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Persons with spinal cord injury (SCI) rely significantly on the use of assistive devices (ADs) to increase independence and enhance participation. This study aimed to determine the most important ADs for persons with SCI living in Switzerland and to identify design features of potentially novel ADs greatly facilitating persons with SCI in performing the tasks of daily life. Descriptive statistics were used to analyze cross-sectional data (N = 1294 participants) from the Swiss Spinal Cord Injury Cohort Study 2017. Open-ended questions regarding the importance of ADs and desirable novel ADs were manually coded and assigned to categories. The results showed that the most important ADs for persons with SCI were a manual wheelchair (61%), an adapted car (46%), and a wheelchair tractor (20%). The importance of ADs varied with gender, age, and SCI severity. While none of the participants indicated a desire for a completely novel AD, over one-fifth described specific design features of novel ADs or adaptions of existing ADs, which were most often related to facilitating transfer (12%), walking support (10%), and facilitating access (9%). These findings have implications for the design and development of ADs to better meet the needs of persons with SCI, improve their quality of life, and promote their independence and participation in daily activities. [ABSTRACT FROM AUTHOR]

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. Job 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. [ABSTRACT FROM AUTHOR]

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.

Objective: To identify barriers to access healthcare services and reveal determinants of satisfaction with healthcare services in people with chronic spinal cord injury (SCI). Design: Cross-sectional survey. Setting : Community setting in Switzerland. Participants : People with chronic SCI. Interventions : Non-applicable. Outcome Measures : Questionnaire-based evaluation of availability and quality of healthcare services for secondary health conditions, satisfaction with fulfillment of healthcare needs, and preference for care from a hypothetical service provider with limited specialized SCI care expertise but in close proximity over comprehensive care from an existing specialized SCI center located at a greater distance. Results: Close to three-quarter of participants (70%) indicated satisfaction with healthcare services received for SCI related health conditions. Elderly individuals (61+ years old) rated the availability and quality of healthcare 6% to 11% higher than younger individuals. The perceived fulfillment of healthcare needs was lower in people with incomplete paraplegia (odds ratio (OR) 2.11, 95%-credibility interval (CI) 1.18-3.84), chronic pain (OR 1.85, CI 1.12-3.08), insufficient access to long distance transportation (OR 5.81, CI 2.74-12.82), and longer travel distances to specialized SCI centers. Conclusion: Perceived inadequateness of access to healthcare services was partly related to transportation barriers, suggesting that outreach services or support with transportation are possible solutions. People with incomplete paralysis and pain consistently rated the fulfillment of care needs associated with SCI less favorably, pointing to the need for enhanced advocacy for this vulnerable groups.

Study Design: Cross-sectional survey., Objectives: To evaluate the annual influenza vaccination coverage rate (IVCR) among community-dwelling individuals with spinal cord injury (SCI)., Setting: SCI community in Switzerland., Methods: Participants were responders to the influenza vaccination question (n = 492) in the 2012 community survey of the Swiss Spinal Cord Injury (SwiSCI) cohort study. IVCR of SwiSCI participants were compared to the normative Swiss population, sampled in the Swiss Health Survey of 2012 using direct standardization, logistic regression standardization, and a genetic matching approach to control for differences in age, sex, and quarterly period of survey response., Results: Individuals with SCI showed higher crude (26%, 95% confidence interval (CI): 22-30%) and age- and sex-standardized (24%, CI: 23-24%) IVCR than observed in the general population (15% CI, 14-15%). The adjustment for age and sex as well as quarterly period of survey response showed that the standardized IVCR of individuals with SCI (17%; CI: 12-23%) approached that of the general population. Low IVCR of about 10% were found among individuals with SCI younger than 45 years. IVCR were similar between men and women and between individuals with incomplete and complete paraplegia and tetraplegia., Conclusion: The IVCR in individuals with chronic SCI was not higher than in the general population and much lower than guidelines recommend. The improvement of the IVCR is an important target of health policy in SCI in Switzerland as to reduce the evidenced excess burden in respiratory-disease related morbidity and mortality.

Background: People with spinal cord injury (SCI) suffer from complex secondary health conditions and rely on specialized health care services, which are often centralized and difficult to reach for individuals living in remote areas. As a consequence, they might move to regions where they expect better access to care. The aims of this study were: 1) to identify regions where people with SCI live compared with the general population, 2) to examine whether their choice of residence is related to the availability of local health care infrastructure, and 3) to ascertain determinants of their consideration to change residence when aging., Methods: This study used information from a nationwide Swiss SCI cohort and inpatient hospital discharge data. To detect clusters in the distribution of people with chronic SCI in Switzerland, a spatial cluster detection test was conducted using the normative population of a region as offset. To identify associations between the residential location of people with SCI and infrastructure variables, a negative binomial model was set up at a regional level with the frequency of people with SCI as outcome, geographical indicators as explanatory variables, and the normative population as offset. Determinants of the consideration to change residence when aging were investigated using logistic regression models., Results: People with SCI were not living equally distributed among the normative population, but clustered in specific areas. They were more likely than the general population to reside close to specialized SCI centers, in areas with a high density of outpatient physicians, and in urban regions. People with SCI living in rural areas were more likely to consider relocating when aging than those living in urban areas. However, only a few people with SCI considered moving closer to specialized centers when such a move required crossing language barriers., Conclusions: Good access to appropriate health care services and amenities of daily life seems to play such an important role in the lives of people with SCI that they are willing to choose their residential location based on local availability of appropriate health care services.