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Su H, Wong J, Kudla A, Park M, Trierweiler R, Capraro P, Crown D, Ezeife N, Tomazin S, Munsell EGS, Heinemann AW. Disability Phenotypes and Job Accommodations Utilization Among People with Physical Disability. J Occup Rehabil 2023; 33:352-361. [PMID: 36323833 PMCID: PMC9629768 DOI: 10.1007/s10926-022-10078-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 05/12/2023]
Abstract
Purpose People with disabilities (PWD) are less likely to be employed than those without disabilities. Reasonable job accommodations are an essential factor for ensuring equal access to jobs for PWD. However, use of job accommodation is less than optimal among PWD with various types of disabilities. Sometimes, PWD have co-occurring impairments, which might affect accommodation use. This research aimed to explore disability phenotypes, frequently used accommodations, and employee- and job-related factors associated with the extent of job accommodation use. Methods A cross-sectional online survey of PWD was conducted in the Midwest region of the United States. Latent class analyses were used to identify disability phenotypes. Descriptive analysis and stepwise Poisson regression were used to identify factors associated with job accommodation use. Results A total of 326 PWD with work experience after acquiring a disability were included in this analysis. We identified three disability phenotypes: (1) Severe disability in cognitive, physical, emotional, communication and visual domains (32%), (2) Moderate cognitive and low physical disability (48%), and (3) High physical disability phenotypes (20%). 80% of PWD received at least one accommodation. Flexible working schedules, telework, and access to a support person in the workplace were the most common accommodations. Employee- (age, disability phenotypes, motor function) and job-related factors (job preparation, self-employment) are associated dependently with accommodation use. Conclusion This analysis identifies three disability phenotypes and highlights both employee- and job-related factors associated with accommodations used. It may be beneficial to consider multiple contextual factors, including co-occurring disability, employee- and job-related factors, when assisting people with job accommodations.
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Affiliation(s)
- Han Su
- Feinberg School of Medicine at Northwestern University, 633 N. St. Clair St., Suite 2000, Chicago, IL, 60611, USA.
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN, 37240, USA.
| | - Jasin Wong
- Department of Special Education, National Tsing Hua University, No. 521, Nanda Rd. East Dist., Hsin-chu, Taiwan
| | - Angelika Kudla
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Mirang Park
- Rehabilitation Counseling Department, Kosin University, 194 Wachi-ro, Yeondo-gu, Pusan, 49104, Republic of Korea
| | | | - Pamela Capraro
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Deborah Crown
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Nnaemezie Ezeife
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | | | - Elizabeth G S Munsell
- Feinberg School of Medicine at Northwestern University, 633 N. St. Clair St., Suite 2000, Chicago, IL, 60611, USA
- Department of Special Education, National Tsing Hua University, No. 521, Nanda Rd. East Dist., Hsin-chu, Taiwan
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine at Northwestern University, 710 N. Lake Shore Dr., Chicago, IL, 60611, USA
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Munsell EGS, Kudla A, Su H, Wong J, Crown D, Capraro P, Trierweiler R, Park M, Heinemann AW. Employers’ Perceptions of Challenges and Strategies in Hiring, Retaining, and Promoting Employees With Physical Disabilities. Rehabilitation Counseling Bulletin 2022. [DOI: 10.1177/00343552221130304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Disability is a common component of human diversity, yet people with disabilities (PWD) are underrepresented in the workplace despite known benefits to PWD and companies alike. There is an urgent need to promote inclusion of PWD in the workplace. The purpose of this study was to explore employer-perceived challenges and strategies for employing, retaining, and promoting people with physical disabilities (PWPD) and to describe the policies, supports, and job accommodations they provide to PWPD. We administered a cross-sectional, online survey to employers in the Midwestern United States ( n = 53). Employers had an average of 8.5 years of experience in their job roles and represented diverse industries and company sizes. Employers provide a range of job accommodations; however, many reported lacking comprehensive disability policies such as training managers on how to support PWPD, providing employee resource groups for PWPD, and having a specific job accommodation fund. Major challenges reported by employers were related to lacking competencies in supporting employees with physical disabilities. However, employers endorsed the utility of strategies to address these challenges, including providing education and training and increasing buy-in from leadership. Study findings inform employers on ways to best support PWPD and improve diversity, equity, and inclusion in the workplace.
