Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-27T09:33:58.031Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinician perspectives of ABI vocational rehabilitation in Queensland

Published online by Cambridge University Press:  23 March 2023

Kerrin Watter Open the ORCID record for Kerrin Watter [Opens in a new window] ,
Alena Murray ,
Vanette McLennan ,
Jessica Vogler ,
Shelley Ehlers ,
Sarah Jeffery ,
Mandy Nielsen  and
Areti Kennedy
Kerrin Watter*
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, QLD, Australia
Alena Murray
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, QLD, Australia
Vanette McLennan
Affiliation:
The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, QLD, Australia School of Allied Health Sciences, Griffith University, QLD, Australia
Jessica Vogler
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
Shelley Ehlers
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
Sarah Jeffery
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
Mandy Nielsen
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, QLD, Australia
Areti Kennedy
Affiliation:
Acquired Brain Injury Transitional Rehabilitation Service, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia The Hopkins Centre, Division of Rehabilitation, Metro South Health and Menzies Institute, Griffith University, QLD, Australia
*
*Corresponding author. Email: Kerrin.Watter@health.qld.gov.au
Get access

Abstract

Introduction:

Services to support adults with acquired brain injury (ABI) and return to work goals are varied. In Queensland, Australia, return to work goals may be addressed through private or publicly funded rehabilitation services or through publicly funded employment programs. No set frameworks or processes are in place to guide clinicians in providing vocational rehabilitation to adults with ABI, and the extent to which services address clients’ vocational goals and/or provide vocational rehabilitation is unknown.

Method:

This qualitative study investigated the clinical practice and experiences of allied health rehabilitation clinicians (n = 34) to identify current practice in providing vocational rehabilitation to adults with ABI, including pathways and services; models, frameworks and tools; and recommendations for ideal services. Focus groups and online surveys were conducted, with data analysed via content analysis.

Results:

ABI vocational rehabilitation was inconsistently delivered within and across services in Queensland, with differences in access to services, aspects of vocational rehabilitation provided and timeframes for rehabilitation. Five key themes were identified regarding ABI vocational rehabilitation and service delivery in Queensland: Factors influencing ABI and return to work; Service provision; ABI vocational rehabilitation processes (including assessment tools and interventions); Service gaps; and Ideal ABI vocational rehabilitation services.

Discussion:

These findings can inform clinical practice and development, and current and future service delivery models for ABI vocational rehabilitation.

