Susan Forwell

There is a shortage of occupational therapists (OTs) in Canada requiring strategies to both increase training opportunities for new therapists as well as retain experienced therapists to maintain a sustainable workforce. One of the strategies for retention is to support therapists who have taken a substantial career break to meet regulatory requirements to return to practice. There is limited research on the re-entry process of OTs and only one study in Canada described a specific re-entry program. There is little information on the factors that facilitate or impede the re-entry transition for OTs in Canada. A literature review revealed a number of factors influencing re-entry of OTs outside of Canada and within other regulated health professions. This study focused on the re-entry transition of OTs in British Columbia (BC) using a mixed methods approach to verify if factors influencing re-entry of OTs elsewhere and of other health professionals also influence the re-entry experience of OTs in BC. A survey followed by semi-structured interviews revealed that returning OTs were primarily mid-career female professionals with children who were highly motivated to return to practice and most had good social support during their re-entry. The study showed that professional connectedness, appropriate supervision that recognized their clinical experience, and opportunities to complete a competence confirmation practicum contributed greatly to a successful return. The study also discovered a number of systemic barriers to successful re-entry primarily related to poor integration among institutional intermediaries involved in the re-entry transition. The lack of active involvement beyond setting re-entry requirements by the regulatory college, the lack of understanding of the re-entry requirements and little or no recognition of re-entry as professional transition by health employers and unions, as well as a lack of direct support for returners by professional associations made the return unnecessarily difficult. Universities could also support the returners by providing refresher courses. This study led to a number of recommendations to improve the re-entry process that would have the potential to lead to higher re-entry success and retention of OTs.

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Introduction-People with disabilities face numerous employment barriers. Disability benefitssystems do not always meet beneficiary’s needs for financial stability, nor do they supportpursuit of employment as one of the criteria for benefits is “unemployable’.Objective- This study investigates the perspective on employment persons with disabilities havebefore and after their participation in an 8-month Employment Mentorship Support Program.Methods- Pre and post-intervention interviews with people with physical disabilities wereconducted and included questions related to disability benefits, goals for the program, and anyconcerns they might have. The thematic analysis of this interview data was guided byinterpretive description where the researcher used their disciplinary lens and knowledge tounderstand the phenomenon and to interpret its usefulness.Results- This thesis provides the results of the thematic analysis and a comprehensive view ofthese themes (accessibility, the right to work, difficulties obtaining work, mentorshipexpectations, and contributing to society).Conclusion- In order for change to occur in the employment sector, it is essential that appropriatepre-vocational worker skills and appropriate supports are in place. This research will informfuture programs about the perspective of and issues faced by people with disabilities consideringemployment, and provide decision makers with systematic evidence to better shape the disabilitybenefits system.

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Background: Individuals living with spinal cord injuries (SCI) are faced with the increased likelihood of secondary health complications, affecting their physical and psychological functioning. Fatigue is among the most common of these problems and has been shown to profoundly affect the lives of people living with SCI. To develop effective fatigue management programs, clinicians first must be able to identify potential causes of fatigue. However, to our knowledge, there is currently no validated, comprehensive assessment battery of this kind. Purpose: The purpose of this study is to test the convergent validity, and internal consistency of a novel Comprehensive Fatigue Assessment Battery for People with Spinal Cord Injury (CFAB-SCI) and to further our understanding of fatigue in SCI. Methods: Seventy community-dwelling adults with SCI were recruited. The participants completed the CFAB-SCI as well as six additional self-report measures to assess convergent validity with six matching sections of the battery. Convergent validity was assessed via Spearman’s ρ correlation, and internal consistency via Cronbach’s α. Open-ended survey data from the CFAB-SCI was analyzed to explore fatigue using a content analysis approach. Results: A total of 64 participants competed the study. Convergent validity and internal consistency values all exceeded the hypothesized values. Content analysis of text data revealed four major groupings when participants were asked to tell us more about their fatigue: 1) experience with fatigue; 2) impact of fatigue; 3) factors of fatigue; and 4) management of fatigue. Significance: Evidence reveals the complexity of fatigue and supports the validity and reliability of the self-report CFAB-SCI as a comprehensive, clinically useful tool to characterize fatigue in SCI. It will offer people with SCI an understanding of factors that may contribute to their fatigue experience and will direct the treatment decisions of clinicians who are intervening to mitigate the impact of fatigue.

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