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Journal of Occupational Rehabilitation
Published in: Journal of Occupational Rehabilitation 4/2021

01-12-2021

Development of a Programme Theory for Early Intervention Vocational Rehabilitation: A Realist Literature Review

Authors: Jennifer A. Dunn, Jonathan J. Hackney, Rachelle A. Martin, Donna Tietjens, Timothy Young, John A. Bourke, Deborah L. Snell, Joanne L. Nunnerley, Andrew Hall, Sarah Derrett

Published in: Journal of Occupational Rehabilitation | Issue 4/2021

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Abstract

Purpose Little is currently known about how early intervention vocational rehabilitation (EIVR) works for people with newly acquired neurological conditions such as traumatic brain injury, acquired brain injury and spinal cord injury. This study aims, from a realist framework, to identify relevant literature and develop an initial programme theory to understand how EIVR might work for people experiencing acquired neurological disability. Realist reviews are ideally placed to address the identified knowledge gap as they assist in gaining a deeper understanding of how the intervention works, for whom it works best, and the contexts that promote the activation of desired outcomes. Methods We used a seven-step iterative process to synthesise literature using a realist approach. The steps included: development of initial programme theory, literature search, article selection, extracting and data organising, synthesis of evidence and programme theory refinement. We performed a literature search using the following databases: Cinahl, Embase, EMcare, Medline, PsychInfo and Scopus. Articles were selected if they contributed to the knowledge describing what is EIVR and how it works in newly acquired neurological conditions. Data were extracted and synthesised to develop a programme theory for EIVR. Results Following screening of 448 references, 37 documents were eligible for data extraction. We developed a refined programme theory of EIVR consisting of three contexts (prioritisation of exploring work options, return to work discussed as an option, and workplace support), nine mechanisms (ensuring rehabilitation teams’ culture, fostering hope, exploring options, optimising self-efficacy, maintaining worker identity, staying connected, setting goals, engaging employer, and flexing roles) and three outcomes (confidence in ability to work, psychological adjustment, and engagement in solution focussed options). Conclusions This appears to be the first paper to explore how EIVR works, for whom and in what situations. We have produced a programme theory that may provide an initial understanding of EIVR following acquired neurological conditions.
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Metadata
Title
Development of a Programme Theory for Early Intervention Vocational Rehabilitation: A Realist Literature Review
Authors
Jennifer A. Dunn
Jonathan J. Hackney
Rachelle A. Martin
Donna Tietjens
Timothy Young
John A. Bourke
Deborah L. Snell
Joanne L. Nunnerley
Andrew Hall
Sarah Derrett
Publication date
01-12-2021
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 4/2021
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-021-10000-z

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