Keywords

Vocational rehabilitationreturn to workbrain injuriesdelivery of healthcare
Type
Original Article
Information
Brain Impairment , Volume 24 , Issue 2 , September 2023 , pp. 371 - 394
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atkins, L., Francis, J., Islam, R., O’Connor, D., Patey, A., Ivers, N., …, & Michie, S. (2017). A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implementation Science, 12(77). doi: 10.1186/s13012-017-0605-9,CrossRefGoogle ScholarPubMed
Australasian Faculty of Rehabilitation Medicine. (2014). Standards for the provision of Rehabilitation Medicine Services in the Ambulatory Setting. Sydney:: Royal Australasian College of Physicians, Retrieved from. Retrieved from https://www.racp.edu.au/docs/default-source/advocacy-library/ambulatory-standards.pdf.Google Scholar
Australasian Faculty of Rehabilitation Medicine. (2019). Standards for the provision of Inpatient Adult Rehabilitation Medicine Services in Public and Private Hospitals. Sydney:: Royal Australasian College of Physicians, Retrieved from. Retrieved from =https://www.racp.edu.au/docs/default-source/default-document-library/default-document-library/afrm-standards-provision-of-inpatient-adult-rehabilitation-medicine-services.pdf?sfvrsn=564f2d1a_4.Google Scholar
Bould, E., & Callaway, L. (2021). A co-design approach to examine and develop pathways to open employment for people with acquired brain injury. Brain Impairment, 22(1), 50–66. doi: 10.1017/BrImp.2020.9 CrossRefGoogle Scholar
Burns, S. P., Schwartz, J. K., Scott, S. L., Devos, H., Kovic, M., Hong, I., & Akinwuntan, A. (2018). Interdisciplinary approaches to facilitate return to driving and return to work in mild stroke: a position paper. Archives of Physical Medicine & Rehabilitation, 10.1016/j.apmr.2018.01.032,CrossRefGoogle ScholarPubMed
Dillahunt-Aspillaga, C., Jorgensen Smith, T., Hanson, A., Ehlke, S., Stergiou-Kita, M., Dixon, C. G., & Quichocho, D. (2015). Exploring vocational evaluation practices following traumatic brain injury. Behavioural Neurology, 2015, 1–11. doi: 10.1155/2015/924027.CrossRefGoogle ScholarPubMed
Donker-Cools, B. H. P. M., Daams, J. G., Wind, H., & Frings-Dresen, M. H. (2016). Effective return-to-work interventions after acquired brain injury: a systematic review. Brain Injury, 30(2), 113–131. doi: 10.3109/02699052.2015.1090014 CrossRefGoogle ScholarPubMed
Donker-Cools, B. H. P. M., Schouten, M. J. E., Wind, H., & Frings-Dresen, M. H. W. (2018). Return to work following acquired brain injury: the views of patients and employers. Disability & Rehabilitation, 40(2), 185–191. doi: 10.1080/09638288.2016.1250118 CrossRefGoogle ScholarPubMed
Donker-Cools, B. H. P. M., Wind, H., & Frings-Dresen, M. H. W. (2016). Prognostic factors of return to work after traumatic or non-traumatic acquired brain injury. Disability & Rehabilitation, 38(8), 733–741. doi: 10.3109/09638288.2015.1061608 CrossRefGoogle ScholarPubMed
Fadyl, J. K., & McPherson, K. M. (2009). Approaches to vocational rehabilitation after traumatic brain injury: a review of the evidence. Journal of Head Trauma Rehabilitation, 24(3), 195–212. doi: 10.1097/HTR.0b013e3181a0d458 CrossRefGoogle ScholarPubMed
Gilworth, G., Eyres, S., Carey, A., Bhakta, A., & Tennant, A. (2008). Working with a brain injury: personal experiences of returning to work following a mild or moderate brain injury. Journal Of Rehabilitation Medicine, 40(5), 334–339. doi: 10.2340/16501977-0169 CrossRefGoogle ScholarPubMed
Graham, C. W., West, M. D., Bourdon, J. L., Inge, K. J., Seward, H. E., & Campbell, C. (2016). Employment interventions for return to work in working aged adults following traumatic brain injury (TBI): a systematic review. Campbell Systematic Reviews, 6(1). doi: 10.4073/csr.2016.6 Google Scholar
Green, J., & Thorogood, N. (2004). Qualitative methods for health researchers. London: SAGE Publications.Google Scholar
Hart, T., Dijkers, M., Fraser, R., Cicerone, K., Bogner, J. A., Whyte, J., & Waldron, B. (2006). Vocational services for traumatic brain injury: treatment definition and diversity within model systems of care. Journal of Head Trauma Rehabilitation, 21(6), 467–482.10.1097/00001199-200611000-00002CrossRefGoogle ScholarPubMed
Hart, T., Dijkers, M., Whyte, J., Braden, C., Trott, C. T., & Fraser, R. (2010). Vocational interventions and supports following job placement for persons with traumatic brain injury. Journal of Vocational Rehabilitation, 32(3), 135–150. doi: 10.3233/JVR-2010-0505 CrossRefGoogle Scholar
Hoffman, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd ed.). Sydney: Elsevier.Google Scholar
