Article Details

Research Database: Article Details

Citation:  Verhoef, J.A.C., Roebroeck, M.E., van Schaardenburgh, N., Floothuis, M.C.S.G., & Miedema, H.S. (2014). Improved occupational performance of young adults with a physical disability after a vocational rehabilitation intervention. Journal of Occupational Rehabilitation, 24 42-51.
Title:  Improved occupational performance of young adults with a physical disability after a vocational rehabilitation intervention
Authors:  Verhoef, J.A.C., Roebroeck, M.E., van Schaardenburgh, N., Floothuis, M.C.S.G., & Miedema, H.S.
Year:  2014
Journal/Publication:  Journal of Occupational Rehabilitation
Publisher:  Springer Science+Business Media New York
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  No
Research design:  Quasi-experimental

Structured abstract:

Background:  Employment leads to more independence as an adult. Many youth with physical disabilities have difficulty gaining and maintaining employment. This may result in a reduced quality of life.
Purpose:  The purpose of the study was to examine how occupational performance of participants of a vocational rehabilitation intervention changed over time. More specifically, it looked at work, self care and leisure. The researchers also looked at the differences between individuals who were employed and those who remained unemployed after the vocational rehabilitation intervention.
Setting:  The setting was an outpatient rehabilitation clinic for young adults located in Rotterdam, the Netherlands.
Study sample:  Participants include eleven young adults with physical disabilities; six male and five females. Their mean age was 22 years prior to the intervention. Three individuals had cerebral palsy, 2 had muscular disease, 2 had traumatic brain injury and the remainder had other types of physical disabilities. The amount time participants had spent looking for work ranged from Five of the participants had not yet looked for work while 2 had been looking for more than 2 years.
Intervention:  The intervention was "At Work?! This is a multidisciplinary vocational rehabilitation intervention that was designed for young adults with physical disabilities, who are entering the labor market, and is geared towards improving abilities to achieve employment. The year long intervention brought rehabilitation and vocational services into a group program that included individuals assessments and coaching.
Control or comparison condition:  There was no control group. The participants served as their own controls.
Data collection and analysis:  Demographic data was collected. Severity of physical limitations was categorized using scores on the Physical Functioning scale of the MOS Short-Form General Health Survey. Occupational performance was explored at baseline and one year later using semi structured interviews. The Canadian Occupational Performance Measure (COPM), an interview, was used to assess self perception of work performance in the areas of self care, productivity and leisure over time. The Occupational Performance History Interview II (OPHI-II) was used to assess aspects of occupational adaptation: occupational identity, competence and setting. Results were summarized using descriptive statistics. Sores on the COPM subscales and the OPHI-II scales were calculated. Qualitative data from the COPM and audio taped OPHI-II were summarized and categorized into the 3 occupational performance categories: self care, leisure and work productivity. Narrative were classified as regressive, stable or progressive. Differences between pre and post intervention scores on COPM and OPHI-II were tested using Wilcoxon signed rank test. Demographics between the employed and unemployed groups were compared using the Mann-Whitney U test. Non-parametric test were used. Data was analyzed using SPSS 16.0.
Findings:  The participants expressed fewer problems after the intervention. Additionally, they showed improved in work performance, self care and leisure. An increase in satisfaction with these improvements was also reported. Occupational identify, competence and overall scores on the OPHI II also increased. The demographic characteristics of the individuals who did not gain employment were not difference from the group that was employed. The unemployed experienced difficulties in all three areas of occupational performance prior to the intervention and more difficulty in the work setting. Post-intervention, their levels of occupational identity, competence and settings were like those of employed persons. Participants showed improved occupational performance post intervention. The unemployed participants appeared to catch up during the intervention but had not achieved employment within one year.
Conclusions:  Young adults with physical disabilities, showed improved occupational performance in work, self care and leisure and were more satisfied with their performance after participating in a one year multidisciplinary vocational rehabilitation intervention. Those who did not go to work faced problems in all three areas at pre-intervention. The goal of employment and the intervention appeared to motivate participants to solve problems related to work, self care and leisure. There is a need for interventions aimed at improving work participation by address problem across the three areas. Young adults who go to work may benefit from ongoing coaching to help address new problems.

Disabilities served:  Cerebral palsy
Multiple sclerosis
Spinal cord injury (SCI)
Traumatic brain injury (TBI)
Populations served:  Gender: Female and Male
Transition-age youth (14 - 24)
Interventions:  Other
Outcomes:  Employment acquisition