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Journal of Occupational Rehabilitation

, Volume 21, Issue 2, pp 167–178 | Cite as

Vocational Rehabilitation From the Client’s Perspective Using the International Classification of Functioning, Disability and Health (ICF) as a Reference

  • Andrea Glässel
  • Monika E. Finger
  • Alarcos Cieza
  • Christine Treitler
  • Michaela Coenen
  • Reuben EscorpizoEmail author
Article

Abstract

Introduction A mixed-methods (qualitative-quantitative), multicenter study was conducted using a focus group design to explore the lived experiences of persons in vocational rehabilitation (VR) with regard to functioning and contextual factors using six open-ended questions related to the ICF components. The results were classified by using the International Classification of Functioning, Disability and Health (ICF) as a frame of reference. Methods The meaningful concepts within the transcribed data were identified and linked to ICF categories according to established linking rules. Results The seven focus groups with 26 participants yielded a total of 4,813 relevant concepts which were linked to a total of 160 different second-level ICF categories. From the client perspective, the ICF components (a) body functions, (b) activities and participation and (c) environmental factors were equally represented, while (d) body structures appeared less frequently. Out of the total number of concepts, 864 concepts (18%) were assigned to the ICF component personal factors which is not yet classified but could indicate important aspects of resource management and strategy development of patients in VR. Conclusion Therefore, VR of patients must not be limited to anatomical and pathophysiologic changes, but should also consider a more comprehensive view which includes client’s demands, strategies and resources in daily life and the context around the individual and social circumstances of their work situation.

Keywords

ICF Vocational rehabilitation Qualitative study Client perspective Focus groups 

Notes

Acknowledgments

The authors would like to express their special thanks to the health professionals who were involved in the study center organization and data collection. In Bellikon, Switzerland: Dr. Hans-Peter Gmünder, Dr. Peter Erhart, Jacqueline Huber, Markus Roth, and Beatrice Jansen. In Zurich, Switzerland: Dr. Andreas Klipstein, Edith Gitermann. In Kirchseeon, Germany: Jochen Kunert, Dr. Maria Schrör, Axel Kunz and Andrea Pfingsten. We want to thank all client/patient participants for their support and contribution to the discussion. From the ICF Research Branch and Swiss Paraplegic Research team, would like to thank Dr. Teresa Brinkel for being involved in the peer review, Katharina Strasky for her help in the transcription of the recordings of the focus groups, Anne Brust for assisting the focus groups, Miriam Lückenkemper for proof reading the manuscript, and Cristina Bostan, who is supported by a Marie Curie Fellowship from the EU funded project MURINET. This project was funded by the Swiss Accident Insurance Company (SUVA).

Conflict of Interest

No conflicting interests.

