title: A Multidisciplinary Model to Guide Employment Outcomes Among People Living With Spinal Cord Injuries in South Africa: A Mixed Methods Study Protocol.
abstract: Spinal cord injury (SCI) often results in complete or partial loss of functioning of the upper and/or lower limbs, leading to the affected individual experiencing difficulties in performing activities of daily living. This results in reduced participation in social, religious, recreational, and economic activities (employment). The South Africa legal framework promotes the employment and assistance of people with disabilities. However, rehabilitation interventions focus mainly on impairments and activity limitations, with few attempts to prepare those with SCI to return to gainful employment. There is therefore a need for a well-coordinated, multidisciplinary rehabilitation initiative that will promote the employment of people living with spinal cord injuries (PLWSCI) in South Africa.
  
  
  
  This study aims to develop a multidisciplinary model to guide employment outcomes amongst PLWSCI in South Africa.
  
  
  
  This study will utilize explanatory mixed methods during 3 phases. The first phase will explore the current rehabilitation practices, and the second will establish the factors that influence employment outcomes among PLWSCI. A multidisciplinary team consisting of health care professionals, representatives from the departments of Labour, Education, Social Development, and Health, and nongovernment organizations representing PLWSCI will provide feedback for the model development of phase 3, along with results from the previous 2 phases, using a multistage Delphi technique.
  
  
  
  It is estimated that the results of phases 1 and 2 will be completed 11 months after data collection commencement (November 2015). Phase 3 results will be finalized 4 months after phases 1 and 2.
  
  
  
  Developing a multidisciplinary model to guide the employment outcomes of PLWSCI will ensure a coordinated response to integrate them into a productive life and will assist them to achieve economic self-sufficiency, personal growth, social integration, life satisfaction, and an improved quality of life. This can be achieved by active inclusion of PLWSCI to ensure that their concerns and recommendations are addressed.
  
  
  
  ClinicalTrials.gov NCT02582619; https://clinicaltrials.gov/ct2/show/NCT02582619 (Archived by WebCite at http://www.webcitation.org/6mBgcj6z7).
authors.affiliation: School of Health Sciences, Division of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Ntsikelelo
authors.identifier: 0000-0001-8856-8482
authors.initials: N
authors.lastname: Pefile
authors.affiliation: Department of Physiotherapy, School of Health Sciences, Univeristy of Pretoria, Pretoria, South Africa.
authors.forename: Joyce
authors.identifier: 0000-0003-4535-6652
authors.initials: J
authors.lastname: Mothabeng
authors.affiliation: Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Saloshni
authors.identifier: 0000-0002-8844-0160
authors.initials: S
authors.lastname: Naidoo
keywords: employment; spinal cord injury; vocational rehabilitation