Developing A Conceptual Framework for Early Intervention Vocational Rehabilitation for People Following Spinal Cord Injury.

Autor: Dunn JA; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand. Jennifer.dunn@otago.ac.nz., Martin RA; Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand.; Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand., Hackney JJ; Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand., Nunnerley JL; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand.; Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand., Snell DL; Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand., Bourke JA; 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., Young T; Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand., Hall A; New Zealand Spinal Trust, Burwood Hospital, Christchurch, New Zealand., Derrett S; Ngāi Tahu Māori Health Research Unit, Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Jazyk: angličtina
Zdroj: Journal of occupational rehabilitation [J Occup Rehabil] 2023 Mar; Vol. 33 (1), pp. 179-188. Date of Electronic Publication: 2022 Aug 04.
DOI: 10.1007/s10926-022-10060-9
Abstrakt: 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.
(© 2022. The Author(s).)
Databáze: MEDLINE
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