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Developing vocational rehabilitation services for people with long-term neurological conditions: Identifying facilitators and barriers to service provision / Kate Hayward in The British Journal of Occupational Therapy, Vol. 82 Issue 6 (Juin 2019)
[article]
Titre : Developing vocational rehabilitation services for people with long-term neurological conditions: Identifying facilitators and barriers to service provision Type de document : texte imprimé Auteurs : Kate Hayward ; Bilal A. Mateen ; Diane E. Playford ; Gail Eva Année de publication : 2019 Article en page(s) : p. 337-347 Note générale : doi.org/10.1177/0308022619830294 Langues : Anglais (eng) Mots-clés : Vocational rehabilitation soft systems methodology long-term neurological conditions service mapping occupational therapy Résumé : Introduction
This study aimed to understand existing vocational rehabilitation service provision in one locality in London (population 3.74 million), identify any gaps and explore reasons for this, to support service development.
Method
Using soft systems methodology to guide the research process, semi-structured interviews were completed with nine participants, who were clinicians and managers providing vocational rehabilitation within a National Health Service context. Data were analysed thematically to build a ‘rich picture’ and develop a conceptual model of vocational rehabilitation service delivery. Findings were then ratified with participants at an engagement event.
Results
The findings indicate a spectrum of vocational rehabilitation service provision for long-term neurological conditions with differing levels of funding in place. Vocational rehabilitation often takes place ‘under the radar’ and therefore the true vocational rehabilitation needs of this population, and the extent of service provision, is not known. There is inconsistency of understanding across the services as to what constitutes vocational rehabilitation and outcomes are not routinely measured.
Conclusion
For vocational rehabilitation services to develop they require appropriate funding, driven by government policy to commissioners. Clear definitions of vocational rehabilitation, collecting and sharing outcome data and effective communication across services are needed at a local level. This is expressed in a conceptual model of vocational rehabilitation service delivery.Permalink : ./index.php?lvl=notice_display&id=84441
in The British Journal of Occupational Therapy > Vol. 82 Issue 6 (Juin 2019) . - p. 337-347[article] Developing vocational rehabilitation services for people with long-term neurological conditions: Identifying facilitators and barriers to service provision [texte imprimé] / Kate Hayward ; Bilal A. Mateen ; Diane E. Playford ; Gail Eva . - 2019 . - p. 337-347.
doi.org/10.1177/0308022619830294
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol. 82 Issue 6 (Juin 2019) . - p. 337-347
Mots-clés : Vocational rehabilitation soft systems methodology long-term neurological conditions service mapping occupational therapy Résumé : Introduction
This study aimed to understand existing vocational rehabilitation service provision in one locality in London (population 3.74 million), identify any gaps and explore reasons for this, to support service development.
Method
Using soft systems methodology to guide the research process, semi-structured interviews were completed with nine participants, who were clinicians and managers providing vocational rehabilitation within a National Health Service context. Data were analysed thematically to build a ‘rich picture’ and develop a conceptual model of vocational rehabilitation service delivery. Findings were then ratified with participants at an engagement event.
Results
The findings indicate a spectrum of vocational rehabilitation service provision for long-term neurological conditions with differing levels of funding in place. Vocational rehabilitation often takes place ‘under the radar’ and therefore the true vocational rehabilitation needs of this population, and the extent of service provision, is not known. There is inconsistency of understanding across the services as to what constitutes vocational rehabilitation and outcomes are not routinely measured.
Conclusion
For vocational rehabilitation services to develop they require appropriate funding, driven by government policy to commissioners. Clear definitions of vocational rehabilitation, collecting and sharing outcome data and effective communication across services are needed at a local level. This is expressed in a conceptual model of vocational rehabilitation service delivery.Permalink : ./index.php?lvl=notice_display&id=84441 Exemplaires (1)
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Exclu du prêtA qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers / Yeliz Prior in The British Journal of Occupational Therapy, Volume 78 numéro 8 (Août 2015)
[article]
Titre : A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers Type de document : texte imprimé Auteurs : Yeliz Prior, Auteur ; Evangeline A. Amanna, Auteur ; Sarah BODELL, Auteur Année de publication : 2015 Article en page(s) : p.467-474 Langues : Anglais (eng) Mots-clés : Work rehabilitation vocational rehabilitation rheumatology work assessments Résumé : Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions.
Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity.
Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice.
Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.Permalink : ./index.php?lvl=notice_display&id=40386
in The British Journal of Occupational Therapy > Volume 78 numéro 8 (Août 2015) . - p.467-474[article] A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis: Perspectives of therapists and their line managers [texte imprimé] / Yeliz Prior, Auteur ; Evangeline A. Amanna, Auteur ; Sarah BODELL, Auteur . - 2015 . - p.467-474.
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Volume 78 numéro 8 (Août 2015) . - p.467-474
Mots-clés : Work rehabilitation vocational rehabilitation rheumatology work assessments Résumé : Introduction Occupational therapy-led work rehabilitation for employed people with inflammatory arthritis and work problems was piloted in five hospitals in the United Kingdom. This qualitative study explored the views of participating occupational therapists and their line managers about the work rehabilitation training received and conducting the intervention, with particular focus on the structured interview used, the Work Experience Survey – Rheumatic Conditions.
Method Face-to-face semi-structured interviews were conducted with occupational therapists (n = 9), followed by telephone interviews with their line managers (n = 2). Interviews were audio-recorded, transcribed verbatim and thematically analysed by three researchers to maximize validity.
Results The main themes emerging from the occupational therapists’ interviews were: varying levels of prior knowledge and experience of work rehabilitation, initial concerns about the feasibility of a lengthy work assessment in practice and increased confidence in delivering work rehabilitation as the study progressed. The line managers’ interviews generated themes around the positive impact of the work rehabilitation training the occupational therapists received, and changes in their practice.
Conclusion The Work Experience Survey – Rheumatic Conditions was considered a good choice of work assessment which can be implemented in practice. Once therapists had provided the work intervention several times, their confidence and skills increased.Permalink : ./index.php?lvl=notice_display&id=40386 Exemplaires (1)
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Exclu du prêtReturn to work after stroke – Feasibility of 6-year follow-up / Julie Phillips in The British Journal of Occupational Therapy, Vol. 82 Issue 1 (Janvier 2019)
[article]
Titre : Return to work after stroke – Feasibility of 6-year follow-up Type de document : texte imprimé Auteurs : Julie Phillips ; Kathryn Gaffney ; Margaret Phillips ; Kate Radford Année de publication : 2019 Article en page(s) : p. 27-37 Note générale : doi.org/10.1177/0308022618791976 Langues : Anglais (eng) Mots-clés : Occupational therapy stroke feasibility vocational rehabilitation long-term effects barriers and enablers Résumé : Introduction
Little is known about long-term work sustainability of stroke survivors. A feasibility trial of early stroke specialist vocational rehabilitation had 32/46 (69.5%) participants available for follow-up at 12 months post stroke. Of these, 19/32 (59.4%) were in work. This study aims to determine the feasibility of longer-term follow-up and explore work status 6 years post stroke.
Method
Forty-eight participants fitting criteria for the feasibility trial were sent postal questionnaires measuring employment, income, mood, functional ability and quality of life, and were invited for interview to explore working 6 years after stroke. Ethical approval was obtained.
Results
Of the 48 participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24–78) years. Fourteen (74%) reported working (paid work n = 10, voluntary work n = 3, full-time education n = 1). Five had retired. Most (11/13) remained with preinjury employers. Half (8/15, 53%) reported decreased income since stroke. Compared to one year, median functional ability was marginally higher (extended activities of daily living 63 (IQR 8, range 32–66) to 60 (IQR 9, range 17–66)), but health-related quality of life was lower (EuroQuol Visual Analogue Scale mean 77.4 [SD 11] to 70.7 [SD14]). Six interviewees felt returning to work was the correct decision but struggled with invisible impairments.
Conclusion
This study suggests that long-term follow-up is feasible and that those who made a good recovery were more likely to respond. Work remains important to stroke survivors 6 years post stroke.Permalink : ./index.php?lvl=notice_display&id=80293
in The British Journal of Occupational Therapy > Vol. 82 Issue 1 (Janvier 2019) . - p. 27-37[article] Return to work after stroke – Feasibility of 6-year follow-up [texte imprimé] / Julie Phillips ; Kathryn Gaffney ; Margaret Phillips ; Kate Radford . - 2019 . - p. 27-37.
doi.org/10.1177/0308022618791976
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol. 82 Issue 1 (Janvier 2019) . - p. 27-37
Mots-clés : Occupational therapy stroke feasibility vocational rehabilitation long-term effects barriers and enablers Résumé : Introduction
Little is known about long-term work sustainability of stroke survivors. A feasibility trial of early stroke specialist vocational rehabilitation had 32/46 (69.5%) participants available for follow-up at 12 months post stroke. Of these, 19/32 (59.4%) were in work. This study aims to determine the feasibility of longer-term follow-up and explore work status 6 years post stroke.
