Hilton Gillean, Unsworth Carolyn A, Stuckey Ruth, Murphy Gregory C
Central Queensland University, Melbourne, VIC, Australia.
Austin Health, Melbourne, VIC, Australia.
Work. 2018;59(1):67-84. doi: 10.3233/WOR-172660.
Vocational potential in people with spinal cord injury (SCI) are unrealised with rates of employment substantially lower than in the labour force participation of the general population and the pre-injury employment rates.
To understand the experience and pathway of people achieving employment outcome after traumatic spinal cord injury by; classifying participants into employment outcome groups of stable, unstable and without employment; identifying pre and post-injury pathways for participants in each group and, exploring the experiences of people of seeking, gaining and maintaining employment.
Thirty-one participants were interviewed. Mixed methods approach including interpretive phenomenological analysis and vocational pathway mapping of quantitative data.
The most common pathway identified was from study and work pre-injury to stable employment post-injury. Four super-ordinate themes were identified from the interpretive phenomenological analysis; expectations of work, system impacts, worker identity and social supports. Implications for clinical practice include fostering cultural change, strategies for system navigation, promotion of worker identity and optimal use of social supports.
The findings increase insight and understanding of the complex experience of employment after spinal cord injury. There is opportunity to guide experimental research, policy development and education concerning the complexity of the return to work experience and factors that influence pathways.
脊髓损伤（SCI）患者的职业潜力未得到充分发挥，其就业率远低于普通人群的劳动力参与率和受伤前的就业率。
通过以下方式了解创伤性脊髓损伤后实现就业的患者的经历和途径：将参与者分为稳定就业、不稳定就业和未就业的就业结果组；确定每组参与者受伤前后的途径，并探索求职、就业和维持就业的经历。
对31名参与者进行了访谈。采用混合方法，包括解释性现象学分析和定量数据的职业途径映射。
确定的最常见途径是从受伤前的学习和工作到受伤后的稳定就业。从解释性现象学分析中确定了四个上位主题；工作期望、系统影响、工作者身份和社会支持。对临床实践的启示包括促进文化变革、系统导航策略、促进工作者身份认同和优化社会支持的使用。
这些发现增加了对脊髓损伤后就业复杂经历的洞察和理解。有机会指导关于重返工作经历的复杂性和影响途径的因素的实验研究、政策制定和教育。
