Skip to main content
Log in

Improved Occupational Performance of Young Adults with a Physical Disability After a Vocational Rehabilitation Intervention

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose The purpose of this study was to investigate into more detail how occupational performance of participants of a 1-year multidisciplinary vocational rehabilitation intervention changed over time, using a broad focus on three areas of occupational performance, addressing work, as well as self-care and leisure. In addition, we explored differences between employed and unemployed persons. Methods In a pre-post-intervention design, changes in occupational performance, addressing work, self-care and leisure, were evaluated using the Canadian Occupational Performance Measure (COPM) and the Occupational Performance History Interview (OPHI-II). Results Eleven young adults (median 22 years) with physical disabilities participated. Post-intervention, participants experienced fewer problems and showed improved occupational performance in work, as well as self-care and leisure, and improved satisfaction with performance. Participants also showed improved occupational identity and occupational competence, and total scores on OPHI-II. Participants who did not achieve employment did not differ in demographic characteristics. They experienced problems in all three areas of occupational performance at pre-intervention, and more difficulty in interacting in occupational settings (environment). Post-intervention, their levels of occupational identity, competence and settings were similar to those of employed persons. Conclusions Participants showed improved occupational performance after the intervention. The goal of employment and the broad integrated approach of the intervention seemed to motivate participants to resolve problems in work, as well as self-care and leisure. Unemployed persons faced problems in all three areas of occupational performance at start. Although they seemed to catch up during the intervention, they did not achieve employment within 1 year.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Devitt R, Colantonio A, Dawson D, Teare G, Ratcliff G, Chase S. Prediction of long-term occupational performance outcomes for adults after moderate to severe traumatic brain injury. Disabil Rehabil. 2006;28:547–59.

    Article  CAS  PubMed  Google Scholar 

  2. Chamberlain MA, Kent RM. The needs of young people with disabilities in transition from paediatric to adult services. Eura Medicophys. 2005;41:111–23.

    CAS  PubMed  Google Scholar 

  3. Roebroeck ME, Jahnsen R, Carona C, Kent RM, Chamberlain MA. Adult outcomes and lifespan issues for people with childhood-onset physical disability. Dev Med Child Neurol. 2009;51:670–8.

    Article  PubMed  Google Scholar 

  4. Nieuwenhuijsen C, van der Laar Y, Donkervoort M, Nieuwstraten W, Roebroeck ME, Stam HJ. Unmet needs and health care utilization in young adults with cerebral palsy. Disabil Rehabil. 2008;30:1254–62.

    Article  PubMed  Google Scholar 

  5. Michelsen SI, Uldall P, Hansen T, Madsen M. Social integration of adults with cerebral palsy. Dev Med Child Neurol. 2006;48:643–9.

    Article  PubMed  Google Scholar 

  6. Lindsay S. Employment status and work characteristics among adolescents with disabilities. Disabil Rehabil. 2010;33:843–54.

    Article  PubMed  Google Scholar 

  7. van Mechelen MC, Verhoef M, van Asbeck FW, Post MW. Work participation among young adults with spina bifida in the Netherlands. Dev Med Child Neurol. 2008;50:772–7.

    Article  PubMed  Google Scholar 

  8. Kingsnorth S, Healy H, Macarthur C. Preparing for adulthood: a systematic review of life skill programs for youth with physical disabilities. J adolesc health: off publ Soc Adolesc Med. 2007;41:323–32. Epub 2007/09/19.

    Article  Google Scholar 

  9. Heinemann AW. Measurement of participation in rehabilitation research. Arch Phys Med Rehabil. 2010;91:S1–4.

    Article  PubMed  Google Scholar 

  10. WHO. The international classification of functioning, disability and health - ICF 2001. World Health Organisation, 2001.

  11. Mallinson T, Hammel J. Measurement of participation: intersecting person, task, and environment. Arch Phys Med Rehabil. 2010;91:S29–33.

    Article  PubMed  Google Scholar 

  12. Law M, Baptiste, S, Carswell, A, McColl, MA, Polatajko, H, Pollock, N Canadian Occupational Performance Measure. Ottawa: CAOT Publications ACE; 1998.

  13. Donkervoort M, Roebroeck ME, Wiegerink DJ, van der Heijden-Maessen H, Stam HJ. Determinants of functioning of adolescents and young adults with cerebral palsy. Disabil Rehabil. 2007;29:453–63.