Method
Forty-eight participants fitting criteria for the feasibility trial were sent postal questionnaires measuring employment, income, mood, functional ability and quality of life, and were invited for interview to explore working 6 years after stroke. Ethical approval was obtained.
Results
Of the 48 participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24–78) years. Fourteen (74%) reported working (paid work n = 10, voluntary work n = 3, full-time education n = 1). Five had retired. Most (11/13) remained with preinjury employers. Half (8/15, 53%) reported decreased income since stroke. Compared to one year, median functional ability was marginally higher (extended activities of daily living 63 (IQR 8, range 32–66) to 60 (IQR 9, range 17–66)), but health-related quality of life was lower (EuroQuol Visual Analogue Scale mean 77.4 [SD 11] to 70.7 [SD14]). Six interviewees felt returning to work was the correct decision but struggled with invisible impairments.
Conclusion
This study suggests that long-term follow-up is feasible and that those who made a good recovery were more likely to respond. Work remains important to stroke survivors 6 years post stroke.Permalink : ./index.php?lvl=notice_display&id=80293 Exemplaires (1)
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Exclu du prêtImplementing evidence-based supported employment in Sussex for people with severe mental illness / Rhonda Van Veggel in The British Journal of Occupational Therapy, Volume 78 numéro 5 (Mai 2015)
[article]
Titre : Implementing evidence-based supported employment in Sussex for people with severe mental illness Type de document : texte imprimé Auteurs : Rhonda Van Veggel, Auteur ; Geoff Waghorn, Auteur ; Shannon Dias, Auteur Année de publication : 2015 Article en page(s) : p. 286-294 Langues : Anglais (eng) Mots-clés : Severe mental illness Employment Vocational rehabilitation Evidence-based practice Résumé : Introduction The aim of this research was to evaluate a large-scale implementation of evidence-based supported employment for people with severe mental illness, at 17 locations throughout Sussex, England.
Method A parallel group observational design was used to evaluate an implementation of the individual placement and support approach to supported employment. Three sites provided both a comparison pre-individual placement and support cohort (n = 140), and a new post-individual placement and support cohort (n = 107) as part of the individual placement and support implementation (n = 446). All individual placement and support sites involved community mental health teams forming partnerships with Southdown Supported Employment to co-locate an employment specialist into each mental health team. The primary outcome was the proportion of participants commencing competitive employment during the follow-up period.
Results The new individual placement and support sites attained higher fidelity with respect to individual placement and support principles and practices (mean 97 of 125) than the pre-individual placement and support sites (mean 77 of 125). Significantly more individual placement and support participants commenced competitive employment than pre-individual placement and support participants (24.9% vs 14.3%). Individual placement and support participants experienced less delay before commencing their first job (153 vs 371 days), and when employed, worked more hours per week (24.3 vs 15.4 hours).
Conclusion This implementation of individual placement and support in Sussex improved on the previous vocational services. Although progress is encouraging there is much room for improvement. More resources appear needed to support programme development, specifically to strengthen site-level management, training, technical support, fidelity assessment, programme monitoring, and outcome evaluation.En ligne : http://bjo.sagepub.com/content/78/5.toc Permalink : ./index.php?lvl=notice_display&id=35948
in The British Journal of Occupational Therapy > Volume 78 numéro 5 (Mai 2015) . - p. 286-294[article] Implementing evidence-based supported employment in Sussex for people with severe mental illness [texte imprimé] / Rhonda Van Veggel, Auteur ; Geoff Waghorn, Auteur ; Shannon Dias, Auteur . - 2015 . - p. 286-294.
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Volume 78 numéro 5 (Mai 2015) . - p. 286-294
Mots-clés : Severe mental illness Employment Vocational rehabilitation Evidence-based practice Résumé : Introduction The aim of this research was to evaluate a large-scale implementation of evidence-based supported employment for people with severe mental illness, at 17 locations throughout Sussex, England.
Method A parallel group observational design was used to evaluate an implementation of the individual placement and support approach to supported employment. Three sites provided both a comparison pre-individual placement and support cohort (n = 140), and a new post-individual placement and support cohort (n = 107) as part of the individual placement and support implementation (n = 446). All individual placement and support sites involved community mental health teams forming partnerships with Southdown Supported Employment to co-locate an employment specialist into each mental health team. The primary outcome was the proportion of participants commencing competitive employment during the follow-up period.
