Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
Spinalis SCI Unit, Rehab Station Stockholm, Stockholm, Sweden.
Scand J Occup Ther. 2021 Oct;28(7):571-581. doi: 10.1080/11038128.2020.1795245. Epub 2020 Aug 5.
To generate knowledge about how professional stakeholders organise and experience the support of the return-to-work (RTW) process for persons with spinal cord injury (SCI).
Constructivist grounded theory approach. Professional stakeholders ( = 34) involved in the RTW process and representing three Swedish Regions were recruited into seven focus groups. Analysis followed initial, focussed, and theoretical coding.
The core category - mediating intentions to support work and possibilities of working through social, labour market, and societal context - illustrates complexities of when and how to support a person with SCI in the RTW process, and a risk of delayed, unequal, or absent RTW processes. Analysis outlines: (1) Assessment of ability to work - uncertainty of how and when; (2) Planning RTW - divide between dynamic and rule-based perspectives; (3) Work re-entry - unequal paths towards viable solutions.
In RTW after SCI, it is critical to acknowledge how the RTW process is situated in relation to the person and context. A possible direction - grounded in an occupational perspective - through early identification of needs and resources and coordination derived from the SCI rehabilitation setting within healthcare is suggested. This can facilitate a time-sensitive and equal RTW process.
了解专业利益相关者如何组织和体验脊髓损伤（SCI）患者重返工作岗位（RTW）过程的支持。
建构主义扎根理论方法。参与 RTW 过程并代表瑞典三个地区的专业利益相关者（共 34 人）被招募到七个焦点小组中。分析遵循初始、聚焦和理论编码。
核心类别 - 通过社会、劳动力市场和社会背景来调解支持工作和工作可能性的意图 - 说明了在 RTW 过程中何时以及如何支持 SCI 患者的复杂性，以及 RTW 过程延迟、不平等或缺失的风险。分析概述了：（1）工作能力评估 - 不确定性的方式和时间；（2）RTW 计划 - 动态和基于规则的观点之间的分歧；（3）工作重新进入 - 可行解决方案的不平等路径。
在 SCI 后的 RTW 中，必须承认 RTW 过程与个人和环境的关系。建议通过在医疗保健中从 SCI 康复环境中早期确定需求和资源并进行协调，基于职业视角，为 RTW 提供一个可能的方向。这可以促进及时和平等的 RTW 过程。
