Hall R.1, Smith E.1, Matthys M.1, White J.1, Trout-Daniels A.1, Inglis-Jassiem G.2
1Western Cape Rehabilitation Centre, Physiotherapy, Cape Town, South Africa, 2Stellenbosch University, Faculty of Medicine & Health Sciences, Physiotherapy, Cape Town, South Africa
Background: Return to work after an injury contributes to self-esteem, financial sustainability and quality of life. To enhance employment outcomes of people with disabilities (PWD), it is important therapists understand the factors that determine successful return to work (RTW).
Purpose: To determine which factors people with disabilities perceive as facilitating or inhibiting return to work, after discharge from inpatient rehabilitation.
Methods: All adult patients who completed rehabilitation for neurological conditions (i.e. stroke, head injury, GBS and spinal cord injury) and were discharged on Landrums outcome level (OL) 5 from WCRC, were eligible for inclusion in this study. Participants were discharged between December 2014 and March 2016, at least 6 months since discharge, allowing for a period of community and work reintegration. A questionnaire was developed to ascertain whether they had returned to gainful employment. Participants were asked to elaborate on factors they perceived could have facilitated or inhibited their return to work. The interviews were conducted telephonically by a team of therapists who had not been involved in the rehabilitation programmes of recruited participants.
Results: Work in progress Results of pilot study:
A total of 43 patients met the inclusion criteria and were contacted telephonically to complete the questionnaire. Sixteen participants consented to the study; presenting with stroke (7), head injury (1), GBS (1) and spinal cord injuries (7). The mean age of the sample was 42 years (range 21-65) with the majority being males (94%). Although all participants attended school, only six completed matric (grade 12) and three a postgraduate diploma. All participants were employed prior to their injury, mainly working as artisans or manual workers and a few working in a supervisory/management role (n=6).
Only nine of these participants (56%) returned to gainful employment. When asked what they viewed as factors that facilitated their return to work it mainly included personal factors (participants attitude, drive and motivation, family support, financial responsibility); intensity and nature of the rehabilitation (dominance retraining); and to a lesser degree improvement in activities (improved mobility).
Those who did not return to work ascribed it to impairments (bowel and bladder problems, back pain, poor hand function, lower limb weakness); environmental factors (employers attitude, transport, physical barriers like stairs); and to a lesser extent difficulties with activities (walking).
Conclusion(s): Patients reported that social support systems, internal drive and having financial responsibilities were factors that facilitated their return to work. The severity of their condition, limited functional abilities and environmental barriers such as a lack of transport were perceived as inhibiting their ability to return to work.
Implications: Therapists who are cognisant of factors as perceived by PWD provide patient centred rehabilitation to ameliorate barriers and facilitate gainful employment post discharge.
Funding acknowledgements: Nil funding.
Topic: Disability & rehabilitation
Ethics approval: Institutional permission has been granted by the management of the Western Cape Rehabilitation Centre, South Africa for this pilot study.
All authors, affiliations and abstracts have been published as submitted.