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Affiliation(s)
| | | | - Han Su
- Northwestern University, Chicago, IL, USA
| | - Jasin Wong
- National Tsing Hua University, Hsinchu City
| | | | | | | | | | - Allen W. Heinemann
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
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Wong J, Ezeife N, Kudla A, Crown D, Trierweiler R, Capraro P, Tomazin S, Su H, Pham T, Heinemann AW. Employment Consequences of COVID-19 for People with Disabilities and Employers. J Occup Rehabil 2022; 32:464-472. [PMID: 35037157 PMCID: PMC8761523 DOI: 10.1007/s10926-021-10012-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 06/01/2023]
Abstract
Purpose The COVID-19 pandemic has disproportionately affected the lives of people with disabilities (PWD). How the pandemic affects the employment of PWD and employers has yet to be determined. We aimed to investigate the employment consequences of the pandemic as experienced by PWD and employers. The research questions were: (1) What employment effects do PWD experience, and what business changes do employers encounter as a result of the COVID-19 pandemic? (2) What challenges have PWD encountered during the pandemic? Methods Cross-sectional online surveys of 733 PWD and 67 employers in the Midwestern United States. Results Compared to non-disabled peers, PWD encountered more challenges in employment during the pandemic. We found high percentages of both employers and PWD experiencing employment changes and business shutdown during the pandemic. For PWD whose employment was not affected, 14.6% of the participants (n = 107) expected a loss of income and worried about the economic uncertainty of the pandemic. Unemployment for PWD is high due to illness or disability, being laid-off or furloughed, business reductions, and not feeling safe to work. However, only about 18.6% of unemployed PWD (n = 16) received pay or benefits for the time they were not working even though more than half filed for unemployment benefits. Conclusions The pandemic adversely affected employment of PWD as reported by workers and employers. Findings parallel the experience of the non-disabled workforce, but reveal vulnerabilities that reflect disability consequences and the need for job accommodations. Results reveal emergent needs for policy supports to reduce the disparities experienced by PWD in the workplace.
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Affiliation(s)
- Jasin Wong
- Department of Special Education, National Tsing Hua University, No. 521, Nanda Rd. East Dist., Hsinchu, Taiwan.
| | - Nnaemezie Ezeife
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Angelika Kudla
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Deborah Crown
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Robert Trierweiler
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Pamela Capraro
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Stephanie Tomazin
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
| | - Han Su
- Center for Health Services and Outcomes Research, Feinberg School of Medicine at Northwestern University, 633 N. St. Clair St., Suite 2000, Chicago, IL, 60611, USA
| | - Tri Pham
- University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, 355 East Erie St., Chicago, IL, 60611, USA
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine at Northwestern University, 710 N. Lake Shore Dr., Chicago, IL, 60611, USA
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Wong J, Kudla A, Pham T, Ezeife N, Crown D, Capraro P, Trierweiler R, Tomazin S, Heinemann AW. Lessons Learned by Rehabilitation Counselors and Physicians in Services to COVID-19 Long-Haulers: A Qualitative Study. Rehabilitation Counseling Bulletin 2021. [DOI: 10.1177/00343552211060014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coronavirus disease (COVID-19) may cause long-lasting adverse consequences after acute recovery, including functional limitations and reduced work capacity. Individuals with long-lasting complications of COVID-19 are known as long-haulers. There is a knowledge gap on how COVID-19 complications affect return-to-work (RTW) efforts. We aimed to describe the challenges that long-haulers encounter when RTW from the perspectives of rehabilitation professionals. In this study, four certified rehabilitation counselors and four rehabilitation physicians in outpatient rehabilitation centers participated in focus groups. Participants discussed challenges in working with long-haulers, including personal attributes, post-COVID-19 symptoms and complications, uncertain recovery and unpredictable outcomes, limited health care accessibility and support, and unsupportive work environments. Participants provide individualized services to meet long-haulers’ diverse needs as they do for all persons with disabilities, although they expressed uncertainty due to the variable disease course and risk of infection. Modifying workplace policies, especially gradual RTW, were frequently mentioned accommodations. The findings highlight the RTW issues of long-haulers. We provide recommendations on increasing awareness of the challenges and job accommodations of long-haulers.
