Understanding Decisions About Work After Spinal Cord Injury
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Introduction Research has consistently shown that many people with spinal cord injury (SCI) do not return to work (RTW), despite evidence that being employed is associated with better quality of life, participation and physical and psychological well-being. While some factors associated with RTW outcome have been identified, very little is known about what influences people’s own decisions about their employment following SCI. This qualitative study sought to identify factors that influenced decisions about whether and when to RTW for people with SCI. Methods Participants were recruited through rehabilitation and support services in Aotearoa/New Zealand, and sampling sought to capture variation in the population, particularly with regard to pre-injury occupation, physical impairment, age, ethnicity and education. In-depth interviews were conducted which were audio-taped and transcribed. Interviews were analysed using rigorous methods drawn from grounded theory. Results Thirteen participants took part in the research. Findings identified four main themes that synthesised experiences about what influenced decisions about employment after SCI: (1) ability to work (given work demands and current resources); (2) presence of responsibilities or pressures that compete with work; (3) access to a suitable job; and (4) whether work was of enough benefit to the individual to be worth pursuing. Conclusions Findings illustrate the complexity of decisions about working after SCI, and provide a framework that health and vocational professionals may find useful to inform discussions with their clients. Findings also provide a basis for further research into interventions to support people to make informed decisions about employment after SCI.
KeywordsSpinal cord injury Vocational rehabilitation Return to work Decision
Appreciation is extended to participants for contributing their time and sharing their experiences; to AUT University for funding the research; to Arron Perriam and Sridhar Atresh for their support and facilitation of recruitment efforts; to Marta Leete for her input as an external reader during analysis; and to the NRC-SANN writing clinic for feedback on a draft of the paper.
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