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Owen HE, Wyeth EH, Maclennan B, Barson D, McBride P, Gabbe BJ, Civil I, Derrett S. Cohort profile: The Trauma Outcomes Project, a prospective study of New Zealanders experiencing major trauma. BMJ Open 2023; 13:e075480. [PMID: 38011969 PMCID: PMC10685924 DOI: 10.1136/bmjopen-2023-075480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE Patient-reported outcome measures (PROMs) are useful for trauma registries interested in monitoring patient outcomes and trauma care quality. PROMs had not previously been collected by the New Zealand Trauma Registry (NZTR). More than 2500 New Zealanders are admitted to hospital for major trauma annually. The Trauma Outcomes Project (TOP) collected PROMs postinjury from three of New Zealand's (NZ's) major trauma regions. This cohort profile paper aims to provide a thorough description of preinjury and 6 month postinjury characteristics of the TOP cohort, including specifically for Māori (Indigenous population in Aotearoa me Te Waipounamu/NZ). PARTICIPANTS Between July 2019 and June 2020, 2533 NZ trauma patients were admitted to one of 22 hospitals nationwide for major trauma and included on the NZTR. TOP invited trauma patients (aged ≥16 years) to be interviewed from three regions; one region (Midlands) declined to participate. Interviews included questions about health-related quality of life, disability, injury recovery, healthcare access and household income adequacy. FINDINGS TO DATE TOP recruited 870 participants, including 119 Māori. At 6 months postinjury, most (85%) reported that the injury still affected them, 88% reported problems with≥1 of five EQ-5D-5L dimensions (eg, 75% reported problems with pain or discomfort, 71% reported problems with usual activities and 52% reported problems with mobility). Considerable disability (World Health Organization Disability Assessment Schedule, WHODAS II, score ≥10) was reported by 45% of participants. The prevalence of disability among Māori participants was 53%; for non-Māori it was 44%. Over a quarter of participants (28%) reported trouble accessing healthcare services for their injury. Participation in paid work decreased from 63% preinjury to 45% 6 months postinjury. FUTURE PLANS The 12 and 24 month postinjury data collection has recently been completed; analyses of 12 month outcomes are underway. There is potential for longer-term follow-up interviews with the existing cohort in future. TOP findings are intended to inform the National Trauma Network's quality improvement processes. TOP will identify key aspects that aid in improving postinjury outcomes for people experiencing serious injury, including importantly for Māori.
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Affiliation(s)
- Helen E Owen
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Brett Maclennan
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - David Barson
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Paul McBride
- New Zealand Health Quality and Safety Commission, Wellington, New Zealand
| | - Belinda J Gabbe
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ian Civil
- New Zealand National Trauma Network, Wellington, New Zealand
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Timothy E, Bourke J, Dunn J, Martin R, Nunnerley J. United and flexible: a collaborative approach to early vocational rehabilitation on a spinal unit. A realist study. Spinal Cord Ser Cases 2023; 9:33. [PMID: 37443167 PMCID: PMC10344866 DOI: 10.1038/s41394-023-00587-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
STUDY DESIGN Qualitative study using realist review. OBJECTIVES To conceptualise how Early Intervention Vocational Rehabilitation (EIVR) functions within inpatient multidisciplinary contexts during spinal cord injury (SCI) rehabilitation. SETTING New Zealand Spinal Unit. METHODS People with newly acquired SCI and members of their rehabilitation team were observed in a range of rehabilitation sessions, team meetings and therapeutic interactions. Participants were also interviewed to explore how EIVR functioned alongside the multidisciplinary team (MDT). Interviews and observations were transcribed, coded and analysed using realist methods. RESULTS We identified three primary contexts which influenced how EIVR was delivered within the MDT: (1) a united approach, (2) a flexible approach, and (3) a hesitant approach. These contexts generated four work-related outcomes for people with SCI; enhanced work self-efficacy, strengthened hope for work, maintained work identity, and the less desirable outcome of increased uncertainty about work. CONCLUSIONS To optimise work outcomes for people after SCI, it is important to consider how EIVR is delivered and integrated within the wider MDT. Such an understanding can also inform the establishment of new EIVR services in different settings. Results suggest that unity, flexibility and clarity between EIVR services and the wider MDT are essential foundations for supporting people with SCI on their journey to employment. SPONSORSHIP This research was funded by Health Research Council NZ grant in partnership with Canterbury District Health Board.
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Affiliation(s)
- Emily Timothy
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand.
| | - John Bourke
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine | Te Tari Hāparapara me te Whaiora Ua-kāhiwi, University of Otago, Christchurch, New Zealand
| | - Rachelle Martin
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- Rehabilitation Teaching and Research Unit | Te Whare Whakamatūtū, University of Otago, Wellington, New Zealand
| | - Jo Nunnerley
- Burwood Academy | Hā-i-mano, Christchurch, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine | Te Tari Hāparapara me te Whaiora Ua-kāhiwi, University of Otago, Christchurch, New Zealand
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Cimino SR, Cadel L, Guilcher SJT, Wasilewski M, Hitzig SL. Social disconnectedness and perceived social isolation in persons with spinal cord injury/dysfunction living in the community: A scoping review. J Spinal Cord Med 2023; 46:367-389. [PMID: 36269865 PMCID: PMC10116929 DOI: 10.1080/10790268.2022.2129170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Context: Persons with spinal cord injury/dysfunction (SCI/D) are particularly at risk for social disconnectedness and/or perceived social isolation, which are key components to overall well-being. However, there is limited evidence that aims to understand these phenomena in this population.Objective: To investigate what is known about social disconnectedness and perceived social isolation for adults with SCI/D living in the community.Methods: A scoping review was conducted. A computer assisted search of four online databases was completed on all articles published until May 18th, 2021. Gray literature and key agencies were also searched for relevant documents. Two key concepts (spinal cord injury/dysfunction and social disconnectedness/perceived social isolation) and associated terms were used. All articles were double screened for inclusion by two reviewers.Results: Following deduplication, title and abstract screening and full-text screening, 37 articles met the criteria for inclusion in this review. Most of the included articles were published in North America, used quantitative methods and a cross-sectional design. Articles identified several factors that influenced social disconnectedness and perceived social isolation including participant characteristics, social support, psychological well-being, participation in activities, the built environment and physical health.Conclusion: The current literature suggests that issues with social disconnectedness and perceived social isolation exist for persons living with SCI/D in the community. More work is needed to better understand the relationship between these constructs. A more nuanced understanding can inform targeted interventions to help mitigate the impact of these phenomena on the SCI/D population.
