Context/Objective:

Prolonged unemployment is common for people living with a spinal cord injury or disorder (SCI/D) and can impact negatively on quality of life. The present study examines stakeholder perspectives and experiences with the job search process in order to identify service gaps and return-to-work solutions.

Design:

In-depth semi-structured interviews were thematically analysed, with questions focused on factors that can help or hinder efforts to gain employment. Generated themes were then applied to the Person-Environment-Occupation (PEO) systems model of participation.

Setting:

Community-based disability service provider in South Australia.

Participants:

Purposive sample of persons with SCI/D (n = 8) and rehabilitation professionals (n = 4).

Results:

Person-centred themes were strongly endorsed by both groups and focused on incentives of, and motivation for, employment. Equally important to the job search process were individual expectations and attitudes, particularly job readiness. Environmental facilitators included employers’ positive attitude, although workplace discrimination remained a concern. Occupation-based barriers, rather than opportunities, were identified – namely, difficulties in SCI/D self-management, the need for timely functional assessments, and more opportunities for education, upskilling and retraining.

Conclusions:

The PEO model provides a broad framework to better understand the complex return-to-work process for people with a SCI/D and, potentially, uncover tangible solutions. The suggestion is that vocational rehabilitation should go beyond skills training and include motivational support to enhance job readiness. This must be done on a case-by-case basis. There is also a need for active and covert discrimination to be addressed through employment policies. The findings will be used to develop intervention targets for a newly established vocational rehabilitation service.

中文翻译：

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慢性脊髓损伤或疾病患者就业的促进因素和障碍：以人-环境-职业模型为框架的定性研究

背景/目标：

长期失业对于患有脊髓损伤或疾病 (SCI/D) 的人来说很常见，并且会对生活质量产生负面影响。本研究考察了利益相关者在求职过程中的观点和经验，以确定服务差距和重返工作岗位的解决方案。

设计：

对深入的半结构化访谈进行了主题分析，问题集中在可以帮助或阻碍努力获得就业的因素上。然后将生成的主题应用于参与的人-环境-职业 (PEO) 系统模型。

环境：

南澳大利亚的社区残障服务提供商。

参加者：

SCI/D 患者（n  = 8）和康复专业人员（n  = 4）的目的样本。

结果：

以人为本的主题得到了两个群体的强烈支持，并侧重于就业的激励和动机。对求职过程同样重要的是个人期望和态度，尤其是工作准备情况。环境促进因素包括雇主的积极态度，尽管工作场所的歧视仍然是一个问题。确定了基于职业的障碍，而不是机会——即 SCI/D 自我管理的困难、及时功能评估的需要以及更多的教育、技能提升和再培训机会。

结论：

PEO 模型提供了一个广泛的框架，可以更好地理解 SCI/D 患者复杂的重返工作流程，并有可能发现切实可行的解决方案。建议职业康复不应局限于技能培训，还应包括激励支持以增强就业准备。这必须根据具体情况进行。还需要通过就业政策解决主动和隐蔽的歧视问题。调查结果将用于为新成立的职业康复服务制定干预目标。