Hilton Gillean, Unsworth Carolyn, Murphy Gregory
a Department of Occupational Therapy , Central Queensland University , Melbourne , Australia.
b Victorian Spinal Cord Service , Austin Health , Melbourne , Australia.
Disabil Rehabil. 2018 Jul;40(15):1745-1753. doi: 10.1080/09638288.2017.1312566. Epub 2017 Apr 11.
This review sought to answer the question "What are the barriers and facilitators influencing people's experience of return to work following spinal cord injury?"
Studies that met the selection criteria were identified, presented and critically appraised using National Institute for Health and Care Excellence guidelines. Thematic synthesis was completed with studies possessing strong methodological rigor. Synthesis and interpretation involved three stages; coding of primary data; development of descriptive themes reflective of the primary data; and establishment of analytical themes to answer the review question.
Data from nine papers were included in the thematic synthesis. Several descriptive themes and three analytical themes were drawn from the data to answer the research question. Analytical themes included: a matrix of personal and environmental factors exists requiring complex navigation in order to create possibilities and opportunities for postinjury employment; the process of seeking or gaining employment shares a reciprocal relationship with the temporal nature of adjustment to spinal cord injury; and there is an intrinsic need for occupational engagement through paid employment.
Returning to or gaining employment after spinal cord injury is a fundamentally difficult experience for people. Multiple strategies are required to support the navigation of the process. There is, however, a need in people with spinal cord injury, to be a worker, and with that comes the inherent benefits of being employed. Implications for rehabilitation Returning to work should be a significant focus of spinal cord injury rehabilitation. Employment is both possible and health promoting following spinal cord injury. Multiple strategies are required to support people to navigate the return to work process. It is important to be cognizant of the individual motivations for being a worker and the complexity of the adjustment process. Spinal cord injury centers can provide a consistent and supportive framework and culture of positivity about employment after spinal cord injury.
本综述旨在回答“影响脊髓损伤患者重返工作岗位体验的障碍和促进因素有哪些？”这一问题。
根据英国国家卫生与临床优化研究所的指南，确定、呈现并严格评估符合选择标准的研究。对方法严谨性强的研究进行主题综合分析。综合与解读包括三个阶段：对原始数据进行编码；形成反映原始数据的描述性主题；确立分析性主题以回答综述问题。
九篇论文的数据被纳入主题综合分析。从这些数据中提炼出若干描述性主题和三个分析性主题以回答研究问题。分析性主题包括：存在个人和环境因素的矩阵，需要复杂的应对才能为伤后就业创造可能性和机会；求职或就业过程与脊髓损伤适应的时间特性存在相互关系；通过有偿工作实现职业参与存在内在需求。
脊髓损伤患者重返工作岗位或获得工作机会从根本上来说是一段艰难的经历。需要多种策略来支持这一过程。然而，脊髓损伤患者有成为劳动者的需求，而就业也会带来相应的固有益处。对康复的启示重返工作岗位应成为脊髓损伤康复的重要关注点。脊髓损伤后就业既可行又有益健康。需要多种策略来支持患者完成重返工作岗位的过程。认识到个人成为劳动者的动机以及适应过程的复杂性很重要。脊髓损伤中心可以提供一个一致且支持性的框架，以及对脊髓损伤后就业持积极态度的文化氛围。
