Underlying Dimensions of Barriers and Facilitators to Employment among Individuals with Spinal Cord Injury

Abstract

Background

Despite demonstrated physical and psychological benefits of employment after spinal cord injury (SCI), there are many barriers that must be navigated to promote job acquisition, retention, and advancement.

Objective

Our purpose was to identify the underlying dimensions of perceived barriers and facilitators to employment so that they may be measured and used in vocational practice to improve employment outcomes.

Method

2830 adults with traumatic SCI completed a 32-item measure of barriers to employment, developed based on previous research.

Results

Using principal axis factor analysis with varimax rotation, four factors emerged: (1) health considerations, encompassing pain, fatigue, stress, and SCI-related care needs; (2) poor job fit, reflecting perceptions of limited, inaccessible, or low-paying job opportunities; (3) low motivation/confidence, indicating low desire or self-efficacy for work; and (4) limited resources, representing insufficient education, training, transportation, and related supports.

Conclusion

These factors offer a parsimonious framework for vocational counseling, which will allow vocational counselors to examine sets of barriers and facilitators simultaneously, rather than just individually. Future research is needed on the relationship of these themes to employment outcomes, including job stability and quality, as well as for developing targeted interventions to improve employment outcomes.