To work or not to work? The occupational trajectories of wheelchair users.
OBJECTIVE
To throw light upon the dynamic processes which may or may not lead persons with severe motor disability to employment.


METHODS
A qualitative approach to the chronology of both the professional and non-professional occupations of wheelchair users between acquisition of the disability and the interview; this approach focuses upon actions and meanings, thus allowing the authors to identify the diverse factors which help build the occupation situation at the time of the study. The narratives of 36 wheelchair users of working age were used. The objective of the analysis was to reconstitute the occupation trajectories of the participants and hence to suggest a typology. This involved pinpointing the various actors, the external and cognitive contexts of their decisions and actions, and their consequences and related feelings.


RESULTS
The wide diversity found in the trajectories forced the authors to go beyond any simple notion of 'work versus non-work' and to focus on the quality of the individual's process of occupation appropriation. Indeed, it is possible to successfully appropriate both work and non-work situations, just as, inversely, it is possible for a person to fail to appropriate either type of situation. Analysis of this process allows one to pinpoint different types of trajectory. On the one hand, trajectories within which people appropriate their occupations--gradual, intermittent, through rupture and successive adjustment--and, on the other hand, unstable or endured occupation trajectories.


CONCLUSIONS
The findings suggest that with regard to rehabilitation practices, we should be focussing as much on the appropriation process as on return to work.
Ville
Isabelle
I
INSERM (National Institute of Health and Medical Research), U.750, Villejuif, France. ville@vjf.cnrs.fr
Winance
Myriam
M
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D014910:Wheelchairs / Q000523:psychology*; D014937:Work / Q000523:psychology