Early vocational rehabilitation for patients with spinal injury: a qualitative research study of service providers

Background/Aims: Early intervention is among the factors frequently associated with positive vocational rehabilitation outcomes. However, vocational rehabilitation is not generally a core component of inpatient rehabilitation for individuals with spinal cord injury, who traditionally have poor vocational outcomes. This study explored the perceptions of vocational coordinators providing early and integrated vocational rehabilitation services in the inpatient hospital settings and their opinions regarding the structures and processes of the interventions. Methods: All the four vocational coordinators involved in providing early integrated vocational services at the three spinal units in New South Wales, Australia were interviewed (in-depth) as key informants using a semi-structured approach. Transcripts of the interviews were created via audio recordings, transcribed verbatim, and the contents were analysed thematically. Findings: Many benefits were seen for vocational coordinators working within a multidisciplinary team in the hospital settings chiefly providing and promoting vocationally oriented therapy. Timing of service provision was not the overarching issue given the optional and voluntary nature of the intervention. The counselling role was seen as eminent given the challenging and (occasionally confronting) nature of working with newly injured individuals. Conclusions: The key nature of service provision being patient-centred and paced, within the context of a supportive spinal cord injury rehabilitation team, seemed to engender much hope and optimism, which are salient for newly injured individuals with spinal cord injury in the hospital setting.