Exploring barriers and facilitators to return to work for clients with spinal cord injuries, in Cape Town, South Africa

Ngemntu, Sharon Nokuzola (2018-03)

Thesis (MHumanRehabSt)--Stellenbosch University, 2018.

Thesis

ENGLISH SUMMARY : Background: Spinal cord injury is a catastrophic event, characterised with loss of function below the level of the lesion and increased dependence on family and societal support. The researcher has been working as an Occupational Therapist in a centre for physical rehabilitation of clients with physical impairments, including those with spinal cord injuries, for more than five years. She has observed that only a small percentage of clients with spinal cord injuries that have completed their rehabilitation programme were able to go back to work after the injury. After examining statistics of the clients seen in the period January-December 2001, when working at a local tertiary Hospital’s Work Assessment Unit in February 2014, the researcher was then further motivated to explore barriers and facilitators to return to work for clients with spinal cord injuries. Hence the aim of this study is to explore barriers and facilitators to return to work for clients with spinal cord injuries. Method: A qualitative study design was implemented to explore views of clients, managers/supervisors of clients with spinal cord injuries and rehabilitation professionals with regard to barriers and facilitators to return to work of clients with spinal cord injuries. Semi-structured interviews were conducted with 13 participants, including clients with spinal cord injuries, a manager of one of the persons with disabilities participating in the study, and Occupational Therapists involved in physical rehabilitation (including rehabilitation of persons with spinal cord injuries) or vocational rehabilitation (work assessment or return to work). Interview schedules were used to conduct interviews, which were recorded and later analysed thematically. Results: The findings highlighted return-to-work barriers related to inaccessible and non-supportive environment, the employers’ attitudes, injury-related issues, the challenging job demands of the previous work as well as transport issues. The facilitators indicated were provision of assistance and support (received from family, friends, church and work); the role of rehabilitation and rehabilitation team members and other role players as well as the necessity of reasonable accommodation in successfully reintegrating persons with spinal cord injuries. Triangulation was done and two common themes emerged amongst the three groups of participants (clients with spinal cord injuries, Occupational Therapists and the Manager) and these indicated the support received by persons with spinal cord injuries and the process of reasonable accommodation which facilitated integration to work. Conclusion: The study findings indicated a need for support for persons with spinal cord injuries, making sure the environment is accessible or conducive for return to work, putting reasonable accommodation measures in place and involvement of all stake holders in the successful reintegration of persons with spinal cord injury to work. These measures could assist all stake holders involved in understanding the needs of persons with spinal cord injury, the responsibility of each of the stakeholders and knowledge about available resources in fostering a smooth transition back to work for spinal cord injury clients.

AFRIKAANSE OPSOMMING : Agtergrond: Rugmurgbesering is ’n katastrofiese geval, gekenmerk aan verlies van funksie onderkant die vlak van die beskadiging en verhoogde afhanklikheid van familie en gemeenskapsondersteuning. Die navorser is meer as vyf jaar werksaam as ’n arbeidsterapeut in ’n sentrum vir fisiese rehabilitasie van kliënte met fisiese beskadiging asook diegene met rugmurgbeserings. Sy het waargeneem dat slegs ’n klein persentasie van kliënte met rugmurgbeserings, wat hulle rehabilitasieprogram voltooi het, in staat was om na die besering terug werk toe te gaan. Nadat die statistieke van kliënte, wat gedurende Januarie tot Desember 2001 gesien is, tydens haar werk in Februarie 2014 by ’n plaaslike tersiêre hospitaal se werkassesseringseenheid ondersoek is, is die navorser verder gemotiveer om hindernisse en geleenthede/fasiliteerders om terug te keer werk toe vir kliënte met rugmurgbeserings te ondersoek. Die doel van die studie is dus om die hindernisse en geleenthede/fasiliteerders om terug te keer werk vir kliënte met rugmurgbeserings te ondersoek. Metode: ’n Kwalitatiewe navorsingsontwerp is geïmplimenteer om die siening van kliënte, bestuurders/toesighouers van kliënte met rugmurgbeserings en rehabilitasie beroepsmense met betrekking tot hindernisse en geleenthede/fasiliteerders van kliënte met rugmurgbeserings wat terugkeer werk toe te ondersoek. Semi-gestruktureerde onderhoude is gevoer met 13 deelnemers wat ingesluit het kliënte met rugmurgbeserings, ’n bestuurder/toesighouer van een van die persone met gestremdhede (wat aan die studie deelneem) en arbeidsterapeute betrokke in fisiese rehabilitasie van persone met rugmurgbeserings (wat rehabilitasie van persone met rugmurgbeserings insluit) of beroepsrehabilitasie (werkassessering of terugkeer werk toe). Onderhoudskedules is gebruik om die onderhoude te voer, wat aangeteken is en later tematies ontleed is. Resulate: Die bevindinge het aangetoon dat die terugkeer-werktoe hindernisse verband hou met ontoeganklike en nie-ondersteunende omgewings, werkgewers se houdings, die uitdagende eise van die vorige werk sowel as vervoerprobleme. Die geleenthede/fasiliteerders wat aangedui is, was voorsiening van hulp en ondersteuning (deur familie, vriende, die kerk en werk); die rol van rehabilitasie en rehabilitasiespanlede en ander rolspelers asook die noodsaaklikheid van redelike tegemoetkomendheid vir suksesvolle herintegrasie van persone met rugmurgbeserings. Triangulasie is gedoen en twee algemene temas het uitgekom tussen die drie groepe deelnemers (kliënte met rugmurgbeserings, arbeidsterapeute en bestuurders). Die temas het uitgelig die ondersteuning wat persone met rugmurgbeserings ontvang en die proses van redelike tegemoetkomendheid wat integrasie met werk fasiliteer. Hierdie maatstawe kan alle rolspelers wat betrokke is om die behoeftes van persone met rugmurgbeserings te verstaan, die verantwoordelikheid van elke rolspeler en die kennis van beskikbare hulpmiddels om die gladde oorgang te bewerkstellig vir kliënte met rugmurgbeserings wat teruggaan werk toe, assisteer.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103756
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