| Background: |
Return to work after Spinal Cord Injury is complex. Employment rates are also on the decline. Some knowledge has been gained about return to work post injury through qualitative studies. However more research is needed to examine what motivates an adult to go back to work after injury. |
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Purpose:
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This study explored the factors facilitating return to work for four adults with SCI. The main question was "what factors facilitate adults with acquired physical disability rejoining the workforce?" |
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Setting:
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The study took place in a urban area that has a population of over 1 million in the Southern United States. |
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Study sample: |
Six people with SCI were identified. Three agreed to participate. A study participant also referred the researchers to someone s/he knew who had returned to work, which added a fourth subject.
The final sample included four individuals who sustained a traumatic SCI in adulthood and who were employed at the time of injury. Age range was 42 to 57 years; three were males and one was a female. Time since injury ranged from 24 to 37 years. All but one person had an educational level beyond high school diploma. The occupational titles of the four participants were: college prep coordination, attorney, information specialist and bank fraud analyst. Two individuals reported C-5 injuries, another C 6/7 and the other T-6 injury. One person used a power chair, the others used manual. |
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Control or comparison condition:
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There was no control or comparison condition. |
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Data collection and analysis:
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Each person was interviewed. The interviews took approximately 40 minutes to one hour. They were recorded and transcribed.
The interview was guided by a script and the questions asked were open-ended. The adaptive equipment that helped with return to work was photographed.The data collected was coded and then organized into themes, subthemes and important quotes.
Coded transcripts were reviewed as needed until consensus was reached. Photographs of the adaptive equipment were compared to the emerging themes to triangulate them with the information participants provided during the interviews. |
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Findings:
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Four themes emerged. This included: resources for rejoining the workforce, motivation, challenges and benefits. Resources were categorized as follows: early training resources, long term support and assistive technology.
Motivation was categorized as extrinsic (i.e. encouragement, role models and health insurance) and intrinsic motivators (i.e. wanting to work, strong work ethic, not wanting to give up.) Challenges included: stamina, body gets worn out, scheduling, other health conditions, bowel and bladder control, and being understood.
Benefits codes included: have a social network, keep mind and body active, not being bored among others. The results showed that while each return to work after SCI was unique there are some similarities among participants. The most unique is the role and degree of motivation that the participants had for return to work. Intrinsic and extrinsic motivating factors seem to be of particular importance. This is similar to other research that indicates intrinsic motivation, optimism, and self esteem are important. Challenges related to physical environment, health and employer attitudes were also important influences. |
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Conclusions:
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It may be helpful if individuals with SCI to receive early and consistent counseling about their potential for future employment. This group may also benefit from motivational interviewing. It is important for patients to become aware of these and other resources and are guided through a process to obtain and maintain these. The four factors influencing return to work: resources for gaining and maintaining employment, motivation and the associated challenges and benefits is beneficial but more research is needed. |
