Multidisciplinary Model to Guide Employment Amongst PLWSCI

October 12, 2021 updated by: Ntsikelelo Pefile, University of KwaZulu

Development of a Multidisciplinary Model to Guide Employment Outcomes in People Living With Spinal Cord Injuries in South Africa.

Spinal cord injury often results in complete or partial loss of functioning of the upper and or lower limbs, leading to the affected individual experiencing difficulties in performing activities of daily living. This in turn results in reduced participation in social, religious, recreational and economic activities (employment). Globally, there is a low employment rate (11-67%) amongst PLWSCI. In South Africa, according to Statistics South Africa, the unemployment rate of people with disabilities is estimated to be 25.2%. However, there is no information available on employment amongst PLWSCI in South Africa.

Furthermore, there is insufficient knowledge related to SCI in South Africa to enable a model to be developed and implemented. Data on the current SCI rehabilitation practices (with specific reference to vocational rehabilitation); employment status and factors (both personal and environmental); barriers and facilitators of employment amongst PLWSCI is limited. This information is needed to develop a return to work model for individuals with SCI in South Africa.

In South Africa, a legal framework exists that promotes the employment as well as assistance of people with disabilities in the workplace, such as: the Constitution of Republic of South Africa, 1996; the Employment Equity Act (EEA), 1998; the Promotion of Equality and Prevention of Unfair Discrimination Act (PEPUDA), 2000; Labour Relations Act (LRA), 1995; Skills Development Act (SDA), 1998; Public Service Act (PSA), 1994; Basic Conditions of Employment Act (BCEA), 1997 and the Integrated National Disability Strategy (2000). However, rehabilitation interventions provided in rehabilitation institutions are mainly medical, with limited attempts to prepare those with SCI to return to gainful employment. There is therefore a need for a well-coordinated, multi-sectorial, multi-disciplinary and multi-factorial rehabilitation intervention that will promote the employment of PLWSCI in South Africa.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is a cross-sectional study in which mixed methods will be used in various phases of the study. Mixed methods involve the collection and analysis of both quantitative and qualitative data in a single study. Data are collected concurrently or sequentially and integrated at one or more stages during the research process. This study will be divided into 3 phases with stages to answer the objectives.

Phase one of this study will attempt to answer objectives 1-3 of the study. Stage 1 will include a systematic review of literature to identify the most effective vocational rehabilitation interventions amongst PLWSCI. Stage 2 will determine rehabilitation services rendered to individual who sustain SCI in South Africa with an intention of identifying gaps in vocational rehabilitation practices by retrospectively analysing medical files. This phase will be concluded by a focus group to further explore current vocational rehabilitation practices rendered to PLWSCI (Stage3).

Phase two will answer objectives 4-5. Stage 1 of this phase will determine the employment status as well as factors that influence employment amongst PLWSCI. Stage 2 will determine the barriers and facilitators of employment amongst PLWSCI. Results obtained from phase 1 to 2, will be utilised to by the researcher to develop the proposed model.

The final phase will aim to develop, validate and refine the model. Stage 1 of this phase will include the researcher using the information gained in previous phases to develop the proposed model. The second stage will include a focus group to validate the content of the proposed model. The last stage will included obtaining consensus amongst the stakeholders regarding the structure and the content of the proposed model and subsequently refine it.

Study Type

Observational

Enrollment (Actual)

180

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • South Africa
    • KwaZulu-Natal
      • Durban, KwaZulu-Natal, South Africa, 4000
        • King Dinizulu Hospital
      • Durban, KwaZulu-Natal, South Africa, 4068
        • Phoenix Spinal Rehabilitation Centre
      • Pietermaritzburg, KwaZulu-Natal, South Africa, 3200
        • Greys Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years to 65 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

Phase One :

Rehabilitation Professionals People living with Spinal Cord Injuries Representatives from various working environment

Description

Phase One:

Inclusion Criteria:

• Rehabilitation professionals who are directly involved in the management of individuals who sustain SCI and have more than 1 year of working experience post community service.

Exclusion Criteria:

• Rehabilitation professionals who are not directly involved in the management of individuals who sustain SCI and have less than 1 year working experience post community service.

