Return to work in the context of everyday life 7–11 years after spinal cord injury – a follow-up study

Abstract

Purpose: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords:

• Vocational rehabilitation
• work reentry
• expectations
• meaning
• occupation
• occupational science

Acknowledgements

We would like to extend our appreciation to the participants in this study who by sharing their stories made the work possible. We also thank co-supervisors Docent Claes Hultling and Professor Åke Seiger for valuable advice and Claire Uchida for language assistance.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

Doctoral School in Health Care Sciences at Karolinska Institutet

Norrbacka-Eugenia Foundation10.13039/501100004875

Neuro Sweden

Spinalis Foundation

Swedish Association of Occupational TherapistsDoctoral School in Health Care Sciences

The Doctoral School in Health Care Sciences at Karolinska Institutet (dnr 2-1955/2013), Norrbacka-Eugenia Foundation, Neuro Sweden, Spinalis Foundation, and the Swedish Association of Occupational Therapists supported the study.