References

  1. 1.
    Escorpizo R, Ekholm J, Gmünder HP, Cieza A, Kostanjsek N, Stucki G. Developing a core set to describe functioning in vocational rehabilitation using the international classification of functioning, disability, and health (ICF). J Occup Rehabil. 2010.Google Scholar
  2. 2.
    Selander J, Marnetoft S, Bergroth A, Ekholm J. Return to work following vocational rehabilitation for neck, back and shoulder problems: risk factors reviewed. Disabil Rehabil. 2002;24(14):704–12.PubMedCrossRefGoogle Scholar
  3. 3.
    Young AE. Return to work following disabling occupational injury—facilitators of employment continuation. Scand J Work Environ Health. 2010.Google Scholar
  4. 4.
    Young AE. Employment maintenance and the factors that impact it after vocational rehabilitation and return to work. Disabil Rehabil. 2010;32(20):1621–32.PubMedCrossRefGoogle Scholar
  5. 5.
    Slebus FG, Sluiter JK, Kuijer PP, Willems JH, Frings-Dresen MH. Work-ability evaluation: a piece of cake or a hard nut to crack? Disabil Rehabil. 2007;29(16):1295–300.PubMedCrossRefGoogle Scholar
  6. 6.
    World Health Organization. WHO Rehabilitation after cardiovascular diseases, with special emphasis on developing countries. Report of WHO expert committee. Geneva: WHO; 1993.Google Scholar
  7. 7.
    O’Donovan MA, Doyle A, Gallagher P. Barriers, activities and participation: incorporating ICF into service planning datasets. Disabil Rehabil. 2009;31(25):2073–80.PubMedCrossRefGoogle Scholar
  8. 8.
    Sandberg MA, Bush SS, Martin T. Beyond diagnosis: understanding the healthcare challenges of injured veterans through the application of the International Classification of Functioning, Disability and Health (ICF). Clin Neuropsychol. 2009;23(8):1416–32.PubMedCrossRefGoogle Scholar
  9. 9.
    Homa DB. Using the International Classification of Functioning, Disability and Health (ICF) in job placement. Work. 2007;29(4):277–86.PubMedGoogle Scholar
  10. 10.
    Fantoni SQ, Peugniez C, Duhamel A, Skrzypczak J, Frimat P, Leroyer A. Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil. 2010;20(1):49–58.PubMedCrossRefGoogle Scholar
  11. 11.
    World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: WHO; 2001.Google Scholar
  12. 12.
    Keus F, de Vries J, Gooszen HG, van Laarhoven CJ. Assessing factors influencing return back to work after cholecystectomy: a qualitative research. BMC Gastroenterol. 2010;10:12.PubMedCrossRefGoogle Scholar
  13. 13.
    Tjulin A, Edvardsson Stiwne E, Ekberg K. Experience of the implementation of a multi-stakeholder return-to-work programme. J Occup Rehabil. 2009;19(4):409–18.PubMedCrossRefGoogle Scholar
  14. 14.
    Mays N, Pope C. Qualitative research in health care: assessing quality in qualitative research. BMJ. 2000;320:50–2.PubMedCrossRefGoogle Scholar
  15. 15.
    Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Giacomini M, Cook D. Users’ guides to the medical literature: XXIII. Qualitative research in health care, A. Are the results of the study valid. JAMA. 2000;284:357–62.PubMedCrossRefGoogle Scholar
  17. 17.
    MacEachen E, Kosny A, Ferrier S. Unexpected barriers in return to work: lessons learned from injured worker peer support groups. Work. 2007;29(2):155–64.PubMedGoogle Scholar
  18. 18.
    Cohen D, Marfell N, Webb K, Robling M, Aylward M. Managing long-term worklessness in primary care: a focus group study. Occup Med. 2010;60(2):121–6.CrossRefGoogle Scholar
  19. 19.
    Pincus T, Woodcock A, Vogel S. Returning back pain patients to work: how private musculoskeletal practitioners outside the National Health Service perceive their role (an interview study). J Occup Rehabil. 2010;20(3):322–30.PubMedCrossRefGoogle Scholar
  20. 20.
    Dunn EC, Wewiorski NJ, Rogers ES. A qualitative investigation of individual and contextual factors associated with vocational recovery among people with serious mental illness. Am J Orthopsychiatry. 2010;80(2):185–94.PubMedCrossRefGoogle Scholar
  21. 21.
    Alaszewski A, Alaszewski H, Potter J, Penhale B. Working after a stroke: survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disabil Rehabil. 2007;29(24):1858–69.PubMedCrossRefGoogle Scholar
  22. 22.
    Coutu MF, Baril R, Durand MJ, Cote D, Rouleau A, Cadieux G. Transforming the meaning of pain: an important step for the return to work. Work. 2010;35(2):209–19.PubMedGoogle Scholar
  23. 23.
