Describing pathways for return to work following spinal cord injury

BACKGROUND: Spinal cord injury (SCI) frequently occurs in working-aged adults. Following SCI, return to work (RTW) is complex. OBJECTIVE: To describe RTW pathways for people with SCI in New Zealand. METHOD: Data from interviews of people with SCI were analysed using conventional content analysis and themes were developed. These themes were used to develop a graphic that described RTW pathways. RESULTS: Three groups of participants were identified: those who had returned to work, those who would work when they were ready and those where work seemed too far off. Among the first two groups, the themes of constantly recalibrating expectations, having a supportive employer, control/autonomy over work role, exploring options, maintaining hope and knowing work will be there when I am ready, were prevalent. For participants where work seemed too far off, two themes, I don't know if I can work and rehabilitation is my priority, were identified. The resulting model highlighted that RTW pathways following SCI are complex and non-linear. CONCLUSION: While RTWmay be reasonably straightforward for some, for others it can be more circuitous and difficult to navigate. Therefore, vocational rehabilitation programmes should consider where the individual is on the RTW pathway and provide appropriate individualised interventions.