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Affiliation(s)
- Stephanie R. Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Sara J. T. Guilcher
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Marina Wasilewski
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Farias L, Holmlund L, Asaba E. Stakeholders' Expectations of Return-to-Work After Spinal Cord Injury: A 1-Year Follow-Up. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:180-187. [PMID: 35574664 PMCID: PMC10021116 DOI: 10.1177/15394492221097355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Understanding the process of return-to-work is key to supporting people's social participation and health after a disability. This phenomenographic study aimed to explore the expectations and ways of understanding return-to-work from the perspectives of three stakeholder types: three workers with spinal cord injuries, their employers, and an occupational therapist coordinator. Participants were interviewed twice, at 6 and 12 months, after having participated in a research-based return-to-work intervention in Sweden. A phenomenographic approach was used to analyze the data. The findings highlight how stakeholders' different expectations prevented them from openly discussing more flexible arrangements to make return-to-work viable and sustainable. The study contributes to occupational therapy practice by raising awareness of the challenges of work reintegration. It also adds to the body of knowledge in occupational science by illuminating how normative social expectations and policy concerning work/productivity influence the return-to-work process.
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Affiliation(s)
| | | | - Eric Asaba
- Karolinska Institutet, Huddinge, Sweden.,Stockholms Sjukhem Foundation, Sweden
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Dunn JA, Martin RA, Hackney JJ, Nunnerley JL, Snell DL, Bourke JA, Young T, Hall A, Derrett S. Developing A Conceptual Framework for Early Intervention Vocational Rehabilitation for People Following Spinal Cord Injury. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:179-188. [PMID: 35927599 PMCID: PMC10025215 DOI: 10.1007/s10926-022-10060-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Early intervention vocational rehabilitation (EIVR) can improve return to work (RTW) outcomes for people with spinal cord injury (SCI). However, mechanisms explaining how and why EIVR works are not well understood. This study aims to develop a conceptual framework describing key mechanisms of EIVR intervention effect following SCI. METHODS We synthesised data from a realist literature review with data from interviews of people with SCI (n = 30), a survey of people with SCI who had received EIVR (n = 37), a focus group of EIVR providers and a focus group of community vocational providers. We first synthesised the literature review and interviews to develop an initial programme theory describing the contexts in which mechanisms are activated to produce EIVR outcomes. Then we used data from the survey and focus groups to further refine the EIVR programme theory. Finally, a conceptual framework was developed to support knowledge dissemination. RESULTS By ensuring consistent messaging across the multi-disciplinary team, EIVR programmes establish and maintain hope that work is possible following injury. Conversations about work allow individuals to determine the priority of work following injury. These conversations can also improve self-efficacy by providing individualized support to envisage pathways toward RTW goals and maintain worker identity. The synthesised study findings highlight the contexts and resources required to trigger activation of these mechanisms. CONCLUSIONS EIVR key mechanisms of effect are not specific to SCI as a health condition, therefore enabling this framework to be applied to other populations who face similar impairments and return to work barriers.
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Affiliation(s)
- Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand.
| | - R A Martin
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
| | - J J Hackney
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - J L Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - D L Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - J A Bourke
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, Queensland, Australia
- Ngāi Tahu Māori Health Research Unit, Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - T Young
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | - A Hall
- New Zealand Spinal Trust, Burwood Hospital, Christchurch, New Zealand
| | - S Derrett
- Ngāi Tahu Māori Health Research Unit, Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Martin RA, Nunnerley JL, Young T, Hall A, Snell DL, Hackney JJ, Bourke JA, Derrett S, Dunn JA. Vocational wayfinding following spinal cord injury: In what contexts, how and why does early intervention vocational rehabilitation work? JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early intervention vocational rehabilitation (EIVR) is used to optimize return to work (RTW) outcomes for people following spinal cord injury (SCI). However, theoretical clarity is required about how EIVR works, for whom and under what circumstances. OBJECTIVE: To develop a theoretical understanding of how people respond to EIVR following SCI and the contexts in which mechanisms of intervention effect are likely to be activated. METHODS: Realist research methods were used to analyze interviews with 30 participants who had received EIVR following SCI. RESULTS: We conceptualized the reporting of our analyses using a travel metaphor, encapsulating the types and degree of wayfinding support participants required to think about, plan and action their vocational aspirations. Developing, maintaining and enacting hope, supporting self-identity and vocational identity, and focusing on environmental context adaptations required to enact vocational aspirations, appear to be critical mechanisms of intervention effect within EIVR. CONCLUSIONS: Various contexts and mechanisms of EIVR contribute to successful negotiation, achievement and sustainability of RTW outcomes for people following SCI. These theoretical understandings can refine EIVR service provision within SCI rehabilitation and inform how EIVR can improve RTW outcomes for people with acquired neurological conditions in other rehabilitation contexts.
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Affiliation(s)
- Rachelle A. Martin
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington South, New Zealand
| | - Joanne L. Nunnerley
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Deborah L. Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - John A. Bourke
- Burwood Academy Trust, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, QL, Australia
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jennifer A. Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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A mixed-methods study exploring and comparing the experiences of people who sustained a spinal cord injury earlier versus later in life. Spinal Cord 2022; 60:706-711. [PMID: 35169302 DOI: 10.1038/s41393-022-00767-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Mixed-methods. OBJECTIVES (1) To explore psychosocial and quality of life outcomes between those injured early versus later in life, and (2) to explore their post-injury experiences. SETTING GF Strong Rehabilitation Centre, Vancouver, Canada. METHODS For this community-based study, we recruited individuals with SCI (>55 years of age) who were either injured between the ages of 15-30 (n = 15) or after the age of 50 (n = 15). We collected quantitative data about participants' sociodemographics and participants completed standardised questionnaires assessing personal factors, environmental factors, life habits, and quality of life. An independent samples t test was performed for continuous variables and the Chi-square test was conducted for the categorical variables. Qualitative data were collected via semi-structured interviews. Thematic content analysis was performed on the interview transcripts. RESULTS We found no statistically significant differences between the two groups on any of the psychosocial outcomes. However, those injured later in life were significantly more likely to be female, have a higher income, and live in residential care. We identified three main qualitative themes that were consistent across the two groups: 'dealing with health and changes in occupation', 'enacting interdependence', and 'living in the community'. Some sub-themes varied between groups. CONCLUSIONS To facilitate better rehabilitation, clinicians need to be aware of disparities among people with SCI relating to age of injury. Across age cohorts, it is important to increase independence, provide greater support when entering or returning to the workforce, and reduce societal stigma.