Phase Two :

Inclusion Criteria:

• Person who sustained injury to the spine, resulting in permanent neurological damage (complete or incomplete) and must reside in a rural, peri-urban and urban.

Exclusion Criteria

• People living with spinal cord injuries who cannot verbally communicate

Phase Three Inclusion Criteria

  • PLWSCI Injury to who resides in a rural, peri-urban and urban.
  • Rehabilitation professionals who are directly involved in the management of individuals who sustain SCI and have more than 2 years of experience post community service.
  • An individual who is full time employed in a supervisory and managerial capacity in both private and public sector, currently have subordinates who are PLWSCI.
  • A representative from the Disability Section of an insurance company that is the member of the LOA.

Exclusion Criteria

  • PLWSCI who cannot verbally communicate.
  • Rehabilitation professionals who are not directly involved in the management of individuals who sustain SCI and have less than two years of experience post community service.
  • An individual who is employed on a part-time basis and not in supervisory or managerial positions and have no subordinates who are PLWSCI.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Ecologic or Community
  • Time Perspectives: Cross-Sectional

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Rehabilitation Professionals
Focus group consisting of rehabilitation professionals that will inform the study on vocational rehabilitation interventions rendered during acute to in-patient rehabilitation in KwaZulu-Natal.
Other: Focus groups, semistructured interviews and Delphi rounds
People living with Spinal Cord Injuries (PLWSCI)

Focus group consisting of PLWSCI that will inform the study on the perspective of the patient on vocational rehabilitation needs or desires during acute care and in-patient rehabilitation.

This group will inform the study on the employment rate amongst people living with spinal cord injuries as well as factors that influence employment.

This group will also inform the study on the perceived barriers and facilitators of employment
Other: Focus groups, semistructured interviews and Delphi rounds
Stakeholders

Representatives from the following departments or organisations will be invited to participate in the interviews and focus groups:

Government Departments:

Education Social Development Health Labour Transport

Private Companies:

Insurance Companies and Health Risk Management companies Non-profit Organisations QASA DPSA
Other: Focus groups, semistructured interviews and Delphi rounds
Experts
A delphi technique will be used to get an expert opinion and consensus on the aspects of the model to be developed.
Other: Focus groups, semistructured interviews and Delphi rounds

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
A multidisciplinary model to guide employment amongst people living with spinal cord injuries
Time Frame: 18 months
The final model will be developed using all the information gained from the Phase one and two of the study. A validation process will be done through the delphi rounds.
18 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Systematic Review of effective Vocational Rehabilitation interventions amongst People Living With Spinal Cord Injuries
Time Frame: Five Months
The review study will follow the Chocrane A journal article will be published in a peer reviewed journal.
Five Months
Rehabilitation Practices that promote employability of People Living with Spinal Cord Injuries
Time Frame: Three months
Stage 2 and Stage Three of Phase one will develop a matrix or guideline of vocational rehabilitation interventions throughout the phases of rehabilitation.
Three months
Employment and Factors that affect employment amongst People living with Spinal Cord Injuries
Time Frame: Five months
Employment rates and nature of employment will be quantified using the International Labour Organisation definition of employment. The Factors affecting employment will also be quantified using the modified Life Situation Questionnaire.
Five months
Barriers and Facilitators of employment amongst people living with spinal cord injuries.
Time Frame: 8 months
Interviews and focus groups will be conducted to determine the barriers and facilitators of employment amongst PLWSCI.
8 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of KwaZulu

Investigators

  • Principal Investigator: Ntsikelelo Pefile, MScMedSc, University of KwaZulu

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2015

Primary Completion (Actual)

August 1, 2019

Study Completion (Actual)

August 1, 2021

Study Registration Dates

First Submitted

October 15, 2015

First Submitted That Met QC Criteria

October 19, 2015

First Posted (Estimate)

October 21, 2015

Study Record Updates

Last Update Posted (Actual)

October 20, 2021

Last Update Submitted That Met QC Criteria

October 12, 2021

Last Verified

October 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • BE499/14

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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