脊髓损伤患者再就业影响因素分析

Contributors of Return to Work for a Cohort of Spinal Cord Injured Workers

目的探讨脊髓损伤患者受伤18个月后的再就业情况及对其再就业有影响的社会心理因素。方法设计结构性问卷收集161名脊髓损伤患者相关资料。问卷包括人口统计资料信息,如性别、年龄、婚姻状态、教育程度、工作状态和受伤程度等,以及世界卫生组织残疾评估量表、残疾接受量表、Rosenberg自我尊重量表、抑郁量表、自我效能量表及Zimet多维觉察社会支持量表的内容。结果再就业率为31%。Logistic回归分析显示,脊髓损伤类型(截瘫或四肢瘫)(OR=4.397)、残疾接受态度(OR=0.979)、自我残疾评估(OR=0.948)及信仰/信念对日常生活的影响(OR=0.681)4个社会心理因素对再就业影响最大。结论对于脊髓损伤发生18个月后的患者,残疾类型及残疾后对社会心理因素调节与适应的程度是制约再就业的主要原因;而外部因素,如社会支持因素影响较少。

Objective To explore the rate of return to work among a cohort of spinal cord injury （SCI） who were at least 18 months post injury and some psychosocial factors contributing to return to work. MethodsA convenient sampling method was adopted and total 161 subjects were involved. The demographic characteristic and psychosocial variable were collected by 6 self-reported questionnaires： World Health Organization Disability Assessment Schedule Ⅱ,Acceptance of Disability Scale,Rosenberg Self-Esteem Scale,Center for Epidemiologic Studies Short Depression Scale,Generalized Self-Efficacy Scale and Multidimensional Scale of Perceived Social Support. Self-administered,telephone and face-to-face interview were the manners to capture data. ResultsThe return to work rate is 31%. The result generated from Logistic regression showed that the type of SCI （paraplegia or quadriplegia） （OR=4.397）,acceptance of disability （OR=0.979）,disability assessment level （OR=0.948）,and the impact of belief to activities of daily living （OR=0.681） were the contributors for successful return to work. ConclusionFor those who suffering from SCI after 18 months,both psychosocial adjustment factors and physical functioning may have the great impacts for the outcomes of return to work rather than that of external factors,such as social supports.