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Dunn JA, Hackney JJ, Martin RA, Tietjens D, Young T, Bourke JA, Snell DL, Nunnerley JL, Hall A, Derrett S. Development of a Programme Theory for Early Intervention Vocational Rehabilitation: A Realist Literature Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:730-743. [PMID: 34524575 DOI: 10.1007/s10926-021-10000-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
Purpose Little is currently known about how early intervention vocational rehabilitation (EIVR) works for people with newly acquired neurological conditions such as traumatic brain injury, acquired brain injury and spinal cord injury. This study aims, from a realist framework, to identify relevant literature and develop an initial programme theory to understand how EIVR might work for people experiencing acquired neurological disability. Realist reviews are ideally placed to address the identified knowledge gap as they assist in gaining a deeper understanding of how the intervention works, for whom it works best, and the contexts that promote the activation of desired outcomes. Methods We used a seven-step iterative process to synthesise literature using a realist approach. The steps included: development of initial programme theory, literature search, article selection, extracting and data organising, synthesis of evidence and programme theory refinement. We performed a literature search using the following databases: Cinahl, Embase, EMcare, Medline, PsychInfo and Scopus. Articles were selected if they contributed to the knowledge describing what is EIVR and how it works in newly acquired neurological conditions. Data were extracted and synthesised to develop a programme theory for EIVR. Results Following screening of 448 references, 37 documents were eligible for data extraction. We developed a refined programme theory of EIVR consisting of three contexts (prioritisation of exploring work options, return to work discussed as an option, and workplace support), nine mechanisms (ensuring rehabilitation teams' culture, fostering hope, exploring options, optimising self-efficacy, maintaining worker identity, staying connected, setting goals, engaging employer, and flexing roles) and three outcomes (confidence in ability to work, psychological adjustment, and engagement in solution focussed options). Conclusions This appears to be the first paper to explore how EIVR works, for whom and in what situations. We have produced a programme theory that may provide an initial understanding of EIVR following acquired neurological conditions.
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Affiliation(s)
- Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.
| | | | - Rachelle A Martin
- Burwood Academy Trust, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Donna Tietjens
- Wellington Medical and Health Sciences Library, University of Otago, Wellington, Wellington, New Zealand
| | | | - John A Bourke
- Burwood Academy Trust, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Deborah L Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
| | - Joanne L Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand
- Burwood Academy Trust, Christchurch, New Zealand
| | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Sarah Derrett
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Snell DL, Hackney JJ, Maggo J, Martin RA, Nunnerley JL, Bourke JA, Hall A, Derrett S, Dunn JA. Early vocational rehabilitation after spinal cord injury: A survey of service users. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-211166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early vocational rehabilitation following spinal cord injury (SCI) improves return to work (RTW) outcomes, but there is limited information about who benefits from such interventions, why and in what contexts. OBJECTIVE: We aimed to describe demographic and clinical characteristics and RTW outcomes of adults with SCI who received early vocational rehabilitation. We sought to identify key mechanisms of early vocational rehabilitation. METHODS: This is a cross-sectional survey of people with SCI recruited from the New Zealand Spinal Trust Vocational Rehabilitation Service, who had sustained an SCI within the previous five years. RESULTS: Of the 37 people who responded to the survey, 54% returned to paid work (90% of whom retained their pre-injury employment). Those in autonomous roles returned to work faster with greater odds of returning to their pre-injury employer and role. Participants highlighted the importance of feeling hopeful about RTW while still in the spinal unit as a key mechanism of effect within the early vocational intervention. CONCLUSIONS: Findings suggested key mechanisms of early vocational intervention could be framed by models of hope. However, for gains to be optimised, continuity of support beyond the acute stage was suggested as an area for future research.
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Affiliation(s)
- Deborah L. Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - Jasjot Maggo
- Burwood Academy of Independent Living, Christchurch, New Zealand
| | - Rachelle A. Martin
- Burwood Academy of Independent Living, Christchurch, New Zealand
- Department of Medicine, University of Otago Wellington, Wellington South, New Zealand
| | - Joanne L. Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
- Burwood Academy of Independent Living, Christchurch, New Zealand
| | - John A. Bourke
- Burwood Academy of Independent Living, Christchurch, New Zealand
- Menzies Health Institute, Griffith University, Queensland, Australia
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew Hall
- New Zealand Spinal Trust, Christchurch, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jennifer A. Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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Cimino SR, Hitzig SL, Craven BC, Bassett-Gunter RL, Li J, Guilcher SJT. An exploration of perceived social isolation among persons with spinal cord injury in Ontario, Canada: a qualitative study. Disabil Rehabil 2020; 44:3400-3409. [PMID: 33356633 DOI: 10.1080/09638288.2020.1861485] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To advance the understanding of perceived social isolation among persons with spinal cord injury (SCI), the objectives of the present study were to explore: (1) experiences of perceived social isolation and (2) factors that contribute to perceived social isolation. METHODS Interpretive description qualitative methodology was used to conduct semi-structured interviews with 30 individuals with SCI from across Ontario (Canada) from November 2016 to August 2017. Data were analyzed using thematic analysis. RESULTS Participants identified disruption to social networks that seemed to impact perceived social isolation. Five major themes were identified: (1) impact on structure and frequency of social network; (2) importance of feeling heard; (3) importance of employment, hobbies, and sports; (4) need to improve physical accessibility and built environment; and (5) individual characteristics. Changes in quality of social networks, rather than size, contributed to greater feelings of perceived social isolation. The built environment, maintenance of employment, hobbies, and sports, social media, and technology use, as well as individual traits, were also found to impact perceived social isolation. CONCLUSION Future research should focus on the development of programs to help maintain or improve social network quality for persons with SCI to minimize the impact of perceived social isolation.IMPLICATIONS FOR REHABILITATIONPerceived social isolation, resulting from physical and environmental barriers, is a challenge that is faced by many individuals who are living in the community with a spinal cord injury (SCI).Rehabilitation and community programs should utilize an individualized approach to find solutions to challenges faced by this population to prevent the effects of perceived social isolation.Education on how to adapt to changes in social network, together with the provision of access to peer-to-peer support groups, and SCI specific return to work or leisure programs, is recommended as an essential component of rehabilitation.
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Affiliation(s)
- Stephanie R Cimino
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, Faculty of Medicine,, University of Toronto, Toronto, Canada
| | - B Catharine Craven
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Neural Engineering & Therapeutics Team, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Joyce Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
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11
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Lee M, Choi Y, Lee EY, Kim DA, Ho SH. Life Experiences with Using Community Care among People with Severe Physical Disabilities: A Comparative Analysis between South Korea and Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9195. [PMID: 33317015 PMCID: PMC7764412 DOI: 10.3390/ijerph17249195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/02/2020] [Accepted: 12/05/2020] [Indexed: 12/02/2022]
Abstract
This study identified the pathways chosen by people with severe physical disabilities (PWSPD) in South Korea and Japan in using community care throughout their life and compared their experiences while navigating these pathways from their perspective. A concurrent nested mixed-method design was adopted. Quantitative data analysis included pathway mapping of facilities and services used throughout their lives. For qualitative data, interpretative phenomenological analysis (IPA) was applied. Eleven South Korean (congenital 7, acquired 4) and nine Japanese (congenital 6, acquired 3) participants were surveyed and interviewed. Pathway mapping was conducted by classifying the participants into focus groups. South Korean participants took nine years more than the Japanese participants to reach independence and showed different pathway characteristics. Superordinate themes from the IPA provided insight into the differences in experiences between PWSPD of the two countries: (1) accessibility and continuity of medical services; (2) experience of vocational training; (3) way and degree of social support for independent living; (4) care planning for receiving comprehensive services. In developing a community care model for the PWSPD to accelerate their time to independence, the government should strive for accessibility and connectivity of medical services, strengthen vocational training, social support for independent living, and information provision for the PWSPD.
