Employment, health outcomes, and life satisfaction after spinal cord injury: comparison of veterans and nonveterans

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Abstract

Study design

Retrospective cohort study.

Objective

To explore differences between veterans and nonveterans with spinal cord injury (SCI) for employment, health, and satisfaction with life outcomes after controlling for demographic and injury characteristics.

Setting

Hospitals in the Spinal Cord Injury Model System of care.

Methods

A total of 9754 (85% nonveterans and 15% veterans) adults with traumatic SCI interviewed from 2000 and 2015 and completed follow-up years 1, 5, and 10 were included in this study. Employment status and the Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) measured employment. The SF-36 for self-perceived health status, CHART-SF, and rehospitalization determined health outcomes. Satisfaction with life was measured by the Satisfaction with Life Scale (SWLS). Secondary data analyses using χ2, t-tests, and generalized estimating equations (GEEs) model to determine group differences with control of demographic and injury characteristics.

Results

There were no significant differences for employment and SWL between nonveterans and veterans. There were some differences in health outcomes; whereas, veterans had better physical independence and mobility compared with nonveterans.

Conclusion

Interventions for both groups should target adults with a disability from SCI, be customized for varying levels of injury that address differences in healthcare systems, demographic backgrounds, economic resources, disincentives, and motivation.

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Data archiving

The datasets generated during and/or analyzed during the current study are available in the National Spinal Cord Injury Statistical Center [https://www.nscisc.uab.edu/Public_Pages/Database] [36].

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Funding

The contents of this publication were developed with grants (grant nos 90SI5016 and 90SI5002) from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Author information

KWG was responsible for developing the research idea, developing aims and objectives, searching the literature, extracting and analyzing the data, interpreting the results, creating the reference list, and writing the manuscript. YC was responsible for extracting and analyzing the data, writing sections of manuscript, and creating tables. SPB was responsible for interpreting the results and providing feedback on the manuscript. SDM was responsible for interpreting results and providing feedback on the manuscript. JSK was responsible for data access and retrieval, developing research idea, developing aims and objectives, interpreting results, providing feedback on the manuscript, and providing overall mentorship on entire project.

Correspondence to Kelli W. Gary.

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The authors declare that they have no conflict of interest.

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We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers for this database were followed before this information was used as secondary data to conduct this research.

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