    Johnsson A, Fornander T, Rutqvist LE, Olsson M. Factors influencing return to work: a narrative study of women treated for breast cancer. Eur J Cancer Care. 2010;19(3):317–23.CrossRefGoogle Scholar
  24. 24.
    Buijs PC, Lambeek LC, Koppenrade V, Hooftman WE, Anema JR. Can workers with chronic back pain shift from pain elimination to function restore at work? Qualitative evaluation of an innovative work related multidisciplinary programme. J Back Musculoskelet Rehabil. 2009;22(2):65–73.PubMedGoogle Scholar
  25. 25.
    Stergiou-Kita M, Yantzi A, Wan J. The personal and workplace factors relevant to work readiness evaluation following acquired brain injury: occupational therapists’ perceptions. Brain Inj. 2010;24(7–8):948–58.PubMedCrossRefGoogle Scholar
  26. 26.
    Cowls J, Galloway E. Understanding how traumatic re-enactment impacts the workplace: assisting clients’ successful return to work. Work. 2009;33(4):401–11.PubMedGoogle Scholar
  27. 27.
    Gardner BT, Pransky G, Shaw WS, Nha Hong Q, Loisel P. Researcher perspectives on competencies of return-to-work coordinators. Disabil Rehabil. 2010;32(1):72–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Ammendolia C, Cassidy D, Steensta I, Soklaridis S, Boyle E, Eng S, et al. Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach. BMC Musculoskelet Disord. 2009;10:65.PubMedCrossRefGoogle Scholar
  29. 29.
    Pransky G, Shaw WS, Loisel P, Hong QN, Desorcy B. Development and validation of competencies for return to work coordinators. J Occup Rehabil. 2010;20(1):41–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Kvale S. Interviews- an introduction to qualitative research interviewing. California: Sage; 1996.Google Scholar
  31. 31.
    Patton MQ. Qualitative evaluation and research methods. 2nd ed. Thousand Oaks: Sage; 1990.Google Scholar
  32. 32.
    Dekkers-Sanchez PM, Wind H, Sluiter JK, Frings-Dresen MH. A qualitative study of perpetuating factors for long term sick leave and promoting factors for return to work: chronic work disabled patients in their own words. J Rehabil Med. 2010;42(6):544–52.PubMedCrossRefGoogle Scholar
  33. 33.
    Cabral LH, Sampaio RF, Figueiredo IM, Mancini MC. Factors associated with return to work following a hand injury: a qualitative/quantitative approach. Rev Bras Fisioter. 2010;14(2):149–57.PubMedCrossRefGoogle Scholar
  34. 34.
    Joyce KE, Smith KE, Henderson G, Greig G, Bambra C. Patient perspectives of condition management programmes as a route to better health, well-being and employability. Fam Pract. 2010;27(1):101–9.PubMedCrossRefGoogle Scholar
  35. 35.
    Chan SK, Man DW. Barriers to returning to work for people with spinal cord injuries: a focus group study. Work. 2005;25(4):325–32.PubMedGoogle Scholar
  36. 36.
    Coenen M, Cieza A, Stamm TA, Amann E, Kollerits B, Stucki G. Validation of the International Classification of Functioning, Disability and Health (ICF) core Set for rheumatoid arthritis from the patient perspective using focus groups. Arthritis Res Ther. 2006;8(4):R84.PubMedCrossRefGoogle Scholar
  37. 37.
    Kirchberger I, Sinnott A, Charlifue S, Kovindha A, Luthi H, Campbell R, et al. Functioning and disability in spinal cord injury from the consumer perspective: an international qualitative study using focus groups and the ICF. Spinal Cord. 2010;48(8):603–13.PubMedCrossRefGoogle Scholar
  38. 38.
    Kirchberger I, Coenen M, Hierl FX, Dieterle C, Seissler J, Stucki G, et al. Validation of the International Classification of Functioning, Disability and Health (ICF) core set for diabetes mellitus from the patient perspective using focus groups. Diabet Med. 2009;26(7):700–7.PubMedCrossRefGoogle Scholar
  39. 39.
    Hieblinger R, Coenen M, Stucki G, Winkelmann A, Cieza A. Validation of the International Classification of Functioning, Disability and Health core set for chronic widespread pain from the perspective of fibromyalgia patients. Arthritis Res Ther. 2009;11(3):R67.PubMedCrossRefGoogle Scholar
  40. 40.
    Glaser BG, Strauss A. Discovery of grounded theory. Strategies for qualitative research. Mill Valley: Sociology Press; 1967.Google Scholar
  41. 41.
    Strauss A, Corbin J. Basics of qualitative research: grounded theory. Procedures and technique. 2nd ed. NewburyPark: Sage; 1998.Google Scholar
  42. 42.
    Gradinger F, Köhler B, Khatami R, Mathis J, Cieza A, Bassetti C. Problems in functioning from the patient perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference. J Sleep Res. 2010.Google Scholar
  43. 43.