Results The new individual placement and support sites attained higher fidelity with respect to individual placement and support principles and practices (mean 97 of 125) than the pre-individual placement and support sites (mean 77 of 125). Significantly more individual placement and support participants commenced competitive employment than pre-individual placement and support participants (24.9% vs 14.3%). Individual placement and support participants experienced less delay before commencing their first job (153 vs 371 days), and when employed, worked more hours per week (24.3 vs 15.4 hours).
Conclusion This implementation of individual placement and support in Sussex improved on the previous vocational services. Although progress is encouraging there is much room for improvement. More resources appear needed to support programme development, specifically to strengthen site-level management, training, technical support, fidelity assessment, programme monitoring, and outcome evaluation.En ligne : http://bjo.sagepub.com/content/78/5.toc Permalink : ./index.php?lvl=notice_display&id=35948 Exemplaires (1)
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Exclu du prêtIndicators of long-term return to work after severe traumatic brain injury: A cohort study / V. Wang in Annals of physical and rehabilitation medicine, Vol. 62, n°1 (Janvier 2019)
[article]
Titre : Indicators of long-term return to work after severe traumatic brain injury: A cohort study Type de document : texte imprimé Auteurs : V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. Année de publication : 2019 Article en page(s) : p. 28-34 Note générale : Doi : 10.1016/j.rehab.2018.08.003 Langues : Anglais (eng) Mots-clés : Return to work Traumatic brain injury Occupational outcome Job stability Vocational rehabilitation Résumé : Background
Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied.
Objective
The objective was to assess long-term RTW and the associated factors after severe TBI.
Material and methods
Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs).
Results
Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5).
Conclusion
Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors.Permalink : ./index.php?lvl=notice_display&id=82636
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34[article] Indicators of long-term return to work after severe traumatic brain injury: A cohort study [texte imprimé] / V. Wang ; E. Fort ; M. Beaudoin-Gobert ; et al. . - 2019 . - p. 28-34.
Doi : 10.1016/j.rehab.2018.08.003
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 62, n°1 (Janvier 2019) . - p. 28-34
Mots-clés : Return to work Traumatic brain injury Occupational outcome Job stability Vocational rehabilitation Résumé : Background
Return to work (RTW) is a major objective in the rehabilitation of individuals with severe traumatic brain injury (TBI). Implications for long-term occupational integration (beyond 5 years) have rarely been studied.
Objective
The objective was to assess long-term RTW and the associated factors after severe TBI.
Material and methods
Retrospective analysis of a cohort of individuals 16 to 60 years old admitted to hospital after severe TBI from 2005 to 2009 and followed prospectively. Medical and occupational data were collected from medical files and by systematic telephone interview to assess outcome at a minimum of 6 years post-trauma. Factors associated with RTW were investigated by multivariable regression analysis, estimating prevalence ratios (PRs) and 95% confidence intervals (CIs). A proportional hazards model was used to study RTW delay, estimating hazard ratios (HRs).
Results
Among the 91 individuals included (mean [SD] age 28.5 [11.3] years; 79% male), 63.7% returned to work after a mean of about 20 months, and 57.1% were still working at the time of the survey. Factors significantly associated with RTW on multivariable analysis were higher educational level (adjusted PR, 1.53; 95% CI, 1.15 to 2.03), absence of motor disability (adjusted PR, 1.82; 1.12 to 2.95) and behavioural disorder (adjusted PR, 1.26; 1.01 to 1.60), as well as disabled worker status (adjusted PR, 1.26; 1.01 to 1.60) (likelihood of the multivariate analysis model 53.1). Delayed RTW was associated with health insurance payments (adjusted HR, 0.40; 95% CI, 0.22 to 0.71), motor disability (adjusted HR, 0.34; 0.15 to 0.76), low educational level (adjusted HR, 2.20; 1.06 to 4.56) and moderate disability on the Extended Glasgow Outcome Scale (adjusted HR, 0.49; 0.27 to 0.91) (likelihood of the multivariate analysis model 335.5).
Conclusion
Individuals with the most severe TBI are able to RTW and remain in work. This study highlights the multiple determinants involved in RTW and the role of socioenvironmental factors.Permalink : ./index.php?lvl=notice_display&id=82636 Exemplaires (1)
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Exclu du prêtA Hospital-Based Supported Employment Service for Persons with Mental Illness in Hong Kong / Rose Chiu in WFOT Bulletin, N°44 (01/11/2001)
PermalinkOccupational therapy and job retention: supporting clients, supporting employers / Richard FROST in The British Journal of Occupational Therapy, volume 77 numéro 6 (Juin 2014)
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