Experiences of vocational rehabilitation and support services for people living with a long term condition: qualitative systematic review

Abstract

Purpose

Identify and synthesise qualitative research evidence on activities and processes within formal vocational service provision that contribute to experiences of effective support to gain employment for people living with long term conditions.

Methods

A pre-published protocol was developed using PRISMA guidelines. Seven databases were searched to identify qualitative research. Results of the search were screened against inclusion criteria and for methodological quality. Findings from included studies were extracted and then analysed using thematic synthesis methods.

Results

Twenty two studies met the inclusion criteria. Six themes were identified that elucidated factors that contribute to experiences of supportive and effective vocational rehabilitation service delivery: a personalised service with service user preferences at the core; sustainable, timely and ongoing support; proactive collaboration with the employing organisation; peer support, the essential and necessary skills for gaining employment; and critical vocational worker skills, knowledge and attitudes.

Conclusion

This study demonstrates the utility of synthesising qualitative research to provide insight into the factors that contribute to experiences of supportive and effective vocational rehabilitation services that traverse various contexts. Future high quality qualitative research is required to probe a broader range of long term conditions to better identify the similarities and differences across services and groups.

IMPLICATIONS FOR REHABILITATION

• Across qualitative studies, common aspects of “good” vocational services can be identified that contribute to experiences of effective support to gain paid work for people living with long term conditions.

• Services are experienced positively when they are personalised, flexible, collaborative and take into account both lived experience and knowledge of the person’s condition.

• Vocational rehabilitation services should proactively build collaborative relationships between the job seeker, employing organisation and other agencies and services.

• Specific skills and services that people living with long-term conditions find particularly helpful include peer support, work-focused skill development and workplace adjustment and accommodations.

Keywords:

• Chronic disease
• employment
• qualitative research
• rehabilitation
• vocational
• systematic review

Acknowledgments

Thank you to the leaders and members of the stakeholder reference groups that contributed to this work. Leaders: Dr. Helen Lockett, Sean Gray, Dr. Matire Harwood, Neil Woodhams;

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the New Zealand Ministry of Social Development and Health Research Council partnership grant number 18/804.