Factors related to sustainable employment of people with acquired brain injury or spinal cord injury: The employer's perspective

Abstract

BackgroundOf those people with an acquired brain injury (ABI) or spinal cord injury (SCI) who initially successfully returned to paid employment, some exit the workforce before reaching official retirement age. Employers play a central role in ensuring a sustainable work situation for employees with a disability and in preventing such exits. However, the factors and mechanisms involved from the employer's perspective are still poorly understood.PurposeThe purpose was to determine factors which, from employer's perspective, have a particularly positive or negative influence on sustainable employment of people with ABI or SCI.MethodsTwenty semi-structured interviews were conducted with employers of people with ABI or SCI and thematically analyzed.ResultsIdentified factors could be assigned to four thematic areas for both health conditions: socio-demographic and psychological characteristics of the disabled person, their work performance, the work environment, and other social/environmental conditions. Good disability self-management and proactive communication of needs on the part of the employee are contributing factors to long-term employment from the employer's perspective. Differing expectations and assessments of work performance by employees and employers pose a challenge. Employers feel a responsibility to provide an optimal work environment to allow the employee with a disability to reach his or her full potential. This includes appropriate work tasks, development opportunities, a compassionate work team, flexible work arrangements, providing resources to address specific needs, and an inclusive culture. Employers find the support provided by occupational specialists very helpful, as they often lack the knowledge to design the work environment to meet the person's needs.ConclusionsEmployers emphasize the benefits of professional support during vocational rehabilitation to prepare employers and employees for long-term, sustainable employment. Such support is often lacking when changes and problems occur at a later stage. Therefore, people with a disability should be able to communicate their work-related needs and take charge of their own health so that problems that arise can be addressed as early as possible. Continued awareness of the environment is also beneficial. In addition, the expansion of low-threshold health-specific support services for long-term problems was found to be of great importance for employers in Switzerland.

Risk factors and service gaps affecting a sustainable vocational integration: A qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland

“…To address our research question, we carried out a secondary analysis of data from focus group discussions and semi-structured interviews (8, 9) that were conducted between May 2019 and July 2020. The original three studies investigated factors associated with sustainable work of persons with ABI and SCI (10)(11)(12). In the current secondary analysis, the gathered data was re-analyzed thematically (13,14).…”

“…The focus groups and the interviews followed the same procedure of discussing facilitators and barriers for sustainable work, service gaps and risk factors for labor market dropout. Detailed information on the data collection is published elsewhere (10)(11)(12).…”

Risk factors and service gaps affecting a sustainable work: a qualitative multi-stakeholder analysis in the context of persons with acquired brain injury living in Switzerland

“…The original project aimed to identify barriers and facilitators to sustainable employment for individuals with a disability, specifically focusing on those with acquired brain injuries and spinal cord injuries (SCI) [33]. To respond to this study aim, we conducted focus group discussions and semi-structured interviews [34,35] with individuals with ABI and SCI [36], health and vocational integration professionals [37], as well as employers of persons with ABI and SCI [38]. Based on our finding that the availability and structure of vocational integration services were perceived as a major barrier to employment sustainability, especially for persons with ABI, we decided to conduct an in-depth secondary analysis of the qualitative data, focusing on perceived service gaps and their relation to the identified risk factors for sustainable employment of people with ABI.…”

“…The focus groups and the interviews followed the same procedure of discussing facilitators and barriers for sustainable work, service gaps and risk factors for labor market dropout. Detailed information on the data collection is published elsewhere [36][37][38]. The guidelines of the focus groups and the interviews are provided in the supplementary material (S1-S4).…”

Prioritizing risk factors and identifying target areas to address with interventions to improve sustainable employment of persons with a brain injury or a spinal cord injury – A multi-stakeholder consensus process

“…The qualitative studies evaluated the perspectives of injured workers with ABI or SCI, health, work, or insurance professionals, and employers of persons with ABI or SCI (29)(30)(31). The qualitative study results showed that the most influential facilitators for sustained employment from the injured person's perspective are adaptation of the workplace and work schedule, a supportive social environment at home and at work, and ability to self-advocate, communicate and cope with a disability.…”