Exploring barriers and facilitators to return to work for clients with spinal cord injuries, in Cape Town, South Africa

[摘要] ENGLISH SUMMARY : Background: Spinal cord injury is a catastrophic event, characterised with loss of function below the level of the lesion and increased dependence on family and societal support. The researcher has been working as an Occupational Therapist in a centre for physical rehabilitation of clients with physical impairments, including those with spinal cord injuries, for more than five years. She has observed that only a small percentage of clients with spinal cord injuries that have completed their rehabilitation programme were able to go back to work after the injury. After examining statistics of the clients seen in the period January-December 2001, when working at a local tertiary Hospital's Work Assessment Unit in February 2014, the researcher was then further motivated to explore barriers and facilitators to return to work for clients with spinal cord injuries. Hence the aim of this study is to explore barriers and facilitators to return to work for clients with spinal cord injuries.Method: A qualitative study design was implemented to explore views of clients, managers/supervisors of clients with spinal cord injuries and rehabilitation professionals with regard to barriers and facilitators to return to work of clients with spinal cord injuries. Semi-structured interviews were conducted with 13 participants, including clients with spinal cord injuries, a manager of one of the persons with disabilities participating in the study, and Occupational Therapists involved in physical rehabilitation (including rehabilitation of persons with spinal cord injuries) or vocational rehabilitation (work assessment or return to work). Interview schedules were used to conduct interviews, which were recorded and later analysed thematically.Results: The findings highlighted return-to-work barriers related to inaccessible and non-supportive environment, the employers' attitudes, injury-related issues, the challenging job demands of the previous work as well as transport issues. The facilitators indicated were provision of assistance and support (received from family, friends, church and work); the role of rehabilitation and rehabilitation team members and other role players as well as the necessity of reasonable accommodation in successfully reintegrating persons with spinal cord injuries. Triangulation was done and two common themes emerged amongst the three groups of participants (clients with spinal cord injuries, Occupational Therapists and the Manager) and these indicated the support received by persons with spinal cord injuries and the process of reasonable accommodation which facilitated integration to work.Conclusion: The study findings indicated a need for support for persons with spinal cord injuries, making sure the environment is accessible or conducive for return to work, putting reasonable accommodation measures in place and involvement of all stake holders in the successful reintegration of persons with spinal cord injury to work. These measures could assist all stake holders involved in understanding the needs of persons with spinal cord injury, the responsibility of each of the stakeholders and knowledge about available resources in fostering a smooth transition back to work for spinal cord injury clients.

[发布机构] Stellenbosch University