Return-to-work: Exploring professionals’ experiences of support for persons with spinal cord injury

Abstract

Purpose: To generate knowledge about how professional stakeholders organise and experience the support of the return-to-work (RTW) process for persons with spinal cord injury (SCI). Methods: Constructivist grounded theory approach. Professional stakeholders (n ¼ 34) involved in the RTW process and representing three Swedish Regions were recruited into seven focus groups. Analysis followed initial, focussed, and theoretical coding. Findings: The core categorymediating intentions to support work and possibilities of working through social, labour market, and societal contextillustrates complexities of when and how to support a person with SCI in the RTW process, and a risk of delayed, unequal, or absent RTW processes. Analysis outlines: (1) Assessment of ability to workuncertainty of how and when; (2) Planning RTWdivide between dynamic and rule-based perspectives; (3) Work re-entryunequal paths towards viable solutions. Conclusions: In RTW after SCI, it is critical to acknowledge how the RTW process is situated in relation to the person and context. A possible directiongrounded in an occupational perspectivethrough early identification of needs and resources and coordination derived from the SCI rehabilitation setting within healthcare is suggested. This can facilitate a time-sensitive and equal RTW process.

Qualitative study exploring factors affecting the implementation of a vocational rehabilitation intervention in the UK major trauma pathway

“…Previous research in acquired brain injury and spinal cord injury indicates that patients who understand the impact of their injuries are more able to discuss their limitations with employers. 17, 53 Understanding their employee’s injury and limitations is essential in facilitating a successful RTW 17 53 54. In general, employers feel they lack the necessary experience and knowledge to support an RTW for someone post-injury 17 53.…”

“…17, 53 Understanding their employee’s injury and limitations is essential in facilitating a successful RTW 17 53 54. In general, employers feel they lack the necessary experience and knowledge to support an RTW for someone post-injury 17 53. Further evidence suggests that employers require functional advice (eg, planning phased RTW, reasonable adjustments) as well as psychological support to understand and address the needs of their employee 53 54.…”

“…In general, employers feel they lack the necessary experience and knowledge to support an RTW for someone post-injury 17 53. Further evidence suggests that employers require functional advice (eg, planning phased RTW, reasonable adjustments) as well as psychological support to understand and address the needs of their employee 53 54. Providing a central point of contact to liaise with, educate and support the employer and patient, negotiating RTW plans, and providing advice and emotional support (via OT and clinical psychologist), are key components of our intervention.…”

Development of employment indicators to advance the quality of spinal cord injury rehabilitation care: SCI-High Project

“…VR does not conventionally fall within the health portfolio and the availability of VR varies across Canada, although ironically, employment is an important driver of health status. Strong evidence indicating the importance of having access to VR services in promoting RTW 49 was the primary rationale for the selection of the structure indicator. VR that provides information about employment opportunities, education and training prerequisites, can help to facilitate vocational decision-making among patients with SCI/D; 50 and promote community participation to obtain employment.…”

Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury

“…3-5 10 These studies drew on narratives over time with adults not working early after injury, 3 5 participatory research with people working after SCI 4 and focus group interviews with professional stakeholders. 10 The results indicated a risk of delayed, absent or unequal RTW processes 3 5 10 and people with a SCI needing to find their own paths towards work after injury. 4 This was due to a fragmented support, and inequalities depending on employment status at the time of injury.…”