Holmlund Lisa, Guidetti Susanne, Eriksson Gunilla, Asaba Eric
a Department of Neurobiology, Care Science and Society, Division of Occupational Therapy , Karolinska Institutet , Huddinge , Sweden.
b Spinalis SCI Unit , Rehab Station Stockholm , Stockholm , Sweden.
Disabil Rehabil. 2018 Dec;40(24):2875-2883. doi: 10.1080/09638288.2017.1362597. Epub 2017 Aug 9.
The aim of this follow-up study was to explore experiences of return to work in the context of everyday life among adults 7-11 years after spinal cord injury (SCI).
This study used in-depth interviews and observations in a qualitative design with eight persons who had previously been interviewed in 2008. A narrative approach was used during data gathering and analysis.
Return to work was experienced as something constantly needing to be negotiated in the context of everyday life. Several years after SCI expectations for work and perceptions of possibilities for meaningful work had changed. Five main themes were identified through the analysis, (1) negotiating the possibilities of working, (2) hope for future work tempered with concern, (3) education as a possible path to employment, (4) paths toward return to work in light of unmet support, and (5) unpaid occupations grounded in interest and competence.
Persons who have no higher education or lack viable employment to return to after SCI seem to be vulnerable in return to work. Early and timely interventions tailored to the person's interests and competencies, in which the rehabilitation team has a distinct coordinating role, are thus critical in return to work. Implications for Rehabilitation Tensions between hope and expectations for work and unmet needs of support can lead to barriers in return to work, particularly for those who have no higher education or lack employment to return to after spinal cord injury. Rehabilitation after spinal cord injury can benefit from focus on how the balance of work fits into routines in the context of everyday life. Early and timely interventions integrating the person's interests and competencies in return to work after spinal cord injury in combination with having a health care provider who has a distinct coordinating role are critical.
这项随访研究的目的是探讨脊髓损伤（SCI）7至11年后成年人在日常生活背景下重返工作岗位的经历。
本研究采用定性设计，对8名曾在2008年接受过访谈的人员进行深入访谈和观察。在数据收集和分析过程中采用了叙事方法。
重返工作岗位被视为在日常生活背景下需要不断协商的事情。脊髓损伤几年后，对工作的期望和对有意义工作可能性的认知发生了变化。通过分析确定了五个主要主题：（1）协商工作的可能性；（2）对未来工作的希望与担忧并存；（3）教育作为就业的可能途径；（4）鉴于未得到满足的支持而重返工作岗位的途径；（5）基于兴趣和能力的无薪职业。
脊髓损伤后没有高等教育学历或缺乏可行的工作岗位可重返的人在重返工作岗位方面似乎较为脆弱。因此，针对个人兴趣和能力的早期及时干预至关重要，其中康复团队要发挥明确的协调作用。对康复的启示工作的希望与期望以及未得到满足的支持需求之间的紧张关系可能导致重返工作岗位的障碍，特别是对于那些没有高等教育学历或脊髓损伤后没有工作岗位可重返的人。脊髓损伤后的康复可受益于关注工作平衡如何融入日常生活中的常规活动。将个人兴趣和能力纳入脊髓损伤后重返工作岗位的早期及时干预，同时要有一个发挥明确协调作用的医疗服务提供者，这一点至关重要。
