A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol

Abstract

BackgroundSpinal cord injury (SCI) often results in complete or partial loss of functioning of the upper and/or lower limbs, leading to the affected individual experiencing difficulties in performing activities of daily living. This results in reduced participation in social, religious, recreational, and economic activities (employment). The South Africa legal framework promotes the employment and assistance of people with disabilities. However, rehabilitation interventions focus mainly on impairments and activity limitations, with few attempts to prepare those with SCI to return to gainful employment. There is therefore a need for a well-coordinated, multidisciplinary rehabilitation initiative that will promote the employment of people living with spinal cord injuries (PLWSCI) in South Africa.ObjectiveThis study aims to develop a multidisciplinary model to guide employment outcomes amongst PLWSCI in South Africa.MethodsThis study will utilize exploratory mixed methods during 3 phases. The first phase will explore the current rehabilitation practices, and the second will establish the factors that influence employment outcomes among PLWSCI. A multidisciplinary team consisting of health care professionals, representatives from the departments of Labour, Education, Social Development, and Health, and nongovernment organizations representing PLWSCI will provide feedback for the model development of phase 3, along with results from the previous 2 phases, using a multistage Delphi technique.ResultsIt is estimated that the results of phases 1 and 2 will be completed 11 months after data collection commencement (November 2015). Phase 3 results will be finalized 4 months after phases 1 and 2.ConclusionsDeveloping a multidisciplinary model to guide the employment outcomes of PLWSCI will ensure a coordinated response to integrate them into a productive life and will assist them to achieve economic self-sufficiency, personal growth, social integration, life satisfaction, and an improved quality of life. This can be achieved by active inclusion of PLWSCI to ensure that their concerns and recommendations are addressed.ClinicalTrialClinicalTrials.gov NCT02582619; https://clinicaltrials.gov/ct2/show/NCT02582619 (Archived by WebCite at http://www.webcitation.org/6mBgcj6z7)

Effect of Rebound Exercises and Circuit Training on Complications Associated with Type 2 Diabetes: Protocol for a Randomized Controlled Trial

“…No strategies have been identified for the control of complications associated with diabetes such as MSKP, depression, and reduction in the QoL. To date no additional rehabilitation [ 31 ] that is aimed at alleviating MSKP associated with diabetes complication. Exercises in the management of type 2 DM are of different type of different modes and intensity, most of the exercises are aerobic in nature and involves weight bearing, and strength training, mostly targeted for glycemic control, cholesterol, and few in QoL.…”

Interventions to Improve Employment Outcomes for People With Spinal Cord Injuries: a Scoping Review Protocol Using the Donabedian Model

“…Spinal cord injury (traumatic or non-traumatic) often results in motor and sensory loss below the level of the lesion, leading to various secondary health conditions and inability to participate in productive life (including employment) [1]. Improved access to healthcare and rehabilitation has led to improved survival rates among people who sustain spinal cord injury [2] and are expected to have longer life expectancies and participate in all life situations, including employment.…”

“…Therefore, the purpose of this scoping review is to map and identify and describe rehabilitation interventions that aim to improve employment outcomes for PWSCI using the Donabedian model and the ICF. The information gained in this review will partially inform the development of a model that intends to guide employment outcomes for PWSCI in the study setting [1].…”

Perceived readiness for hospital discharge: Patients with spinal cord injury versus physiotherapists

“…As a result, employment is one of the most important psychosocial aspects for PWSCI. However, the estimated employment rate in people with disabilities in South Africa is estimated at 25.2% (Pefile, Mothabeng & Naidoo 2016 ). Personal psycho-emotional factors may also affect RHD and functioning after discharge.…”