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Affiliation(s)
- Minyoung Lee
- Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, Seoul 01022, Korea; (M.L.); (Y.C.); (E.Y.L.)
| | - Yeji Choi
- Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, Seoul 01022, Korea; (M.L.); (Y.C.); (E.Y.L.)
| | - Eun Young Lee
- Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, Seoul 01022, Korea; (M.L.); (Y.C.); (E.Y.L.)
| | - Dong-A Kim
- Division of Public Medical Rehabilitation, National Rehabilitation Center, Seoul 01022, Korea;
| | - Seung Hee Ho
- Department of Healthcare and Public Health Research, National Rehabilitation Research Institute, Seoul 01022, Korea; (M.L.); (Y.C.); (E.Y.L.)
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Holmlund L, Guidetti S, Hultling C, Seiger Å, Eriksson G, Asaba E. Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury. BMJ Open 2020; 10:e036000. [PMID: 32819984 PMCID: PMC7443280 DOI: 10.1136/bmjopen-2019-036000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility of: (1) ReWork-SCI with regard to adherence and acceptability and (2) a study design for evaluating ReWork-SCI with regard to recruitment, retention and outcome measures. DESIGN Pre-test and post-test, single group, feasibility study. SETTING Spinal cord injury (SCI) unit at a regional rehabilitation centre in Sweden. PARTICIPANTS Two women and five men (n=7). Eligible criteria: (1) sustained traumatic or non-traumatic SCI; (2) completed the first acute care episode in a hospital; (3) between 18 to 65 years of age; (4) assessed by a physician as approachable for participation in the intervention; (5) history of permanent or temporary employment; (6) self-reported desire to return to work; and (7) ability to communicate in English or Swedish. INTERVENTION ReWork-SCI is a person-centred intervention for return-to-work (RTW), developed and evaluated using the Medical Research Council's guidelines. ReWork-SCI follows a person-centred, structured and coordinated intervention process led by a coordinator within a SCI rehabilitation team. OUTCOME MEASURES The feasibility of ReWork-SCI and a study design was evaluated using a set of outcome measurement tools, vocational data, logbooks and semi-structured interviews. RESULTS All eligible participants accepted enrolment and follow-up. All participants had a plan for RTW after 3 months and four participants had initiated part-time work or work trial 6 months after commencement of intervention. Adherence and acceptability were overall good. Challenges of the intervention related to the person-centred follow-up, staff shortage and rootedness in the SCI team. CONCLUSIONS ReWork-SCI was feasible and can contribute to a systematic design of an individualised plan, facilitate decision-making and build trust in the RTW process after SCI. Core features of the intervention was the systematic structure, use of a person-centred approach and dialogue with the employer. For the effectiveness of ReWork-SCI, modifications and considerations of study design are needed.
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Affiliation(s)
- Lisa Holmlund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Rehab Station Stockholm/Spinalis, R&D Unit, Rehab Station Stockholm, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Claes Hultling
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Neurology, Karolinska Universitetssjukhuset, Solna, Sweden
| | - Åke Seiger
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Rehab Station Stockholm/Spinalis, R&D Unit, Rehab Station Stockholm, Stockholm, Sweden
| | - Gunilla Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Research, Education, and Development Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden
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13
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Holmlund L, Guidetti S, Eriksson G, Asaba E. Return-to-work: Exploring professionals' experiences of support for persons with spinal cord injury. Scand J Occup Ther 2020; 28:571-581. [PMID: 32755475 DOI: 10.1080/11038128.2020.1795245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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 = 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 category - mediating intentions to support work and possibilities of working through social, labour market, and societal context - illustrates 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 work - uncertainty of how and when; (2) Planning RTW - divide between dynamic and rule-based perspectives; (3) Work re-entry - unequal 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 direction - grounded in an occupational perspective - through 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.
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Affiliation(s)
- Lisa Holmlund
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Spinalis SCI Unit, Rehab Station Stockholm, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Gunilla Eriksson
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Research, Education, and Development Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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14
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Bloom J, Dorsett P, McLennan V. Vocational rehabilitation to empower consumers following newly acquired spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre, Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
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15
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16
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Lambert M, Wyeth EH, Brausch S, Harwood MLN, Anselm D, Wright-Tawha T, Metzger B, Ellison P, Derrett S. "I couldn't even do normal chores": a qualitative study of the impacts of injury for Māori. Disabil Rehabil 2019; 43:2424-2430. [PMID: 31846590 DOI: 10.1080/09638288.2019.1701102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS To investigate the rehabilitation experiences of Māori who were still reporting disability 24 months after an injury resulting in hospitalisation. METHODS Participants had been hospitalised for an Accident Compensation Corporation (New Zealand's no-fault injury compensation insurer) entitlement claim injury between 2007 and 2009, and were experiencing disability 24 months post-injury. In-depth kanohi ki te kanohi (face-to-face) qualitative interviews with 12 participants aged between 37 and 71 years at the time of interviews were conducted. Interpretive analyses of interview transcripts, focused on the impacts of injury was conducted with the aid of NVivo software. RESULTS The overarching theme identified during the analysis was "Impact" with four sub-themes of: Impact on daily life; Impact on relationships, Impact on employment; and, long-term or ongoing impacts. CONCLUSIONS For Māori living with disability 24 months after hospitalisation for injury, adjusting to life after the injury and the rehabilitation process was challenging. Participants discussed frustration with feeling dependent on others, being bored and feeling unfulfilled after their injury, and that many aspects of their lives were impacted on and not always in the expected directions. Many reported longer lasting impacts even after rehabilitation was completed. Implications for rehabilitation programmes e.g., strengthening programmes by taking into account issues discussed by participants, recognising the long-term impacts on both those injured and their whānau (family), and further investigations required are also discussed.IMPLICATIONS FOR REHABILITATIONDisability after injury can have long term impacts for injured Māori and their relationships.Social impacts can be perceived as more debilitating than the physical impacts after injury.Experiences of employment changes and future prospects are often difficult to navigate for Māori returning to work after an injury.
