title: Improved occupational performance of young adults with a physical disability after a vocational rehabilitation intervention.
abstract: OBJECTIVE
  The purpose of this study was to investigate into more detail how occupational performance of participants of a 1-year multidisciplinary vocational rehabilitation intervention changed over time, using a broad focus on three areas of occupational performance, addressing work, as well as self-care and leisure. In addition, we explored differences between employed and unemployed persons.
  
  
  METHODS
  In a pre-post-intervention design, changes in occupational performance, addressing work, self-care and leisure, were evaluated using the Canadian Occupational Performance Measure (COPM) and the Occupational Performance History Interview (OPHI-II).
  
  
  RESULTS
  Eleven young adults (median 22 years) with physical disabilities participated. Post-intervention, participants experienced fewer problems and showed improved occupational performance in work, as well as self-care and leisure, and improved satisfaction with performance. Participants also showed improved occupational identity and occupational competence, and total scores on OPHI-II. Participants who did not achieve employment did not differ in demographic characteristics. They experienced problems in all three areas of occupational performance at pre-intervention, and more difficulty in interacting in occupational settings (environment). Post-intervention, their levels of occupational identity, competence and settings were similar to those of employed persons.
  
  
  CONCLUSIONS
  Participants showed improved occupational performance after the intervention. The goal of employment and the broad integrated approach of the intervention seemed to motivate participants to resolve problems in work, as well as self-care and leisure. Unemployed persons faced problems in all three areas of occupational performance at start. Although they seemed to catch up during the intervention, they did not achieve employment within 1 year.
authors.affiliation: Centre of Expertise Innovations in Care, Rotterdam University of Applied Sciences, P.O. Box 25035, 3001 HA, Rotterdam, The Netherlands, J.A.C.Verhoef@hr.nl.
authors.forename: Joan A C
authors.initials: JA
authors.lastname: Verhoef
authors.forename: Marij E
authors.initials: ME
authors.lastname: Roebroeck
authors.forename: Natascha
authors.initials: N
authors.lastname: van Schaardenburgh
authors.forename: Monique C S G
authors.initials: MC
authors.lastname: Floothuis
authors.forename: Harald S
authors.initials: HS
authors.lastname: Miedema
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D002170:Canada; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004650:Employee Performance Appraisal / Q000706:statistics & numerical data*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009788:Occupational Therapy; D017060:Patient Satisfaction; D012050:Rehabilitation, Vocational / Q000379:methods*; D012648:Self Care; D058992:Social Participation; D016896:Treatment Outcome; D055815:Young Adult