    Tschiesner U, Linseisen E, Coenen M, Rogers S, Harreus U, Berghaus A, et al. Evaluating sequelae after head and neck cancer from the patient perspective with the help of the International Classification of Functioning, Disability and Health. Eur Arch Otorhinolaryngol. 2009;266(3):425–36.PubMedCrossRefGoogle Scholar
  44. 44.
    Krueger R, Casey M. Focus groups: a practical guide for applied research. Thousand Oaks: Sage; 2000.Google Scholar
  45. 45.
    Depoy E, Gitlin LN. Introduction to research. St. Louis: Mosby; 1998.Google Scholar
  46. 46.
    Karlsson G. Psychological qualitative research from a phenomenological perspective. Stockholm: Almqvist & Wiksell International; 1993.Google Scholar
  47. 47.
    Cieza A, Brockow T, Ewert T, Amman E, Kollerits B, Chatterji S, et al. Linking health-status measurements to the International Classification of Functioning, Disability and Health. J Rehabil Med. 2002;34(5):205–10.PubMedCrossRefGoogle Scholar
  48. 48.
    Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G. ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37(4):212–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Measur. 1960;20:37–46.CrossRefGoogle Scholar
  50. 50.
    Vierkant R. A SAS macro for calculating bootstrapped confidence intervals about a kappa coefficient. Marshfield: Medical Research Foundation. Available from: http://www2.sas.com/proceedings/sugi22/STATS/PAPER295.PDF. 2010.
  51. 51.
    United Nations Convention of the rights of Persons with Disabilities. In: U.NATIONS (Ed, New York, 2006).Google Scholar
  52. 52.
    Young AE. Return-to-work experiences: prior to receiving vocational services. Disabil Rehabil. 2009;31(24):2013–22.PubMedCrossRefGoogle Scholar
  53. 53.
    Brouwers EP, Terluin B, Tiemens BG, Verhaak PF. Predicting return to work in employees sick-listed due to minor mental disorders. J Occup Rehabil. 2009;19(4):323–32.PubMedCrossRefGoogle Scholar
  54. 54.
    Lydell M, Grahn B, Mansson J, Baigi A, Marklund B. Predictive factors of sustained return to work for persons with musculoskeletal disorders who participated in rehabilitation. Work. 2009;33(3):317–28.PubMedGoogle Scholar
  55. 55.
    Stice BD, Dik BJ. Depression among injured workers receiving vocational rehabilitation: contributions of work values, pain, and stress. J Occup Rehabil. 2009;19(4):354–63.PubMedCrossRefGoogle Scholar
  56. 56.
    Tjulin A, Maceachen E, Ekberg K. Exploring workplace actors experiences of the social organization of return-to-work. J Occup Rehabil. 2010;20(3):311–21.PubMedCrossRefGoogle Scholar
  57. 57.
    Amir Z, Wynn P, Chan F, Strauser D, Whitaker S, Luker K. Return to work after cancer in the UK: attitudes and experiences of line managers. J Occup Rehabil. 2009.Google Scholar
  58. 58.
    Morgan DL. Focus groups as qualitative research. 2nd ed. Newbury Park: Sage; 1997.Google Scholar
  59. 59.
    Curtis S, Gesler W, Smith G, Washburn S. Approaches to sampling and case selection in qualitative research: examples in the geography of health. Soc Sci Med. 2000;50:1001–14.PubMedCrossRefGoogle Scholar
  60. 60.
    Knodel J. The design and analysis of focus group studies. In: Morgan DL, editor. Successful focus groups. Newbury Park: Sage; 1993. p. 35–50.Google Scholar
  61. 61.
    Krueger RA. The future of focus groups. Qual Health Res. 1995;5(4):524–30.CrossRefGoogle Scholar
  62. 62.
    Carey A. The group effect in focus groups: planning, implementing, and interpreting focus group research. 1994; 225–41.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Andrea Glässel
    • 1
    • 2
  • Monika E. Finger
    • 1
    • 2
    • 4
  • Alarcos Cieza
    • 1
    • 2
    • 3
    • 5
  • Christine Treitler
    • 6
  • Michaela Coenen
    • 2
    • 3
    • 5
  • Reuben Escorpizo
    • 1
    • 2
    • 7
    Email author
  1. 1.Swiss Paraplegic Research (SPF)NottwilSwitzerland
  2. 2.ICF Research Branch of WHO Collaborating Centre for the Family of International Classifications in GermanNottwilSwitzerland
  3. 3.ICF Research Branch of WHO Collaborating Centre for the Family of International Classifications in GermanMunichGermany
  4. 4.Rehaklinik BellikonBellikonSwitzerland
  5. 5.Institute for Health and Rehabilitation Sciences, Research Unit for Biopsychosocial HealthLudwig-Maximilians UniversitätMunichGermany
  6. 6.Berufsförderungswerk MünchenKirchseeonGermany
  7. 7.Department of Health Sciences and Health PolicyUniversity of Lucerne and SPFNottwilSwitzerland

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