1436 Disability & Rehabilitation, 2013; 35(17): 1436–1446 © 2013 Informa UK, Ltd. ISSN 0963-8288 print/ISSN 1464-5165 online DOI: 10.3109/09638288.2012.737079 Purpose: Little is known about employment experience after spinal cord injury (SCI) because most research to date concentrates on employment predictors. We explored the experiences of people with SCI, and vocational rehabilitation (VR) professionals working for a VR programme, in pursuing a return to employment in New Zealand (NZ) post-SCI. Methods: Twelve people with SCI (four employed, three job-seeking, five unemployed) and six VR professionals were interviewed, and the transcripts subjected to an Interpretative Phenomenological Analysis. Results: The core meaning of employment post- SCI was to live a normal life. Work advantages were social connectedness, a sense of self-worth, earning a living, and being occupied. Employment was the zenith of rehabilitation but not the first priority post-SCI. Employment barriers and facilitators were congruent with those found in similar studies. The role of VR was to sow the seeds of return to employment and to partner with the SCI client. Conclusions: For persons employed pre-SCI, we posit that employment identity modification is part of the return to employment process, alongside a supportive social context and networks, and adapted work environments. VR professionals may facilitate return to employment through understanding and fostering the process of employment identity modification and supporting clients to find work opportunities congruent with employment identity. Keywords: Spinal cord injury, employment, work, vocational rehabilitation, employment identity Introduction Being employed (paid work) confers material, social and emotional beneits and is associated with better quality of life ater spinal cord injury (SCI) [1]. Most research has concen- trated on elucidating variables that predict employment post- injury. he experience of persons with SCI and the vocational rehabilitation (VR) professionals who work with them in pursuing a return to employment post-injury is less clear. We conducted this qualitative study to understand more about the meaning of employment in the lives of people post-SCI in New Zealand (NZ), and perceptions of employment barriers and facilitators. Employment ater SCI has emerged as a goal [2] and meaningful measure of successful rehabilitation in concert with increased survival rates over the past 20 years [3,4]. Post-SCI employment is associated with better quality of life [1], improved adjustment [5], and beyond inancial reward confers a sense of normality and being a productive member of society [6]. Furthermore, potential for work, employment, and career advancement are major determinants of success in Western society [1]. RESEARCH PAPER “The final piece of the puzzle to fit in”: an interpretative phenomenological analysis of the return to employment in New Zealand after spinal cord injury E. Jean C. Hay-Smith 1 , Bridget Dickson 1,2 , Joanne Nunnerley 2,3 & K. Anne Sinnott 2,4 1 Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand, 2 Burwood Academy of Independent Living, Christchurch, New Zealand, 3 Burwood Hospital, Canterbury District Health Board, New Zealand, and 4 Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand Correspondence: E. Jean C. Hay-Smith, Rehabilitation Teaching and Research Unit, University of Otago, Wellington, P.O. Box 7343, Wellington South 6242, New Zealand. Tel.: +64 3 474 7007, extension 8568; Fax: +64 3 474 7620. E-mail: jean.hay-smith@otago.ac.nz • Employment rates ater spinal cord injury (SCI) vary considerably; the average is about 35%. • Being employed post-SCI is a sign to self and others of living a normal life. • For previously employed persons, adaptation of employment identity is part of the return to work process. • Vocational rehabilitation practice can support adapta- tion of employment identity and help match this with work opportunities. Implications for Rehabilitation (Accepted October 2012) Disabil Rehabil Downloaded from informahealthcare.com by Canterbury DHB on 09/03/13 For personal use only.