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印度尼西亚脊髓损伤患者工作和社会参与的障碍和促进因素。

Barriers and facilitators for work and social participation among individuals with spinal cord injury in Indonesia.

机构信息

University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands.

Department of Public Health, Faculty of Medicine, University of Mataram, Mataram, Indonesia.

出版信息

Spinal Cord. 2021 Oct;59(10):1079-1087. doi: 10.1038/s41393-021-00624-6. Epub 2021 Apr 7.

Abstract

STUDY DESIGN

Qualitative study using in-depth interviews.

OBJECTIVES

To describe experienced barriers and facilitators for work and social participation among individuals with spinal cord injury (SCI).

SETTING

Vocational rehabilitation (VR) center in Yogyakarta Province, Indonesia.

METHODS

Semi-structured interviews were conducted with 12 participants (8 males, 4 females) aged 24-67 years. Five participants still underwent vocational rehabilitation, while seven participants lived in the community. Thematic analysis was used.

RESULTS

None of the participants who worked before the injury returned to her/his previous occupation, most participants became self-employed. The frequency of participation in social activities decreased substantially. Barriers for work and social participation included health conditions and environmental barriers, including inaccessibility, stigma and discrimination and limited institutional support and services. Identified facilitators for work and social participation were perceived importance of work and social participation, adaptations to disability condition, and social support.

CONCLUSION

Barriers to engage in work and social activities for individuals with SCI in Indonesia are combination of physical limitations, lack of accessibility, stigma, and institutional barriers. The capacity of social networks such as family in facilitating participation should be strengthened during the VR processes. VR should provide marketing skills and link self-employed clients with the market, in collaboration with the private sector and industries. Immediate policy and programmatic action is needed to enable these individuals to enhance sustainable work and social participation.

摘要

研究设计

定性研究采用深入访谈法。

研究目的

描述脊髓损伤(SCI)患者工作和社会参与的障碍因素和促进因素。

研究地点

印度尼西亚日惹省的职业康复(VR)中心。

研究方法

对 12 名参与者(8 名男性,4 名女性)进行半结构式访谈,年龄为 24-67 岁。其中 5 名参与者仍在接受职业康复,7 名参与者生活在社区。采用主题分析。

研究结果

没有一名受伤前有工作的参与者回到之前的职业,大多数参与者成为了自雇人士。社会活动的参与频率大幅下降。工作和社会参与的障碍包括健康状况和环境障碍,包括无障碍性、污名化和歧视以及有限的机构支持和服务。工作和社会参与的促进因素包括对工作和社会参与的重视、对残疾状况的适应以及社会支持。

结论

印度尼西亚 SCI 患者参与工作和社会活动的障碍是身体限制、无障碍性缺乏、污名化和机构障碍的综合。社会网络(如家庭)的能力在促进参与方面应在 VR 过程中得到加强。VR 应提供营销技能,并与私营部门和行业合作,将自营客户与市场联系起来。需要立即采取政策和方案行动,使这些人能够增强可持续的工作和社会参与。

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