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Affiliation(s)
- Jasin Wong
- Shirley Ryan AbilityLab (Formerly RIC), Chicago, IL, USA
- Northwestern University, Evanston, IL, USA
| | - Angelika Kudla
- Shirley Ryan AbilityLab (Formerly RIC), Chicago, IL, USA
| | - Tri Pham
- University of Texas Southwestern Medical School, Dallas, USA
| | | | - Deborah Crown
- Shirley Ryan AbilityLab (Formerly RIC), Chicago, IL, USA
| | - Pamela Capraro
- Shirley Ryan AbilityLab (Formerly RIC), Chicago, IL, USA
| | | | | | - Allen W. Heinemann
- Shirley Ryan AbilityLab (Formerly RIC), Chicago, IL, USA
- Northwestern University, Evanston, IL, USA
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Wong J, Kudla A, Pham T, Ezeife N, Crown D, Capraro P, Trierweiler R, Heinemann A. Employment Consequences of COVID-19 on “Long-Haul” Survivors. Arch Phys Med Rehabil 2021. [PMCID: PMC8474041 DOI: 10.1016/j.apmr.2021.07.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research Objectives Coronavirus (COVID-19) is an infectious disease that can cause long-lasting adverse consequences after recovery. COVID-19 can also result in functional limitations that affect daily activities and work capacity. Individuals with these lasting complications are known as long haulers. The demand for vocational services and post-acute rehabilitation is increasing and has become urgent. To address the need, we aimed to describe the challenges that individuals recovering from COVID-19 encounter when returning to work and the experiences of the healthcare professionals who assist them throughout that process. Design Qualitative research with focus groups. Setting Outpatient and vocational rehabilitation (VR) clinics affiliated with a Midwest rehabilitation center. Participants 4 VR counselors and 4 rehabilitation physicians who serve clients recovering from COVID-19. Interventions Not applicable. Main Outcome Measures Not applicable. Results Uncertain COVID-19 recovery trajectory and unpredictable outcomes, various long-lasting symptoms, and disease complications were the three frequently mentioned challenges when returning to work. To support long haulers in regaining employment, VR counselors and physicians communicated with employers, helped clients adjust to COVID-19-related challenges, provided individualized VR support, and helped obtain or short- or long- term disability benefits. Physicians expressed uncertainty in working with patients with COVID-19 due to the unknown disease and its infectiousness. Counselors recommended various job accommodations including modifying workplace policies, flexible scheduling, changing workplace environment, and modifying job responsibilities. Both physicians and counselors recommend support groups and policy changes. Conclusions Long haulers experience persisting physical, cognitive, and emotional consequences of COVID-19 infection requiring rehabilitation therapies and job accommodations. We provide recommendations to guide rehabilitation professionals in helping long haulers return to work. Author(s) Disclosures The authors have no conflict of interest to declare.
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Wong J, Kallish N, Crown D, Capraro P, Trierweiler R, Wafford QE, Tiema-Benson L, Hassan S, Engel E, Tamayo C, Heinemann AW. Job Accommodations, Return to Work and Job Retention of People with Physical Disabilities: A Systematic Review. J Occup Rehabil 2021; 31:474-490. [PMID: 33479811 DOI: 10.1007/s10926-020-09954-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 05/26/2023]
Abstract
Purpose We aimed to identify job accommodations that help persons with physical disabilities maintain or return to work and explore the barriers and facilitators that influence the provision and reception of job accommodations. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in PROSPERO (CRD42019129645). The search strategy incorporated keywords describing physical disabilities, employer-approved job accommodations, and employment retention or return to work approaches. We searched MEDLINE, the Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, and ProQuest Theses and dissertations. Reviewers independently selected studies for inclusion. We used Hawker et al.'s method to assess study quality. Results We identified 2203 articles, of which 52 met inclusion criteria, developed a table of job accommodations commonly used by persons with physical disabilities, summarized the percentages of job accommodations used by persons with disabilities, synthesized evidence of the effectiveness of job accommodations, and identified the factors that influence job accommodation use. The most frequently reported accommodations were as follows: modification of job responsibilities, change of workplace policy, supportive personnel provision, flexible scheduling, and assistive technology. We summarized four types of facilitators and barriers that affect job accommodation use: employee-related factors, accommodation-related factors, job-related factors, and social workplace-related factors. Conclusion The absence of randomized controlled trials and prevalence of cross-sectional surveys provides inconclusive evidence regarding the effectiveness of specific job accommodations for people with particular functional limitations. Our system of categorizing job accommodations provides a guide to investigators seeking to evaluate the effectiveness of job accommodations using experimental methods.
