The experience of attempting to return to work following spinal cord injury : a systematic review of the qualitative literature
- Authors: Hilton, Gillean , Unsworth, Carolyn , Murphy, Gregory
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Disability and Rehabilitation Vol. 40, no. 15 (2018), p. 1745-1753
- Full Text: false
- Reviewed:
- Description: 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. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
The experience of seeking, gaining and maintaining employment after traumatic spinal cord injury and the vocational pathways involved
- Authors: Hilton, Gillean , Unsworth, Carolyn , Stuckey, Ruth , Murphy, Gregory
- Date: 2018
- Type: Text , Journal article
- Relation: Work Vol. 59, no. 1 (2018), p. 67-84
- Full Text: false
- Reviewed:
- Description: BACKGROUND: Vocational potential in people with spinal cord injury (SCI) are unrealised with rates of employment substantially lower than in the labour force participation of the general population and the pre-injury employment rates. OBJECTIVES: To understand the experience and pathway of people achieving employment outcome after traumatic spinal cord injury by; classifying participants into employment outcome groups of stable, unstable and without employment; identifying pre and post-injury pathways for participants in each group and, exploring the experiences of people of seeking, gaining and maintaining employment. METHODS: Thirty-one participants were interviewed. Mixed methods approach including interpretive phenomenological analysis and vocational pathway mapping of quantitative data. RESULTS: The most common pathway identified was from study and work pre-injury to stable employment post-injury. Four super-ordinate themes were identified from the interpretive phenomenological analysis; expectations of work, system impacts, worker identity and social supports. Implications for clinical practice include fostering cultural change, strategies for system navigation, promotion of worker identity and optimal use of social supports. CONCLUSIONS: The findings increase insight and understanding of the complex experience of employment after spinal cord injury. There is opportunity to guide experimental research, policy development and education concerning the complexity of the return to work experience and factors that influence pathways. © 2018 - IOS Press and the authors.