Effective Teams in Vocational Rehabilitation: An Exploration of Complexities and Practice in Aotearoa-New Zealand.

Purpose: Vocational rehabilitation (VR) involves complex skills, and often inter-disciplinary teams need to work effectively to meet the needs of stakeholders. Research highlights important influences on effective teamwork, including funding systems, team structure, policies and procedures, and effects of professional hierarchies. This qualitative study aimed to explore these issues in-depth including how factors interact to produce problems and solutions.

Randomised pragmatic waitlist trial with process evaluation investigating the effectiveness of peer support after brain injury: protocol.

Introduction: Traumatic brain injury (TBI) is an important global health problem. Formal service provision fails to address the ongoing needs of people with TBI and their family in the context of a social and relational process of learning to live with and adapt to life after TBI. Our feasibility study reported peer support after TBI is acceptable to both mentors and mentees with reported benefits indicating a high potential for effectiveness and likelihood of improving outcomes for both mentees and their mentors.

Storytelling as an intervention in traumatic brain injury rehabilitation: a scoping review.

Purpose: Storytelling interventions are increasingly being proposed as a tool for rehabilitation after Traumatic Brain Injury (TBI). This review aimed to systematically map intervention details as described in the TBI rehabilitation/recovery literature to better understand why, when and how storytelling is being used in rehabilitation.

Methods: The review team included a storyteller-performer with lived experience of severe TBI, and two academics.

Return-to-work expectations and workplace supports in New Zealand: injured workers' perspectives.

Aim: Work-disability following musculoskeletal injury causes a significant burden for individuals and healthcare systems. Research into work-disability prevention has investigated the ability of psychosocial factors to predict return-to-work in workers with musculoskeletal injuries. Recent research indicates that both return-to-work expectations and workplace supports influence return-to-work outcome.

Experiences of vocational rehabilitation and support services for people living with a long term condition: qualitative systematic review.

Purpose: Identify and synthesise qualitative research evidence on activities and processes within formal vocational service provision that contribute to experiences of effective support to gain employment for people living with long term conditions.

Methods: A pre-published protocol was developed using PRISMA guidelines. Seven databases were searched to identify qualitative research.

A posthuman decentring of person-centred care.

In this paper, we examine person-centred care through a Deleuzian posthuman lens with the aim of exploring what becomes possible when the concepts of both person and care are . We do so through a consideration of the sets of relations that produce 'the client' in health care contexts. Our analysis maps particular entangled material-semiotic forces producing 'M/michael', a young man with a diagnosis of Duchenne muscular dystrophy, within a rehabilitation clinic.

Effectiveness of vocational interventions for gaining paid work for people living with mild to moderate mental health conditions: systematic review and meta-analysis.

Objectives: To evaluate the effectiveness of vocational interventions to help people living with mild to moderate mental health conditions gain paid work.

Methods: Systematic review of international, peer-reviewed literature. Development of the prepublished protocol and search strategy was done in consultation with stakeholder reference groups consisting of people with lived experience of long-term conditions, advocates and clinicians.

Living with a long-term health condition and seeking paid work: qualitative systematic review and thematic synthesis.

Purpose: An interplay of complex issues influence opportunities to gain paid work for people living with long-term conditions, but there are patterns that traverse the various contexts. Synthesising findings across qualitative studies can inform vocational rehabilitation approaches.

Methods: Public consultation and PRISMA guidelines were used to develop a protocol and comprehensive search strategy.

Problematizing 'productive citizenship' within rehabilitation services: insights from three studies.

The idea that everyone should strive to be a 'productive citizen' is a dominant societal discourse. However, critiques highlight that common definitions of productive citizenship focus on forms of participation and contribution that many people experiencing disability find difficult or impossible to realize, resulting in marginalization. Since rehabilitation services strive for enablement, social participation, and inclusiveness, it is important to question whether these things are achieved within the realities of practice.

Recovery and adaptation after traumatic brain injury in New Zealand: Longitudinal qualitative findings over the first two years.

Knowledge about the impacts of traumatic brain injury (TBI) and aspects that influence recovery and adaptation are key to understanding how best to provide appropriate services. Whilst injury experiences have been documented, factors that help or hinder recovery and adaptation over time and across injury severities remain unclear. We present overarching findings addressing these matters in a large longitudinal qualitative study of recovery and adaptation following TBI.

Living Life After Traumatic Brain Injury: Phase 1 of a Longitudinal Qualitative Study.

Objective: To explore what helps and hinders recovery and adaptation after disabling traumatic brain injury (TBI) and make recommendations for improving service responsiveness.

Design: A longitudinal qualitative descriptive study across all TBI severities.

Setting: Community.

Optimising qualitative longitudinal analysis: Insights from a study of traumatic brain injury recovery and adaptation.

Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature.

Socially constructed 'value' and vocational experiences following neurological injury.

Purpose: Paid work is seen as a key outcome in rehabilitation. However, research demonstrates that because of normative expectations in the job market and workplace, experiences of disability can be intensified in a work context. We sought to explore this issue in more depth by analysing the effects of societal constructions of worker 'value' within individual case studies of people with acquired neurological injury.

