Employment and Social Integration

More than 50% of all persons with spinal cord injury (SCI) in Switzerland are in paid work. Compared to the total population, that is approximately 30% less. The purpose of vocational integration programs is to integrate persons with disabilities into long-term satisfactory and meaningful work and thus to increase the employment rate of persons with SCI at the same time. This requires comprehensive and profound knowledge of those factors which influence vocational integration of persons with disabilities in the short, medium and long term.

Based on data collected in the Swiss Spinal Cord Injury Cohort Study (SwiSCI) and in close cooperation with the Institute for Vocational Guidance (ParaWork) at the Swiss Paraplegic Centre, we conduct research projects to determine the factors which are conducive or obstructive to the long-term and sustainable vocational rehabilitation of persons with SCI. In addition to investigating different options of vocational integration, we focus on the question how to match an individual with the most suitable job. It is our goal to generate approaches for interventions that aim at a sustainable vocational integration of persons with SCI.

In recent years, knowledge has increased constantly about how to optimally support handicapped persons when returning to work after an accident or illness. On the other hand, we still know little about the factors which enable these persons or prevent them from working contently, healthily and permanently until retirement after returning to work. Data collected in the Swiss Spinal Cord Injury Cohort Study (SwiSCI) confirm international studies showing that persons with SCI are more likely to quit working prematurely compared to the average population.

There is a growing awareness that a spinal cord injury not only requires immediate rehabilitation, but also lifelong health management aiming at an ideal (job) participation.

In order to promote an ideal job participation in the long run, we need to know the relevant influencing factors and their effects and need a better understanding of the interactions between them. We will gain fundamental insights by examining and evaluating professional development.

Ability-to-work assessments are based on medical reports. They form the basis for the decision whether a person insured with IV (Invalidity Insurance), «Suva» or a private insurance company is entitled to a daily allowance, a pension or vocational reintegration measures. To keep the decision-making process as fair as possible, medical reports shall provide comparable ability-to-work assessments. They are also meant to make the assessments more transparent.

It is therefore necessary to move away from the biomedical and diagnosis-based approach that has been predominant for a long time and to move towards a biopsychosocial model that focuses on the work-related functioning of a person. A function-based and biopsychosocial assessment can show how disability-related limitations and contextual environmental and individual factors can affect the ability of a person to meet the requirements of a specific job. Based on the holistic biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF), we develop function-based tools that increase standardization and transparency in the field of ability-to-work assessments.