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, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
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.
Chamberlain MA, Kent RM. The needs of young people with disabilities in transition from paediatric to adult services. Eura Medicophys. 2005;41:111–23.
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.
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.
Michelsen SI, Uldall P, Hansen T, Madsen M. Social integration of adults with cerebral palsy. Dev Med Child Neurol. 2006;48:643–9.
Lindsay S. Employment status and work characteristics among adolescents with disabilities. Disabil Rehabil. 2010;33:843–54.
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.
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.
Heinemann AW. Measurement of participation in rehabilitation research. Arch Phys Med Rehabil. 2010;91:S1–4.
WHO. The international classification of functioning, disability and health - ICF 2001. World Health Organisation, 2001.
Mallinson T, Hammel J. Measurement of participation: intersecting person, task, and environment. Arch Phys Med Rehabil. 2010;91:S29–33.
Law M, Baptiste, S, Carswell, A, McColl, MA, Polatajko, H, Pollock, N Canadian Occupational Performance Measure. Ottawa: CAOT Publications ACE; 1998.
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.
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.
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.
Lindsay S. Discrimination and other barriers to employment for teens and young adults with disabilities. Disabil Rehabil. 2011;33:1340–50.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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
- Young adults
- Vocational rehabilitation
- Physically disabled persons
- Social participation
- Activities of daily living