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Affiliation(s)
- Jasin Wong
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA.
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA.
| | - Natasha Kallish
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Deborah Crown
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Pamela Capraro
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | | | - Q Eileen Wafford
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Shahzeb Hassan
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA
| | - Edeth Engel
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Christina Tamayo
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Allen W Heinemann
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
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Rafferty M, Stoff L, Palmentera P, Capraro P, Stanley I, Heinemann AW, Johnson K. Employment Resources for People with Parkinson's Disease: A Resource Review and Needs Assessment. J Occup Rehabil 2021; 31:275-284. [PMID: 33025272 DOI: 10.1007/s10926-020-09915-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose People with Parkinson's disease (PwP) exit the workforce on average 5 years earlier than people without Parkinson's due to motor, cognitive, communicative, and affective symptoms. Decreased employment results in significant individual and societal costs. The objectives of this study were to identify strengths and weaknesses of employment resources and assess the needs of consumer and clinical stakeholders to improve job retention. Methods The study used a qualitative content analysis and Quasi Needs Assessment Framework. Sixteen PwP and 10 clinician stakeholders participated in two rounds of stakeholder discussion panels. Main outcomes included (1) the resources identified through the online content search and themes derived from those resources, and (2) the information gained from discussion panels and themes derived from their conversations. Results Literature review and online searches yielded 59 resources (30 consumer-focused documents, 17 peer-reviewed articles, and 12 documents supplied by key informants who are experts in Parkinson's disease and/or employment). Themes frequently found in the consumer-focused content but not the peer-reviewed literature included diagnosis disclosure decision-making, the benefits of retiring compared to working, and workplace accommodations. Stakeholders identified three key needs with regard to employment-related support for PwP: (1) knowledge about employment support options; (2) a clinician to start the discussion about employment challenges; and (3) an individualized and flexible approach to employment-related interventions. Conclusions Many people with Parkinson's experience unmet employment-related resource and process needs. An individually-tailored interdisciplinary intervention care path could facilitate decisions regarding disclosure and accommodations.
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Affiliation(s)
- Miriam Rafferty
- Shirley Ryan AbilityLab, 355 E. Erie St, Chicago, IL, 60611, USA.
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, 710 N. Lake Shore Dr, Chicago, IL, 60611, USA.
| | - Laura Stoff
- Shirley Ryan AbilityLab, 355 E. Erie St, Chicago, IL, 60611, USA
| | - Pamela Palmentera
- Department of Neurology, Feinberg School of Medicine, Northwestern University, 303 E. Chicago Ave, Chicago, IL, 60611, USA
| | - Pamela Capraro
- Shirley Ryan AbilityLab, 355 E. Erie St, Chicago, IL, 60611, USA
| | - Ivorie Stanley
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University, 633 N. Saint Clair St, Chicago, IL, 60611, USA
- Department of Occupational and Environmental Medicine, University of Illinois at Chicago, 835 S. Wolcott Ave, E-144, Chicago, IL, 60612, USA
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, 355 E. Erie St, Chicago, IL, 60611, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, 710 N. Lake Shore Dr, Chicago, IL, 60611, USA
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University, 633 N. Saint Clair St, Chicago, IL, 60611, USA
| | - Kurt Johnson
- Department of Rehabilitation Medicine, University of Washington, Box 356490, Seattle, WA, 98195, USA
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Wong J, Crown D, Trierweiler R, Engel E, Heinemann A, Capraro P. Job Accommodations and Job Retention for Individuals with Physical Disabilities: A Systematic Review. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Kirschner KL, Geiringer SR, Tarvydas V, Brashler R, Capraro P, Davis WS, Yates T. Your opinion please, doctor: is your patient unable to work in any capacity? PM R 2009; 1:674-80. [PMID: 19627961 DOI: 10.1016/j.pmrj.2009.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 05/28/2009] [Indexed: 10/20/2022]
Affiliation(s)
- Kristi L Kirschner
- Rehabilitation Institute of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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