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

Abstract

Background Unemployment among persons with spinal cord injury (PWSCI) is high and often leads to poverty (including their families). Modifiable and unmodifiable factors that influence employment among PWSCI are known and are addressed throughout the rehabilitation process. The overall aim of rehabilitation of PWSCI is quality of life and community integration (including employment). Interventions that seek to improve employment outcomes among PWSCI are well documented. However, no integrated reviews clearly describe the resources utilised, interventions utilised, duration of interventions and the outcomes (and tools used) to improve employment outcomes among PWSCI. Policymakers and rehabilitation professionals require this information to develop models or strategies to improve employment outcomes for PWSCI. This review aims to map evidence on interventions and approaches that aim to enhance the employment of PWSCI. Methodology This review will map evidence on interventions that improve employment outcomes among PWSCI, using the Arksey and O'Malley framework and the Donabedian model as the guiding lens. The first stage includes the development of the research question and will be reviewed throughout the review process. The PCC framework will be utilised to determine the inclusion and exclusion criteria and develop the search terms. Peer-reviewed primary studies will be identified using the Boolean search terms on PubMed, MEDLINE, Ebscohost, Google Scholar, CINAHL, Cochrane databases. Two independent reviewers will identify primary studies and charting data, and one reviewer will act as a supervisor and arbitrator. Data charting tool will be utilised to gather the required information from the selected studies. Nvivo software version 25 will be used to develop themes for summarising and reporting the data. The quality of the courses selected will be evaluated using the Mixed Methods Appraisal Tool (MMAT). DiscussionData from the selected studies will be discussed in relation to the research questions and the Donabedian model. Information gathered from this scoping review will enable policymakers, rehabilitation professionals and other stakeholders to use this as a foundation in an attempt to develop strategies or models that seek to improve employment outcomes among PWSCI. Moreover, a gap in current practice will be identified, and further research needed in the field will be described.