    Article  PubMed  Google Scholar 

  14. Buffart LM, van den Berg-Emons RJ, van Meeteren J, Stam HJ, Roebroeck ME. Lifestyle, participation, and health-related quality of life in adolescents and young adults with myelomeningocele. Dev Med Child Neurol. 2009;51:886–94.

    Article  PubMed  Google Scholar 

  15. Achterberg TJ, Wind H, de Boer AG, Frings-Dresen MH. Factors that promote or hinder young disabled people in work participation: a systematic review. J Occup Rehabil. 2009;19:129–41.

    Article  CAS  PubMed  Google Scholar 

  16. Lindsay S. Discrimination and other barriers to employment for teens and young adults with disabilities. Disabil Rehabil. 2011;33:1340–50.

    Article  PubMed  Google Scholar 

  17. Verhoef JAC, Miedema HS, van Meeteren J, Stam HJ, Roebroeck ME. A new intervention to improve work participation of young adults with physical disabilities: a feasibility study (accepted for publication March 4 2013 by Dev Med Child Neurol).

  18. Kielhofner G, Braveman B, Finlayson M, Paul-Ward A, Goldbaum L, Goldstein K. Outcomes of a vocational program for persons with AIDS. Am J Occup Ther. 2004;58:64–72.

    Article  PubMed  Google Scholar 

  19. Varekamp I, Heutink A, Landman S, Koning CE, de Vries G, van Dijk FJ. Facilitating empowerment in employees with chronic disease: qualitative analysis of the process of change. J Occup Rehabil. 2009;19:398–408.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Kielhofner G, Mallinson T, Crawford C, Nowak M, Rigby M, Henry A, Walens D. A user’s manual for the occupational performance history interview (version 2.0). Chicago: The Model of Human Occupation Clearing House; 1998.

  21. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann behav med: a publ Soc Behav Med. 2003;26:1–7. Epub 2003/07/18.

    Article  Google Scholar 

  22. Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.

    Article  CAS  PubMed  Google Scholar 

  23. Dedding C, Cardol M, Eyssen IC, Dekker J, Beelen A. Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement. Clin Rehabil. 2004;18:660–7.

    Article  PubMed  Google Scholar 

  24. Nieuwenhuijsen C, Donkervoort M, Nieuwstraten W, Stam HJ, Roebroeck ME. Experienced problems of young adults with cerebral palsy: targets for rehabilitation care. Arch Phys Med Rehabil. 2009;90:1891–7.

    Article  PubMed  Google Scholar 

  25. Kielhofner G, Braveman B, Fogg L, Levin M. A controlled study of services to enhance productive participation among people with HIV/AIDS. Am J Occup Ther. 2008;62:36–45.

    Article  PubMed  Google Scholar 

  26. Levin M, Kielhofner G, Braveman B, Fogg L. Narrative slope as a predictor of work and other occupational participation. Scand J Occup Ther. 2007;14:258–64.

    Article  PubMed  Google Scholar 

  27. Kielhofner G, Mallinson T, Forsyth K, Lai JS. Psychometric properties of the second version of the Occupational Performance History Interview (OPHI-II). Am J Occup Ther. 2001;55:260–7.

    Article  CAS  PubMed  Google Scholar 

  28. Barf HA, Post MW, Verhoef M, Jennekens-Schinkel A, Gooskens RH, Prevo AJ. Restrictions in social participation of young adults with spina bifida. Disabil Rehabil. 2009;31:921–7.

    Article  CAS  PubMed  Google Scholar 

  29. Donkervoort M, Wiegerink DJ, van Meeteren J, Stam HJ, Roebroeck ME. Transition to adulthood: validation of the Rotterdam Transition Profile for young adults with cerebral palsy and normal intelligence. Dev Med Child Neurol. 2009;51:53–62.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the young adults that participated in this study. We thank Gary Kielhofner for the inspiring communication and consultation in developing the intervention and the evaluation study, and dedicate this paper to his memory.This study was supported by funding from Johanna Children’s Fund (JKF) and Child Fund Adriaanstichting (KFA) (Arnhem, the Netherlands Grant Number 2005/0087-952), VSB-fonds (Grant Number 20051606) and the Dutch Employee Benefits Insurance Authority (UWV) (Grant Number IR/06svg01).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joan A. C. Verhoef.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verhoef, J.A.C., Roebroeck, M.E., van Schaardenburgh, N. et al. Improved Occupational Performance of Young Adults with a Physical Disability After a Vocational Rehabilitation Intervention. J Occup Rehabil 24, 42–51 (2014). https://doi.org/10.1007/s10926-013-9446-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-013-9446-9

Keywords

Navigation