Re/creating entrepreneurs of the self: discourses of worker and employee 'value' and current vocational rehabilitation practices.

Vocational rehabilitation for people experiencing work disability is a social practice often situated within health services, but the social and political drivers and effects of this practice are rarely critically analysed in health research or policy. In this study we used a Foucauldian theoretical perspective to analyse the ways in which current vocational rehabilitation practices in New Zealand re/produce notions of worker and employee 'value', and how different approaches to vocational rehabilitation deploy current discourses about value. We also consider the subject positions produced through these different approaches and the identities and actions they make possible for people experiencing work disability.

Establishing a person-centred framework of self-identity after traumatic brain injury: a grounded theory study to inform measure development.

Objective: To develop a theoretically sound, client-derived framework to underpin development of a measure reflecting the impact of traumatic brain injury (TBI) on a person's self-identity.

Design: Grounded theory, based on transcription of audio recordings from focus group meetings with people who have experienced TBI, analysed with constant comparative methods.

Setting: 8 different urban and rural communities in New Zealand.

Exploring participant experiences of research after traumatic brain injury.

Objective: To explore peoples' perceptions and experiences of taking part in research following a traumatic brain injury (TBI) and identify the factors that influence research participation.

Methods: A total of 30 people (15 who had participated in research following a TBI and 15 who had previously declined or not been offered the opportunity to take part), were asked about their perceptions and experiences of research in a semi-structured qualitative interview. Audio recordings of the interviews were transcribed verbatim and analysed using the qualitative description approach.

Development of a new tool to evaluate work support needs and guide vocational rehabilitation: the work-ability support scale (WSS).

Purpose: This article outlines our overall approach, qualitative work, and pilot testing to develop a tool to facilitate identification of level of support needs and assist in planning for vocational rehabilitation interventions.

Methods: A set of foundation principles drawn from literature and previous critiques of work-ability assessment tools were used to guide a set of studies to develop a new tool. A review of the literature regarding factors that influence work-ability, qualitative interviews and focus groups with a range of stakeholders in the return-to-work process, and pilot testing in different settings were used to develop the Work-ability Support Scale (WSS) to a stage where it had face validity, usability and acceptability for a range of key stakeholders and was ready for further testing.

The Work-ability Support Scale: evaluation of scoring accuracy and rater reliability.

Purpose: The Work-ability Support Scale (WSS) is a new tool designed to assess vocational ability and support needs following onset of acquired disability, to assist decision-making in vocational rehabilitation. In this article, we report an iterative process of development through evaluation of inter- and intra-rater reliability and scoring accuracy, using vignettes. The impact of different methodological approaches to analysis of reliability is highlighted.

Foucault, the subject and the research interview: a critique of methods.

Research interviews are a widely used method in qualitative health research and have been adapted to suit a range of methodologies. Just as it is valuable that new approaches are explored, it is also important to continue to examine their appropriate use. In this article, we question the suitability of research interviews for 'history of the present' studies informed by the work of Michel Foucault - a form of qualitative research that is being increasingly employed in the analysis of healthcare systems and processes.

Interrogating discourse: the application of Foucault's methodological discussion to specific inquiry.

Discourse analysis following the work of Michel Foucault has become a valuable methodology in the critical analysis of a broad range of topics relating to health. However, it can be a daunting task, in that there seems to be both a huge number of possible approaches to carrying out this type of project, and an abundance of different, often conflicting, opinions about what counts as 'Foucauldian'. This article takes the position that methodological design should be informed by ongoing discussion and applied as appropriate to a particular area of inquiry.

Perspectives on quality of care for people who experience disability.

Background And Objective: Quality of care is considered to be of central importance in healthcare, disability services and rehabilitation. People experiencing disability often access a range of health and social care services; for some, these services are integral parts of daily life. Little research has explored perspectives of disabled people regarding what constitutes good quality care.

Experience of recovery and outcome following traumatic brain injury: a metasynthesis of qualitative research.

Purpose: To explore the use of qualitative metasynthesis to inform debate on the selection of outcome measures for evaluation of services provided to adults with traumatic brain injury (TBI).

Method: Fifteen databases were searched for qualitative research published between 1965 and June 2009, investigating the lived experience of recovery following TBI acquired during adulthood. Two reviewers independently screened all abstracts.

Factors contributing to work-ability for injured workers: literature review and comparison with available measures.

Purpose: Despite a range of factors being proposed in research literature to be key to 'work-ability', agreed definitions and boundaries of this concept are lacking. This review sought to identify and clarify key factors thought to contribute to individual work-ability, then compare these against existing measures of work-ability for people with injury.

Method: A literature search was undertaken based on principles of systematic review.

Understanding decisions about work after spinal cord injury.

Introduction: Research has consistently shown that many people with spinal cord injury (SCI) do not return to work (RTW), despite evidence that being employed is associated with better quality of life, participation and physical and psychological well-being. While some factors associated with RTW outcome have been identified, very little is known about what influences people's own decisions about their employment following SCI. This qualitative study sought to identify factors that influenced decisions about whether and when to RTW for people with SCI.