, S. (1998, Jun). "Employment after spinal cord injury: differences related to geographic region, gender, and race." Arch Phys Med Rehabil. 79(6):615-24.

Mead, MA; Lewis, a; Jackson, MN & Hess, DW. (2004, Nov). "Race, employment and spinal cord injury." Arch Phys Med Rehabil. 85(11): 1782-92.

Post, MW; Bloemen, J & de Witte, LP. (2005, Feb). "Burden of support for partners of persons with spinal cord injuries." Spinal Cord. PMID 15685263 (PubMed)

Richards, JS; Bombardier, CH; Tate, D; Dijkers, M; Gordon, W; Shewchuk, R. & DeVivo, MJ. (1999, Nov). "Access to the environment and life satisfaction after spinal cord injury." Arch Phys Med Rehabil. 80(11): 1501-6.

Targett, PS; Wehman, PH; McKinley, WO; Young, CL. (2004). "Successful work supports for persons with SCI: Focus on job retention." Journal…