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Affiliation(s)
- Michelle Lambert
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Shawnee Brausch
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Matire L N Harwood
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Deborah Anselm
- Accident Compensation Corporation of New Zealand, Wellington, New Zealand
| | | | - Barbara Metzger
- Ngā Kete Mātauranga Pounamu Charitable Trust, Invercargill, New Zealand
| | - Peter Ellison
- WellSouth Primary Health Network, Dunedin, New Zealand
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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17
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Dorsett P, McLennan V. Exploring the ‘status quo’ in vocational rehabilitation and employment outcomes following spinal cord injury. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-180995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pat Dorsett
- School of Human Services and Social Work, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Queensland, Australia
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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18
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Bloom J, McLennan V, Dorsett P. Occupational bonding after spinal cord injury: A review and narrative synthesis. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-180992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Vanette McLennan
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, QLD, Australia
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19
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Holmlund L, Hultling C, Asaba E. Mapping Out One's Own Paths Toward Work: Focus on Experiences of Return to Work After Spinal Cord Injury. QUALITATIVE HEALTH RESEARCH 2018; 28:2020-2032. [PMID: 29911499 DOI: 10.1177/1049732318782706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Involving persons with spinal cord injury (SCI) as experts in their lives is important for research to design relevant health care interventions. The purpose of this study was to use photovoice methods to explore experiences of barriers and possibilities in return to work among working adults with SCI. The photovoice group consisted of six persons living with SCI that met weekly over 2 months to share and discuss photos related to return to work. Five themes were identified: (a) there is only one way, (b) welcome back-or not, (c) to be like anyone else-or to be perceived as someone else, (d) friction in the absence of clarity, and (e) finding integrated strategies for everyday life with work. Work was experienced as rewarding and viable, but due to lack of societal and workplace support, a need to map out one's own paths toward work was identified.
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Affiliation(s)
- Lisa Holmlund
- 1 Karolinska Institutet, NVS, Huddinge, Sweden
- 2 Rehab Station Stockholm, Sweden
| | - Claes Hultling
- 1 Karolinska Institutet, NVS, Huddinge, Sweden
- 2 Rehab Station Stockholm, Sweden
- 3 Karolinska University Hospital, Solna, Sweden
| | - Eric Asaba
- 1 Karolinska Institutet, NVS, Huddinge, Sweden
- 4 Stockholms Sjukhem Foundation, Stockholm, Sweden
- 5 Tokyo Metropolitan University, Tokyo, Japan
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20
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Bloom J, Dorsett P, McLennan V. Investigating employment following spinal cord injury: outcomes, methods, and population demographics. Disabil Rehabil 2018; 41:2359-2368. [DOI: 10.1080/09638288.2018.1467968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Julia Bloom
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
| | - Vanette McLennan
- The Hopkins Centre: Research for Rehabilitation and Resilience Menzies Health Institute Queensland, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
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21
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Cotner BA, Ottomanelli L, O'Connor DR, Njoh EN, Barnett SD, Miech EJ. Quality of Life Outcomes for Veterans With Spinal Cord Injury Receiving Individual Placement and Support (IPS). Top Spinal Cord Inj Rehabil 2018; 24:325-335. [PMID: 30459495 DOI: 10.1310/sci17-00046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Individual Placement and Support (IPS) is an evidence-based practice that helps persons with mental and/or physical disabilities, including spinal cord injury, find meaningful employment in the community. While employment is associated with positive rehabilitation outcomes, more research is needed on the impact of IPS participation on non-vocational outcomes, particularly quality of life (QOL). Objective: To identity QOL outcomes experienced with (1) IPS participation and (2) IPS participation leading to employment. Methods: Using a mixed method design, data on quality of life outcomes were collected from 151 interviews and 213 surveys completed by veterans with SCI participating in IPS. Results: At 12 months, participants who obtained competitive employment (CE) and those who did not (no-CE) showed improvement on most measures. In months 12-24, the CE group showed improvements on all study measures while the no-CE group declined on many indices. Statistically significant changes were observed between participants who obtained CE versus no-CE on several measures. Themes were identified from interview data related to productivity and well-being. Productivity themes were (1) contributing to society, (2) earning an income, and (3) maintaining employment. Themes for well-being were (1) mental health/self-confidence, (2) physical health, and (3) goal setting. Themes were associated with IPS participation irrespective of employment outcomes. Conclusion: IPS participants who were competitively employed report consistent improvement in handicap, health-related QOL, and life satisfaction measures across time. Qualitative findings revealed improved QOL outcomes in productivity and well-being for veterans participating in IPS overall, regardless of employment outcomes.
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Affiliation(s)
- Bridget A Cotner
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida.,Department of Anthropology, University of South Florida, Tampa, Florida
| | - Lisa Ottomanelli
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida.,Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, Florida
| | - Danielle R O'Connor
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida
| | - Eni N Njoh
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida
| | - Scott D Barnett
- VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida
| | - Edward J Miech
- VA HSR&D Center for Health Information & Communication, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.,VA Health Services Research and Development (HSR&D) PRISM QUERI, Indianapolis, Indiana.,Regenstrief Institute, Indianapolis, Indiana.,Department of Emergency Medicine & Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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22
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Hilton G, Unsworth CA, Stuckey R, Murphy GC. The experience of seeking, gaining and maintaining employment after traumatic spinal cord injury and the vocational pathways involved. Work 2018; 59:67-84. [DOI: 10.3233/wor-172660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Gillean Hilton
- Central Queensland University, Melbourne, VIC, Australia
- Austin Health, Melbourne, VIC, Australia
| | - Carolyn A. Unsworth
- Central Queensland University, Melbourne, VIC, Australia
- Jonkoping University, Jonkoping, Sweden
- Curtin University, Perth, WA, Australia
- La Trobe University, Melbourne, VIC, Australia
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23
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The meaning of work after spinal cord injury: a scoping review. Spinal Cord 2017; 56:92-105. [PMID: 29057988 DOI: 10.1038/s41393-017-0006-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Scoping review. OBJECTIVES To explore the meaning of work after spinal cord injury (SCI) in existing literature. METHODS Arksey and O'Malley's widely used methodological framework for scoping reviews was used to guide this review. Studies involving adults with SCI, conducted using qualitative methods, and published in peer reviewed literature were identified based on key terms and searches in three databases (CINAHL, MEDLINE, PsycINFO). Further search steps included checking citations in identified articles and citation tracking for other relevant articles and reviews. Reported qualitative data were then thematically analysed to generate themes. RESULTS Twelve studies were included. Three themes were identified across these studies that describe the meanings of work after spinal cord injury: re-developing a sense of self, re-establishing place in the community and regaining economic self-sufficiency. CONCLUSIONS The varied meanings of work after SCI identified in this review may be used in rehabilitation programs to explore ideas about work, the types of work they wish to pursue, and the ways in which work may be meaningful for people with SCI, so as to identify individually and contextually relevant work. Taking account of meaning in ICF based models of work participation could enhance patient-centred approaches in SCI rehabilitation.