Holzberg, E. (2001). The best practice for gaining and maintaining employment for individuals with traumatic brain injury. Work-a Journal of Prevention Assessment & Rehabilitation, 16(3), 245–258.Google ScholarPubMed
Hooson, J. M., Coetzer, R., Stew, G., & Moore, A. (2013). Patients’ experience of return to work rehabilitation following traumatic brain injury: a phenomenological study. Neuropsychological Rehabilitation, 23(1), 19–44. doi: 10.1080/09602011.2012.713314 CrossRefGoogle ScholarPubMed
Hsieh, H., & Shannon, S. E. (2005). Three approaches to qualitative analysis. Qualitative Healthcare Research, 15(9), 1277–1288. doi: 10.1177/1049732305276687 CrossRefGoogle Scholar
Jeyaraj, J. A., Clendenning, A., Bellmare-Lapierre, S. I., Lemoise, M.-C., Edwards, D., & Korner-Bitensky, N. (2013). Clinicians’ perceptions of factors contributing to complexity and intensity of care of outpatients with traumatic brain injury. Brain Injury, 27(12), 1338–1347. doi: 10.3109/02699052.2013.823650 CrossRefGoogle ScholarPubMed
Kendall, E., Muenchberger, H., & Gee, T. (2006). Vocational rehabilitation following traumatic brain injury: a quantitative synthesis of outcome studies. Journal of Vocational Rehabilitation, 25(3), 149–160.Google Scholar
Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., Letts, L. (1996). The person-environment-occupation model: a transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63(1), 9–23.CrossRefGoogle Scholar
Levack, W., McPherson, K., & McNaughton, H. (2004). Success in the workplace following traumatic brain injury: are we evaluating what is most important? Disability and Rehabilitation, 26(5), 290–298. doi: 10.1080/09638280310001647615 CrossRefGoogle ScholarPubMed
Libeson, L., Downing, M., Ross, P., & Ponsford, J. (2018). The experience of return to work in individuals with traumatic brain injury (TBI): a qualitative study. Neuropsychological Rehabilitation, 30(3), 1–18. doi: 10.1080/09602011.2018.1470987 Google ScholarPubMed
Macaden, A. S., Chandler, B. J., Chandler, C., & Berry, A. (2010). Sustaining employment after vocational rehabilitation in acquired brain injury. Disability and Rehabilitation, 32(14), 1140–1147. doi: 10.3109/09638280903311594 CrossRefGoogle ScholarPubMed
Mani, K., Cater, B., & Hudlikar, A. (2017). Cognition and return to work after mild/moderate traumatic brain injury: a systematic review. Work-a Journal of Prevention Assessment & Rehabilitation, 58(1), 51–62. doi: 10.3233/WOR-172597 Google ScholarPubMed
McRae, P., Hallab, L., & Simpson, G. (2016). Navigating employment pathways and supports following brain injury in Australia: client perspectives. Australian Journal of Rehabilitation Counselling, 22(2), 76–92. doi: 10.1017/jrc.2016.14 CrossRefGoogle Scholar
Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation Science, 6(42). doi: 10.1186/1748-5908-6-42 CrossRefGoogle ScholarPubMed
Murray, A., Watter, K., McLennan, V., Vogler, J., Nielsen, M., Jeffery, S., & Kennedy, A. (2021). Identifying models, processes and components of vocational rehabilitation following acquired brain injury: a systematic scoping review. Disability and Rehabilitation, 44(24), 7641–7654. doi: 10.1080/09638288.2021.1980622 CrossRefGoogle ScholarPubMed
O’Brien, L. (2007). Achieving a successful and sustainable return to the workforce after ABI: a client-centred approach. Brain Injury, 21(5), 465–478.CrossRefGoogle Scholar
O’Keefe, S., Stanley, M., Adam, K., & Lannin, N. (2019). A systematic scoping review of work interventions for hospitalised adults with an acquired neurological impairment. Journal of Occupational Rehabilitation, 29(3), 569–584. doi: 10.1007/s10926-018-9820-8 CrossRefGoogle ScholarPubMed
OCEBM Working Group. (2009). Oxford centre for evidence-Based medicine: levels of evidence. oxford centre for evidence-Based medicine. Retrieved from. Retrieved from https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009.Google Scholar
Onwuegbuzie, A. J., Dickinson, W. B., Leech, N. L., & Zoran, A. G. (2009). A qualitative framework for collecting and analysing data in focus group research. International journal of qualitative methods, 8(3), 1–21. doi: 10.1177/160940690900800301 CrossRefGoogle Scholar
Ownsworth, T. (2010). A metacognitive contextual approach for facilitating return to work following acquired brain injury: three descriptive case studies. Work-a Journal of Prevention Assessment & Rehabilitation, 36(4), 381–388. doi: 10.3233/WOR-2010-1041 Google ScholarPubMed
