The lived experience of employed patients with spinal cord injury following vocational rehabilitation

Abstract

Background: Vocational rehabilitation creates many employment benefits for patients with spinal cord injury.  Benefits that include restored self-esteem, lower impact of medical conditions and related complications, promotes well-being and facilitates the safe and timely return of patients with spinal cord injury to work following injury, to name a few. Despite its benefits vocational rehabilitation remains underutilized due to barriers such as inadequate follow up, limited employer engagement and vocational rehabilitation services are often unavailable, inaccessible to or unfamiliar to patients with spinal cord injury. The aim of the study was to describe the lived experiences of employed patients with spinal cord injuries who had received vocational rehabilitation in Gauteng, South Africa, focusing in its effectiveness, challenges and impact on workplace reintegration. 

Method: A descriptive phenomenological qualitative method was utilized. Through purposive sampling ten individuals with spinal cord injury who received vocational rehabilitation, were selected. Individual interviews were conducted using a semi-structured interview guide. Interpretative phenomenological analysis was used to analyse the data.

Results: The Person-Environment-Occupation-Participation (PEOP) model was used to extract themes.  The ten employed patients with spinal cord injury, reported how they benefitted from vocational rehabilitation as well as the challenges they experienced upon return to work.  The benefits included (1) overcoming challenges in the workplace, (2) positive effects on employment and (3) financial independence. Participants stated that (4) absenteeism, (5) promotion opportunities and (6) recognition remained challenging.

Conclusion: Vocational rehabilitation, specifically the return-to-work aspect, plays a significant role in terms of the employment of patients with spinal cord injuries.  Findings highlight the need for structured follow-ups, employer collaboration, and enhanced accessibility measures to optimise vocational rehabilitation outcomes.

Implications for practice

• Occupational therapists should contribute through providing education on reasonable accommodation (job adaptations, accessibility and workplace modifications) to employers or potential employers, for reintegration into the workplace
• Occupational therapists can identify physical and psychosocial barriers that they can address by means of therapeutic interventions
• For a successful return to work the occupational therapists need to collaborate with other interprofessional team members
• With the continuous involvement of the occupational therapists after job placement, challenges can be addressed for job retention and job satisfaction. A comprehensive return to work program, provided by OTs, that improves employment opportunities for individuals living with spinal cord injuries, is highly relevant.