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24
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Marti A, Escorpizo R, Schwegler U, Staubli S, Trezzini B. Employment pathways of individuals with spinal cord injury living in Switzerland: A qualitative study. Work 2017; 58:99-110. [DOI: 10.3233/wor-172617] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Albert Marti
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Reuben Escorpizo
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, USA
| | - Urban Schwegler
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | | | - Bruno Trezzini
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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Svendby R, Romsland GI, Moen K. The language of percentages: ranking bodies, shaping realities, and limiting opportunities. Disabil Rehabil 2017; 41:382-388. [DOI: 10.1080/09638288.2017.1390789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rannveig Svendby
- Centre for Gender Research and Department of Community Medicine, University of Oslo, Oslo, Norway
| | | | - Kåre Moen
- Department of Community Medicine, University of Oslo, Oslo, Norway
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Amsters D, Duncan J, Field V, Smales A, Zillmann L, Kendall M, Kuipers P. Determinants of participating in life after spinal cord injury - advice for health professionals arising from an examination of shared narratives. Disabil Rehabil 2017; 40:3030-3040. [PMID: 28835181 DOI: 10.1080/09638288.2017.1367425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore the perceived determinants of participation in life after spinal cord injury and incorporate these into a framework for the promotion of participation suitable for use by rehabilitation professionals. METHOD Four people with spinal cord injury and one health service researcher engaged in a process of sharing narratives of life after spinal cord injury over a period of one year. The narratives were distilled using thematic analysis. RESULTS The relevant subset of data from the narratives categorized as This is what we think determines our participation in life was analyzed in depth to reveal nine themes (1) The world can be my friend or foe; (2) I am who I am; (3) It is a personal journey; (4) Some like to talk, others like to do; (5) We have the technology; (6) A support network is vital and it can be built; (7) Life involves tradeoffs; (8) Push; and (9) Be flexible. These themes were combined into a framework for the promotion of participation to be used by rehabilitation professionals. The collaboratively developed framework has three aspects - Help me, Encourage me and Accept. CONCLUSION The proposed participation promotion framework is grounded in the narratives of the research group but needs to be tested before it can be endorsed for practice. Implications for Rehabilitation In order to promote participation in life after spinal cord injury rehabilitation professionals can help people with spinal cord injury to negotiate the world, build and maintain a support crew and access equipment and technology. Spinal cord injury rehabilitation professionals can encourage people with spinal cord injury to push themselves, be assertive and be flexible, as these attributes can assist participation in life after spinal cord injury. In the pursuit of participation goals, rehabilitation professionals must accept the individuality of each person with spinal cord injury, respect that they may or may not be willing to make tradeoffs to achieve participation goals and that they are on an ever changing life journey.
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Affiliation(s)
- Delena Amsters
- a Spinal Outreach Team , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia
| | - James Duncan
- b Spinal Cord Injury Opinion Leader Panel , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia
| | - Victoria Field
- b Spinal Cord Injury Opinion Leader Panel , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia
| | - Alastair Smales
- b Spinal Cord Injury Opinion Leader Panel , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia
| | - Leanne Zillmann
- b Spinal Cord Injury Opinion Leader Panel , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia
| | - Melissa Kendall
- c Transitional Rehabilitation Program , Queensland Spinal Cord Injuries Service, Princess Alexandra Hospital , Brisbane , Australia.,d Menzies Health Institute Queensland, Griffith University , Brisbane , Australia
| | - Pim Kuipers
- d Menzies Health Institute Queensland, Griffith University , Brisbane , Australia.,e Centre for Functioning and Health Research , Princess Alexandra Hospital , Brisbane , Australia
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Holmlund L, Guidetti S, Eriksson G, Asaba E. Return to work in the context of everyday life 7-11 years after spinal cord injury - a follow-up study. Disabil Rehabil 2017; 40:2875-2883. [PMID: 28793801 DOI: 10.1080/09638288.2017.1362597] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this follow-up study was to explore experiences of return to work in the context of everyday life among adults 7-11 years after spinal cord injury (SCI). METHODS This study used in-depth interviews and observations in a qualitative design with eight persons who had previously been interviewed in 2008. A narrative approach was used during data gathering and analysis. RESULTS Return to work was experienced as something constantly needing to be negotiated in the context of everyday life. Several years after SCI expectations for work and perceptions of possibilities for meaningful work had changed. Five main themes were identified through the analysis, (1) negotiating the possibilities of working, (2) hope for future work tempered with concern, (3) education as a possible path to employment, (4) paths toward return to work in light of unmet support, and (5) unpaid occupations grounded in interest and competence. CONCLUSIONS Persons who have no higher education or lack viable employment to return to after SCI seem to be vulnerable in return to work. Early and timely interventions tailored to the person's interests and competencies, in which the rehabilitation team has a distinct coordinating role, are thus critical in return to work. Implications for Rehabilitation Tensions between hope and expectations for work and unmet needs of support can lead to barriers in return to work, particularly for those who have no higher education or lack employment to return to after spinal cord injury. Rehabilitation after spinal cord injury can benefit from focus on how the balance of work fits into routines in the context of everyday life. Early and timely interventions integrating the person's interests and competencies in return to work after spinal cord injury in combination with having a health care provider who has a distinct coordinating role are critical.
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Affiliation(s)
- Lisa Holmlund
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden.,b Spinalis SCI Unit , Rehab Station Stockholm , Stockholm , Sweden
| | - Susanne Guidetti
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden
| | - Gunilla Eriksson
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden.,c Department of Neuroscience, Rehabilitation Medicine , Uppsala University , Uppsala , Sweden
| | - Eric Asaba
- a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden.,d Research, Education, and Development Unit , Stockholms Sjukhem Foundation , Stockholm , Sweden.,e Department of Occupational Therapy, Graduate School of Human Health Sciences , Tokyo Metropolitan University , Tokyo , Japan
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Dwyer K, Mulligan H. The experiences of individuals with a spinal cord injury following discharge from inpatient rehabilitation. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.8.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kathryn Dwyer
- Postgraduate student School of Physiotherapy, University of Otago, New Zealand; Physiotherapist, Home Action Team (Division of Laura Fergusson Trust), Christchurch, New Zealand
| | - Hilda Mulligan
- Senior Lecturer, School of Physiotherapy, University of Otago, New Zealand
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Hilton G, Unsworth C, Murphy G. The experience of attempting to return to work following spinal cord injury: a systematic review of the qualitative literature. Disabil Rehabil 2017; 40:1745-1753. [PMID: 28395535 DOI: 10.1080/09638288.2017.1312566] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?" METHODS Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question. RESULTS Data from nine papers were included in the thematic synthesis. Several descriptive themes and three analytical themes were drawn from the data to answer the research question. Analytical themes included: a matrix of personal and environmental factors exists requiring complex navigation in order to create possibilities and opportunities for postinjury employment; the process of seeking or gaining employment shares a reciprocal relationship with the temporal nature of adjustment to spinal cord injury; and there is an intrinsic need for occupational engagement through paid employment. CONCLUSIONS Returning to or gaining employment after spinal cord injury is a fundamentally difficult experience for people. Multiple strategies are required to support the navigation of the process. There is, however, a need in people with spinal cord injury, to be a worker, and with that comes the inherent benefits of being employed. Implications for rehabilitation Returning to work should be a significant focus of spinal cord injury rehabilitation. Employment is both possible and health promoting following spinal cord injury. Multiple strategies are required to support people to navigate the return to work process. It is important to be cognizant of the individual motivations for being a worker and the complexity of the adjustment process. Spinal cord injury centers can provide a consistent and supportive framework and culture of positivity about employment after spinal cord injury.