Pagan, E., Ownsworth, T., McDonald, S., Fleming, J., Honan, C., & Togher, L. (2016). A survey of multidisciplinary clinicians working in rehabilitation for people with traumatic brain injury. Brain Impairment, 16(3), 173–195. doi: 10.1017/BrImp.2015.34 CrossRefGoogle Scholar
Queensland Health. (2016). Statewide adult brain injury rehabilitation health service plan 2016-2026. Brisbane:: Queensland Health., Retrieved from. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0029/652628/statewide-abi-rehab-plan-16-26.pdf.Google Scholar
Radford, K., Sutton, C., Sach, T., Holmes, J., Watkins, C., Forshaw, D., & Phillips, J. (2018). Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT. Health Technology Assessment, 22(33), 1–124. doi: 10.3310/hta22330 CrossRefGoogle ScholarPubMed
Rubenson, C., Svensson, E., Linddahl, I., & Björklund, A. (2007). Experiences of returning to work after acquired brain injury. Scandinavian Journal of Occupational Therapy, 14(4), 205–214.CrossRefGoogle ScholarPubMed
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., & Jinks, C. (2018). Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893–1907. doi: 10.1007/s11135-017-0574-8 CrossRefGoogle ScholarPubMed
Schwarz, B., Claros-Salinas, D., & Streibelt, M. (2018). Meta-synthesis of qualitative research on facilitators and barriers of return to work after stroke. Journal of Occupational Rehabilitation, 28(1), 28–44. doi: 10.1007/s10926-017-9713-2 CrossRefGoogle ScholarPubMed
Shames, J., Treger, I., Ring, H., & Giaquinto, S. (2007). Return to work following traumatic brain injury: trends and challenges. Disability and Rehabilitation, 29(17), 1387–1395. doi: 10.1080/09638280701315011 CrossRefGoogle ScholarPubMed
Stergiou-Kita, M., Dawson, D., & Rappolt, S. (2011). An integrated review of the processes and factors relevant to vocational evaluation following traumatic brain injury. Journal of Occupational Rehabilitation, 21(3), 374–394. doi: 10.1007/s10926-010-9282-0 CrossRefGoogle ScholarPubMed
Stergiou-Kita, M., Yantzi, A., & Wan, J. (2010). The personal and workplace factors relevant to work readiness evaluation following acquired brain injury: occupational therapists’ perceptions. Brain Injury, 7(8), 948–958. doi: 10.3109/02699052.2010.491495 CrossRefGoogle Scholar
Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being and justice through occupation. Ottawa, ON: CAOT Publications ACE.Google Scholar
Tyerman, A. (2012). Vocational rehabilitation after traumatic brain injury: models and services. NeuroRehabilitation, 31(1), 51–62. doi: 10.3233/NRE-2012-0774 CrossRefGoogle ScholarPubMed
Tyerman, A., Meehan, M., & Tuner-Stokes, L. (2004). Vocational assessment and rehabilitation after acquired brain injury: inter-agency guidelines. London: British Society of Rehabilitation Medicine.Google Scholar
Vaismoradi, M., & Snelgrove, S. (2019). Theme in qualitative content analysis and thematic analysis. Forum: Qualitative Social Research, 20(3), Art.–23. doi: 10.17169/fqs-20.3.3376 CrossRefGoogle Scholar
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15(3), 398–405. doi: 10.1111/nhs.12048 CrossRefGoogle ScholarPubMed
van Velzen, J. M., van Bennekom, C. A., Edelaar, M. J., Sluiter, J. K., & Frings-Dresen, M. H. (2009). How many people return to work after acquired brain injury?: a systematic review. Brain Injury, 23(6), 473–488. doi: 10.1080/02699050902970737 CrossRefGoogle ScholarPubMed
Van Velzen, J. M., Van Bennekom, C. A., & Frings-Dresen, M. H. (2020). Availability of vocational rehabilitation services for people with acquired brain injury in Dutch rehabilitation institutions. Brain Injury, 34(10), 1401–1407. doi: 10.1080/02699052.2020.1802778 CrossRefGoogle ScholarPubMed
van Velzen, J. M., van Bennekom, C. A., van Dormolen, M., Sluiter, J. K., & Frings-Dresen, M. H. (2011). Factors influencing return to work experienced by people with acquired brain injury: a qualitative research study. Disability and Rehabilitation, 33(23-24), 2237–2246. doi: 10.3109/09638288.2011.563821 CrossRefGoogle ScholarPubMed
Watter, K., Kennedy, A., McLennan, V., Vogler, J., Jeffery, S., Murray, A., …, & Nielsen, M. (2021). Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury. Brain Impairment, 23(2), 1–21. doi: 10.1017/BrImp.2021.4,Google Scholar
World Health Organisation. (2001). International classification of functioning, disability and health: ICF. Geneva: World Health Organisation.Google Scholar
World Health Organisation. (2020). Rehabilitation factsheet. vol. October 2020, Retrieved from, https://www.who.int/news-room/fact-sheets/detail/rehabilitation Google Scholar