Improving work participation of young adults with physicaldi

Improving work participation of young adults with physicaldisabilities

(Joan Verhoef)

Het verbeteren van de arbeidsparticipatie vanjongvolwassenen met lichamelijke beperkingen

The studies for this thesis were performed at the Research Centre Innovations in Care of Rotterdam University of Applied Sciences and the Department of Rehabilitation Medicine of Erasmus University Medical Center, in collaboration with the Transition Research Group of Erasmus University Medical Center and Rijndam Rehabilitation Centre, Rotterdam.

Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof. dr. H.A.P. Pols en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op dinsdag 9 juni 2015 om 13.30 uur door Johanna Alida Cornelia Verhoef geboren te Amsterdam

Aim: The aim of the study was to evaluate the feasibility of a new intervention to improve work participation of young adults with physical disabilities, addressing (1) implementation andcosts and (2) preliminary effectiveness.

Method: Twelve young adults with physical disabilities (six males, six females; age 19-28 y, median age 21y 6 mo) participated in a 1-year multi disciplinary vocational rehabilitation intervention. In a pre-post intervention design, we assessed implementation and costs as well as preliminary effectiveness in terms of employment and occupational performance using questionnaires and interviews. We tested pre-post differences with the McNemar test for proportions and the Wilcox on signed-rank test for scores on occupational performance; p-values less than0.05 were considered statistically significant. Additionally, we assessed workparticipation at follow-up after 2 years and 3 years.

Results: The intervention was implemented in an outpatient rehabilitation clinic for young adults. The median cost per participant for 1 year was €3128, which is an equivalent to the cost of 72 contact hours per participant. Post intervention, and at 2 years and 3years follow-up, a significantly higher proportion of participants were employed (8/12 post vs 2/12 pre-intervention; p<0.05), with the ratio ofthose in paid to unpaid employment being 4:4, 5:3, and 7:1 respectively. Participants showed improved occupational performance in work, self-care, and leisure.

Interpretation: Feasibility and preliminary effectiveness of the intervention are promising. Employed participants seemed to have achieved suitable and continuous employment.

Paperback, 198 pag.

Uitg. Erasmus University Rotterdam, 2015

ISBN 9789461696755

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