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Affiliation(s)
- Gillean Hilton
- a Department of Occupational Therapy , Central Queensland University , Melbourne , Australia.,b Victorian Spinal Cord Service , Austin Health , Melbourne , Australia
| | - Carolyn Unsworth
- a Department of Occupational Therapy , Central Queensland University , Melbourne , Australia.,c School of Health and Welfare , Jönköping University , Jönköping , Sweden.,d School of Occupational Therapy , Curtin University , Perth , Australia.,e School of Public Health La Trobe University , Melbourne , Australia
| | - Gregory Murphy
- e School of Public Health La Trobe University , Melbourne , Australia
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Bloom J, Dorsett P, McLennan V. Integrated services and early intervention in the vocational rehabilitation of people with spinal cord injuries. Spinal Cord Ser Cases 2017; 3:16042. [PMID: 28382213 DOI: 10.1038/scsandc.2016.42] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/27/2016] [Accepted: 12/12/2016] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The design was a narrative review. The objective of the study was to investigate the potential for early vocational rehabilitation (VR) interventions for people with spinal cord injury (SCI) in overcoming barriers in returning to work, and to pinpoint factors contributing to effectiveness in early VR intervention for this population. The setting was at Queensland, Australia. MATERIALS AND METHODS Synthesis of the findings of a literature search of online databases ProQuest and CINAHL, using keywords relating to the employment situation and VR of people with SCI. Themes were identified and analysed in accordance with the research objectives. RESULTS Despite increasing government commitment to the workforce and social participation of people with disabilities, Australians living with SCI have significantly diminished employment outcomes compared with the general population. Current VR approaches usually do not commence until some months post discharge, potentially missing a window of opportunity to preserve pre-existing employment or assist in vocational decision making. The review found that there are opportunities for enhancing VR service provision following SCI, namely integrating the VR programme within the primary rehabilitation team thus facilitating early VR intervention. DISCUSSION Emerging evidence shows promising results for early intervention in VR; however, questions remain regarding ideal intervention approaches, and it is clear that further empirical investigation is required to support the use of early intervention models post SCI. The study was sponsored by Motor Accident Insurance Commission (MAIC).
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Affiliation(s)
- Julia Bloom
- School of Allied Health, Griffith University , Meadowbrook, Queensland, Australia
| | - Pat Dorsett
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia; Menzies Health Institute, Queensland, Australia
| | - Vanette McLennan
- School of Allied Health, Griffith University, Meadowbrook, Queensland, Australia; Menzies Health Institute, Queensland, Australia
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Hilton G, Unsworth CA, Murphy GC, Browne M, Olver J. Longitudinal employment outcomes of an early intervention vocational rehabilitation service for people admitted to rehabilitation with a traumatic spinal cord injury. Spinal Cord 2017; 55:743-752. [DOI: 10.1038/sc.2017.24] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 02/02/2017] [Accepted: 02/07/2017] [Indexed: 11/09/2022]
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Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation. Rehabil Res Pract 2017; 2016:9373786. [PMID: 28127471 PMCID: PMC5227179 DOI: 10.1155/2016/9373786] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/20/2016] [Accepted: 11/16/2016] [Indexed: 11/22/2022] Open
Abstract
Interpersonal interactions and relationships can influence an individual's perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.
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Nordgren L, Söderlund A. Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: a cross-sectional study of people with heart failure. BMJ Open 2016; 6:e009896. [PMID: 28186921 PMCID: PMC5129055 DOI: 10.1136/bmjopen-2015-009896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To live with heart failure means that life is delimited. Still, people with heart failure can have a desire to stay active in working life as long as possible. Although a number of factors affect sick leave and rehabilitation processes, little is known about sick leave and vocational rehabilitation concerning people with heart failure. This study aimed to identify emotions and encounters with healthcare professionals as possible predictors for the self-estimated ability to return to work in people on sick leave due to heart failure. DESIGN A population-based cross-sectional study design was used. SETTING The study was conducted in Sweden. Data were collected in 2012 from 3 different sources: 2 official registries and 1 postal questionnaire. PARTICIPANTS A total of 590 individuals were included. STATISTICS Descriptive statistics, correlation analysis and linear multiple regression analysis were used. RESULTS 3 variables, feeling strengthened in the situation (β=-0.21, p=0.02), feeling happy (β=-0.24, p=0.02) and receiving encouragement about work (β=-0.32, p≤0.001), were identified as possible predictive factors for the self-estimated ability to return to work. CONCLUSIONS To feel strengthened, happy and to receive encouragement about work can affect the return to work process for people on sick leave due to heart failure. In order to develop and implement rehabilitation programmes to meet these needs, more research is needed.
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Affiliation(s)
- Lena Nordgren
- Centre for Clinical Research in Sörmland/Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Callander EJ, Lloyd C. Lifetime impact of injury on education, employment and income for Australians of labour force participation age. Occup Med (Lond) 2016; 66:607-613. [PMID: 27412427 DOI: 10.1093/occmed/kqw083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Research shows that employment rates are low post injury. AIMS To quantify the economic impact of a long-term injury and identify whether having a tertiary level of education attainment would offset this impact. METHODS Cross-sectional analysis of the 2012 Survey of Disability, Aging and Carers, which is nationally representative of the Australian population. RESULTS Males with any long-term injury had incomes 41% less than males with no chronic health condition (95% confidence interval [CI] -49.3%, -31.6%). For males with a long-term injury, there was no significant difference in the likelihood of being not in the labour force between those with and without a tertiary qualification (odds ratio [OR] 0.83, 95% CI 0.45-1.52). There was no significant difference in the incomes of females with any long-term injury compared with those with no chronic health conditions. For females with a long-term injury, there was a significant difference in the likelihood of being not in the labour force between those with and without a tertiary qualification (OR 0.37, 95% CI 0.17-0.80). If men with a long-term injury had the same probability of participating in the workforce as women, the percentage of men not in the labour force would reduce from 37 to 18%. CONCLUSIONS Having a long-term injury was a significant personal cost in terms of labour force absence and lower income for males regardless of higher education attainment. For females, sustaining a long-term injury did not appear to significantly affect income.
