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Multidisciplinary Model to Guide Employment Amongst PLWSCI

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ClinicalTrials.gov Identifier: NCT02582619
Recruitment Status : Unknown
Verified January 2017 by Ntsikelelo Pefile, University of KwaZulu.
Recruitment status was:  Active, not recruiting
First Posted : October 21, 2015
Last Update Posted : January 11, 2017
Sponsor:
Information provided by (Responsible Party):
Ntsikelelo Pefile, University of KwaZulu

Brief Summary:

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.


Condition or disease Intervention/treatment
Spinal Cord Injury Other: Focus groups, semistructured interviews and Delphi rounds

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.


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Study Type : Observational
Estimated Enrollment : 500 participants
Observational Model: Cohort
Time Perspective: Cross-Sectional
Official Title: Development of a Multidisciplinary Model to Guide Employment Outcomes in People Living With Spinal Cord Injuries in South Africa.
Study Start Date : October 2015
Estimated Primary Completion Date : September 2017
Estimated Study Completion Date : December 2017

Resource links provided by the National Library of Medicine


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



Primary Outcome Measures :
  1. 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.


Secondary Outcome Measures :
  1. 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.

  2. 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.

  3. 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.

  4. 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.



Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years to 65 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Phase One :

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

Criteria

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02582619


Locations
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South Africa
King Dinizulu Hospital
Durban, KwaZulu-Natal, South Africa, 4000
Phoenix Spinal Rehabilitation Centre
Durban, KwaZulu-Natal, South Africa, 4068
Greys Hospital
Pietermaritzburg, KwaZulu-Natal, South Africa, 3200
Sponsors and Collaborators
University of KwaZulu
Investigators
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Principal Investigator: Ntsikelelo Pefile, MScMedSc University of KwaZulu

Publications:
Anderson, D., Dumont, S., Azzaria, L., Le Bourdais, M., & Noreau, L. ( 2007). Determinants of return to work among spinal cord injury patients: A literature review. Journal of Vocational Rehabilitation , 27(1), 57-68.
Bromley, I. (2006). Tetraplegia and Paraplegia. Sixth ed. London: Churchill Livingstone Elsevier.
Coetzee, Z. G., C; van der Westhuizen, R; Van Niekerk, L. (2011). Re-conceptualising vocational rehabilitation services towards an inter-sectoral model. South African Journal of Occupational Therapy, 41(2), 32-36.
Department of Health (South Africa). (2000). National Rehabilitation Policy. Pretoria: Government Printer.
Dewbury,G., Clarke, K.,Randall, D., Rouncefield, M., Sommerville, I. (2004). The anti-social model of disability Disability and Society 19(2). 145-158.
Domholdt, E. (2005). Rehabilitation Research: Principles and Applications. Third ed. Missouri: Elsevier Saunders.
Escorpizo, R., Miller,W.C., Trenaman, L.M. (2012). Work and Employment Spinal Cord Rehabilitation Evidence, 4.0., 1-14.
Harvey, L. (2008). Management of Spinal Cord Injuries : A Guide for Physiotherapists. London: Butterworth Heinemann.
Higgins, J.P.T., & Green, S. (2009). Cochrane Handbook for Systematic Reviews of Interventions England The Cochrane Collaboration and John Wiley & Sons (LTD).
Hills, L.& Cullen, E. (2007). A study into the employment trends of individuals treated at a spinal cord injury centre. International Journal of Therapy and Rehabilitation, 14(8), 350-355.
Hsu, C. S., BA. (2007). The Delphi Technique: Making Sense of Consesus. Practical Assessement Research and Evaluation, 12(10), 1-8.
Marini, I., Lee, G. K., Chan, F., Chapin, M. H., & Romero, M. G. (2008). Vocational rehabilitation service patterns related to successful competitive employment outcomes of persons with spinal cord injury. Journal of Vocational Rehabilitation, 28(1), 1-13.
Office of the President (Office of the Status of Disbled People (South Africa). (1997). Integrated National Disability Strategy. Pretoria: Government Printer.
Ottomanelli, L., Bradshaw, L.D.,Cipher, D.J. (2009). Employment and vocationl rehabilitation services use amogst veterans with spinal cord injury Journal of Vocational Rehabilitation, 31, 39-43.
Paddison, S. and Middleton, F. (2005). Physical Management in Neurological Rehabilitation. Third ed. Netherlands: Elsevier.
Powers, M. and Faden, R. (2006). Social Justice: The Moral Foundations of Public Health and Health Policy. New York: Oxford University Press.
Raine,S.,Meadows.,Lynnch-Ellerington,M (2009). Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation.1st ed. West Sussex. Blackwell Publishing Ltd.
Saulino, M. (2011). Rehabilitation of Persons With Spinal Cord Injuires. Medscape Reference. http://emedicine.medscape.com/article/1265209-overview#aw2aab6c12
Somers, M. (2001). Spinal Cord Injury: Functional Rehabilitation (2 ed.). New Jersey: Prentice Hall.
South Africa. (1998). Employment Equity Act no 55 of 1998. Pretoria: Government Printer.
South Africa. (2000). Promotion of Equality and Prevention of Unfair Descrimination Act no 4 of 2000. Pretoria: Government Printer.
South Africa. (1995). Labour Relations Act no 66 of 1995. Pretoria: Government Printer.
South Africa. (1998). Skills Development Act no 97 of 1998. Pretoria: Government Printer.
South Africa. (1994). Public Service Act no 103 of 1994. Pretoria: Government Printer.
South Africa. (1997). Basic Conditions of Employment Act no 11 of 1998. Pretoria: Government Printer.
South Africa. (1996). Constitution of the Republic of South Africa no 108 of 1998. Pretoria: Government Printer.
Umphred, D. (2007). Neurological Rehabilitation (5th ed.). St. Louis, Missouri: Mosby Elsevier.
Vazquez-Ramos, R. L., M; Hernandez, NE. (2007). The Delphi Method in Rehabilitation Counselling Research Rehabilitation Counseling Bulletin, 50(2), 111-118.
Wilson, B., McLellan, D.L.(1997). Rehabilitation Studies Handbook.1st ed. Cambridge:Cambridge University Press.
World Health Organisation. (2002).Towards a Common Language for Functioning, Disability and Health (ICF). Geneva: World Health Organization.
Word Health Organisation (2013). International Perspectives on Spinal Cord Injury. Malta. World Health Organisation
Zolna, J. S., J; Sabata, D; Goldthwaite, J. (2007). Review of accomodation strategies in the workplace for persons with mobility and dexterity impairments: Application to criteria for universal design Technology and Disability, 19, 189-198.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Ntsikelelo Pefile, Mr, University of KwaZulu
ClinicalTrials.gov Identifier: NCT02582619     History of Changes
Other Study ID Numbers: BE499/14
First Posted: October 21, 2015    Key Record Dates
Last Update Posted: January 11, 2017
Last Verified: January 2017

Keywords provided by Ntsikelelo Pefile, University of KwaZulu:
Spinal Cord Injury and Employment

Additional relevant MeSH terms:
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Spinal Cord Injuries
Spinal Cord Diseases
Central Nervous System Diseases
Nervous System Diseases
Trauma, Nervous System
Wounds and Injuries