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Sustained gainful employment after spinal cord injury or traumatic brain injury: A mixed-methods work life course study

English title Sustained gainful employment after spinal cord injury or traumatic brain injury: A mixed-methods work life course study
Applicant Finger Monika
Number 173322
Funding scheme Project funding (Div. I-III)
Research institution Schweizer Paraplegiker-Forschung AG
Institution of higher education Swiss Paraplegic Research - SPF
Main discipline Health
Start/End 01.11.2017 - 30.04.2022
Approved amount 374'340.00
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All Disciplines (2)


Keywords (7)

Mixed-methods; Sustained employment; Spinal cord injury; Work life course; Return to work; Traumatic brain injury; Knowledge translation and implementation

Lay Summary (German)

Der Anteil von Personen, welche den Arbeitsprozess vorzeitig verlassen, liegt bei behinderten Menschen deutlich über demjenigen in der Gesamtbevölkerung. Die Patientenorganisationen von querschnittgelähmten Menschen (SCI) und von Menschen mit traumatischer Hirnverletzung (TBI) werden diesbezüglich regelmäßig von Betroffenen um Unterstützung angefragt. Dabei hat sich gezeigt, dass ein frühzeitiges Intervenieren beim Auftreten von arbeitsbeeinflussenden Problemen erfolgsrelevant ist. Die Einflussfaktoren und deren Interaktionen, welche verhindern, dass Menschen mit einer SCI oder TBI ihre Arbeit nachhaltig, zufrieden und gesund langfristig ausüben können, sind jedoch kaum systematisch erforscht. Hier setzt das Projekt "Nachhaltige Arbeitstätigkeit nach einer Rückenmarks- oder einer Hirnverletzung: eine Mixed-Methods-Studie von beruflichen Lebensverläufen" an.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Das Projekt fusst auf einem ganzheitlichen Modell und erforscht die biologischen, psychologischen und sozialen Risikofaktoren für eine nachhaltige Arbeitsintegration nach einer SCI oder TBI im Lebensverlauf aus der Perspektive der Betroffenen, den Arbeitgebern und weiteren Interessengruppen. Die Ergebnisse sollen in der Folge eine frühzeitige Identifizierung von Personen mit erhöhtem Risiko für einen vorzeitigen Verlust der Arbeit ermöglichen, um zeitgerecht geeignete Unterstützungsmassnahmen anbieten zu können.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Das Projekt zeigt am Beispiel von Menschen mit einer SCI oder TBI exemplarisch die relevanten Erfolgs- und Risikofaktoren für eine nachhaltige Arbeitspartizipation von Menschen mit einer Behinderung auf. Es trägt somit zur Erfüllung der UN-Behindertenrechtskonvention, welcher die Schweiz 2014 beigetreten ist, und besitzt auch breitere Relevanz angesichts einer älter werdenden Arbeitnehmerschaft.

Direct link to Lay Summary Last update: 18.03.2018

Responsible applicant and co-applicants


Project partner


Group / person Country
Types of collaboration
Fragile Suisse Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Research Infrastructure
Swiss Paraplegic Center Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
International Conference «Work and Health» Individual talk Sustainable employment – it’s time to integrate the perspectives of prevention and rehabilitation 14.02.2020 Olten, Switzerland Finger Monika;
ISCoS - Annual Scientific Meeting of the International Spinal Cord Society Poster Sustainable employment for people with a disability:The case of spinal cord injury 05.11.2019 Nice, France Karcz Katarzyina; Finger Monika;
ICOH - 2nd International Conference on Sustainable Employability - Building Bridges between Science and Practice Talk given at a conference Sustainable employment for people with ABI or SCI: a systematic review 12.09.2018 Leuven, NL, Netherlands Trezzini Bruno; Karcz Katarzyina;

Knowledge transfer events


Title Date Place
Results of a literature serch and patient focus groups 04.08.2020 ZOOM Conference, Switzerland


Background and scientific context: Spinal cord injury (SCI) and traumatic brain injury (TBI) are major life events that put a high monetary and non-monetary burden on affected individuals and society. Maintaining gainful employment after SCI or TBI is thus important not only as a means of sustaining the economic self-sufficiency of a person but also as a source of psychological well-being and self-worth, and as marker of social integration and participation. However, although identifying predictors and effective intervention strategies for successful return-to-work has become a major topic of rehabilitation research, knowledge on the factors and dynamics leading to or undermining sustained employment after return-to-work with a permanent disability that affects a person’s mobility or cognitive functioning remains rare and underdeveloped. This research project addresses this gap by asking how sustained long-term employment of persons with SCI and TBI can best be enhanced and how premature withdrawal from the labour market can be prevented. To answer these questions, this research project draws on the World Health Organisation’s conceptual model of functioning, disability and health as well as on life course and vulnerability approaches.Objective and aims: The objective of this project, therefore, is to develop a risk assessment framework and knowledge translation strategy that will help identify and support persons with SCI or TBI who are at risk of a decline in work ability and of leaving the labour market prematurely. More specifically, the study aims are: (1)To identify and examine the most important biological, psychological and social predictors associated with return to work and long-term employment of persons with SCI or TBI.(2)To build a statistical risk prediction model for change in work ability and labor market participation (i.e. decrease in weekly working hours or leaving the labour market altogether) in persons with SCI.(3)To qualitatively validate the findings of aims 1 and 2 and develop an explanatory model of the underlying dynamics and mechanisms of sustained employment across the work life course of persons with SCI or TBI.(4)To develop a knowledge translation and implementation strategy for multiple stakeholders involved in facilitating sustained employment for persons with SCI or TBI.Methods: To achieve the study aims, we will take a sequential mixed-methods approach. First, we will conduct a systematic review of reviews following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Second, we will apply random forest and multiple logistic regression analyses to longitudinal data from the ongoing Swiss Spinal Cord Injury Cohort Study. Third, applying triangulation of sources, we will conduct semi-structured focus groups and individual interviews with persons with SCI or TBI, their employers and their service providers; the transcribed interviews will be analysed using thematic analysis and selected grounded theory techniques. Fourth, to put the research project’s results into practice, Straus et al.’s Knowledge to Action Cycle will be applied and a stakeholder consensus conference conducted. Relevance and impact: Among the project’s major strengths are its comparative, mixed-methods approach, use of data from an ongoing cohort study, the application of cutting edge statistical methods and a clear knowledge transfer strategy. The immediate impact of the study will be to contribute to the successful sustained employment of persons with SCI or TBI by helping them foresee and manage changes in their work ability and labour market participation, thus ensuring they maintain an optimal level of employment across their work life course. In the sense of learning for and from SCI and TBI, the overall impact of this project will extend to other types of (neurological) disabilities, such as multiple sclerosis or stroke, and potentially even to the general aging working population who is believed to increasingly “age into disability”, with attendant mobility and cognitive limitations figuring most prominently.