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Affiliation(s)
- E J Callander
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland 4811, Australia
| | - C Lloyd
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4811, Australia
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Nunnerley J, Dunn J, McPherson K, Hooper G, Woodfield T. Return to work for severely injured survivors of the Christchurch earthquake: influences in the first 2 years. Disabil Rehabil 2015. [PMID: 26213243 DOI: 10.3109/09638288.2015.1070299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study looked at the influences on the return to work (RTW) in the first 2 years for people severely injured in the 22 February 2011 Christchurch earthquake. METHOD We used a constructivist grounded theory approach using semi-structured interviews to collect data from 14 people injured in the earthquake. RESULTS Analysis elicited three themes that appeared to influence the process of RTW following the Christchurch earthquake. Living the earthquake experience, the individual's experiences of the earthquake and how their injury framed their expectations; rebuilding normality, the desire of the participants to return to life as it was; while dealing with the secondary effects of the earthquake includes the earthquake specific effects which were both barriers and facilitators to returning to work. CONCLUSION The consequences of the earthquake impacted on experience, process and outcome of RTW for those injured in the Christchurch Earthquake. Work and RTW appeared key tools to enhance recovery after serious injury following the earthquake. IMPLICATIONS FOR REHABILITATION The altered physical, social and economic environment must be considered when working on the return to work (RTW) of individuals with earthquake injuries. Providing tangible emotional and social support so injured earthquake survivors feel safe in their workplace may facilitate RTW. Engaging early with employers may assist the RTW of injured earthquake survivors.
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Affiliation(s)
- Joanne Nunnerley
- a Department of Orthopaedic Surgery & Musculoskeletal Medicine , University of Otago , Christchurch , New Zealand and
| | - Jennifer Dunn
- a Department of Orthopaedic Surgery & Musculoskeletal Medicine , University of Otago , Christchurch , New Zealand and
| | - Kathryn McPherson
- b Health and Rehabilitation Research Institute, AUT University , Auckland , New Zealand
| | - Gary Hooper
- a Department of Orthopaedic Surgery & Musculoskeletal Medicine , University of Otago , Christchurch , New Zealand and
| | - Tim Woodfield
- a Department of Orthopaedic Surgery & Musculoskeletal Medicine , University of Otago , Christchurch , New Zealand and
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Aiachini B, Cremascoli S, Escorpizo R, Pistarini C. Validation of the ICF Core Set for Vocational Rehabilitation from the perspective of patients with spinal cord injury using focus groups. Disabil Rehabil 2015; 38:337-45. [DOI: 10.3109/09638288.2015.1041611] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA, and
- Swiss Paraplegic Research, Nottwil, Switzerland
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Nordgren L, Söderlund A. Being on sick leave due to heart failure: Encounters with social insurance officers and associations with sociodemographic factors and self-estimated ability to return to work. Eur J Cardiovasc Nurs 2015; 15:e27-36. [PMID: 25648847 DOI: 10.1177/1474515115571033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about sick leave and the ability to return to work (RTW) for people with heart failure (HF). Previous research findings raise questions about the significance of encounters with social insurance officers (SIOs) and sociodemographics in people sick-listed due to HF. AIMS To investigate how people on sick leave due to HF experience encounters with SIOs and associations between sociodemographic factors, experiences of positive/negative encounters with SIOs, and self-estimated ability to RTW. METHODS This was a population-based study with a cross-sectional design. The sample consisted of 590 sick-listed people with HF in Sweden. A register-based investigation supplemented with a postal survey questionnaire was conducted. Bivariate correlations and logistic regression analysis was used to test associations between sociodemographic factors, positive and negative encounters, and self-estimated ability to RTW. RESULTS People with low income were more likely to receive sickness compensation. A majority of the responders experienced encounters with SIOs as positive. Being married was significantly associated with positive encounters. Having a low income was related to negative encounters. More than a third of the responders agreed that positive encounters with SIOs facilitated self-estimated ability to RTW. High income was strongly associated with the impact of positive encounters on self-estimated ability to RTW. CONCLUSION Encounters between SIOs and people on sick leave due to HF need to be characterized by a person-centred approach including confidence and trust. People with low income need special attention.
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Lindbäck C, Nordgren L. To be on sick-leave due to heart failure: a qualitative perspective. Disabil Rehabil 2014; 37:1732-8. [DOI: 10.3109/09638288.2014.974835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Khazaeipour Z, Norouzi-Javidan A, Kaveh M, Khanzadeh Mehrabani F, Kazazi E, Emami-Razavi SH. Psychosocial outcomes following spinal cord injury in Iran. J Spinal Cord Med 2014; 37:338-45. [PMID: 24621045 PMCID: PMC4064583 DOI: 10.1179/2045772313y.0000000174] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective/background In patients with spinal cord injury (SCI), SCI causes psychosocial complications that vary based on culture, conditions, and the amenities of each community. Health planners and social services should have full knowledge of these issues in order to plan schedules that address them. In this study, we aimed to understand the psychosocial problems of persons with SCI in Iran and to explore the requirements for minimizing these difficulties. Design This was a descriptive cross-sectional study. Setting Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. Participants One hundred nineteen persons with SCI referred to BASIR clinic to receive outpatient rehabilitation. Methods In this study, trained interviewers administered a questionnaire to the participants. The questionnaire consisted of socio-demographic variables and psychosocial questions about finances, employment, housing, education, and social communication problems. Results Psychosocial problems for persons with SCI are mainly associated with financial hardship due to unemployment and the high cost of living, followed by difficulties with transportation, house modification, education, marriage, social communication, sports, and entertainment. Psychological problems include sadness, depression, irritability/anger, suicidal thoughts, and a lack of self-confidence. The levels of the aforementioned problems differ with respect to sex. Conclusion Persons suffering from SCI can face some serious psychosocial problems that may vary according to sex. For example, transportation difficulties can lead to problems such as unsociability. After recognizing these problems, the next step would be providing services to facilitate a productive lifestyle, enhancing social communication and psychological health, and ultimately creating a higher quality of life.
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Affiliation(s)
- Zahra Khazaeipour
- Correspondence to: Zahra Khazaeipour, Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, 1419733141, Iran. ,
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