BACKGROUND: Finding and sustaining employment can be a challenge for persons with a physical disability (PwPD) because they may be limited in the work they can do, may require workplace accommodations, or experience discrimination.
OBJECTIVE: Our aim was to understand how successfully employed PwPDs find and sustain employment, and to use this information to build a conceptual model.
METHODS: We searched published studies on physical disability and employment from electronic databases (1980–2015) and bibliographical reviews of retrieved studies. We used meta-ethnography to synthesize the findings.
RESULTS: We reviewed 19 studies and identified 10 themes highlighting common issues experienced by PwPDs. Using these themes, we developed a process model to illustrate the dynamic employment process PwPDs’ experience and the factors that create barriers or facilitators as they attempt to find, maintain employment, and/or advance at work.
CONCLUSIONS: PwPDs encounter a range of barriers at different stages of their employment journey which make them feel “stuck” and “exposed” in lower-level positions with little opportunity to advance or to move laterally within an organization. This study provides a framework to help rehabilitation specialists, employers, and researchers understand what PwPDs need at each stage of their employment journey to attain more sustainable employment outcomes.
AlaszewskiA., AlaszewskiH., PotterJ., & PenhaleB. (2007). Working after a stroke: Survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disability and Rehabilitation, 29(24), 1858–1869.
AliM., SchurL., & BlanckP. (2011). What types of jobs do people with disabilities want?Journal of Occupational Rehabilitation, 21(2), 199–210.
4.
AndersonP. R. (1999). Open employment services for people with disabilities in Australia, 1995 to 1997. Journal of Vocational Rehabilitation, 13(2), 79–94.
5.
BaandersA. N., RijkenP. M., & PetersL. (2002). Labour participation of the chronically ill. European Journal of Public Health, 12(2), 124–130.
6.
BambraC.,WhiteheadM., &
HamiltonV. (2005). Does ‘welfare-to-work’ work? A systematic review of the effectiveness of the UK’s welfare-to-work programmes for people with a disability or chronic illness. Social Science & Medicine, 60, 1905–1918.
7.
BlanckP. (2004). First Thornburgh family lecture on disability law and policy-Americans with disabilities and their civil rights: Past, present, and future. University of Pittsburgh Law Review, 66, 687–719.
8.
BrittenN., CampbellR., PopeC., DonovanJ., MorganM., & PillR. (2002). Using meta-ethnography to synthesise qualitative research: A worked example. Journal of Health Services Research & Policy, 7(4), 209–215.
9.
BurchartT. (2004). The education and employment of disabled young people. York (UK): Joseph Rowntree Foundation. Retrieved from http://www.efds.co.uk/assets/0000/3412/OOO40.pdf
10.
ButlerS., CruddenA., & SansingW. (2005). Overcoming barriers to employment: Strategies of rehabilitation providers. Journal of Visual Impairment & Blindness, 99(06), 1403–1409.
11.
ChanF., McMahonB., CheingG., RosenthalD., & BezyakJ. (2005). Drivers of workplace discrimination against people with disabilities: The utility of attribution theory. Work: Journal of Prevention, Assessment & Rehabilitation, 25(1), 77–88.
12.
ConyersL. M., KochL. C., & SzymanskiE. M. (1998). Life-span perspectives on disability and work: A qualitative study. Rehabilitation Counseling Bulletin, 42, 51–75.
13.
CrooksV. A. (2007). Women’s experiences of developing musculoskeletal diseases: Employment challenges and policy recommendations. Disability and Rehabilitation, 29(14), 1107–1116.
14.
CunninghamI., JamesP., & DibbenP. (2004). Bridging the gap between rhetoric and reality: Line managers and the protection of job security for ill workers in the modern workplace. British Journal of Management, 15(3), 273–290.
15.
DetailleS. I., HaafkensJ. A., & van DijkF. J. (2003). What employees with rheumatoid arthritis, diabetes mellitus and hearing loss need to cope at work. Scandinavian Journal of Work, Environment & Health, 29, 134–142.
16.
Dixon-WoodsM., AgarwalS., JonesD., YoungB., & SuttonA. (2005). Synthesising qualitative and quantitative evidence: A review of possible methods. Journal of Health Services Research and Policy, 10(1), 45–53.
17.
Dray-SpiraR., GueguenA., LertF., & the VESPA Study Group (2008). Disease severity, self-reported experience of workplace discrimination and employment loss during the course of chronic HIV disease: Differences according to gender and education. Occupational and Environmental Medicine, 65, 112–119.
18.
EricksonW., LeeC., & von SchraderS. (2015). Employment and disability institute: Disability statistics from the 2013 American Community Survey. Retrieved from www.disabilitystatistics.org
19.
Eurostat. Disability statistics: Labour market access (2014). Retrieved from http://ec.europa.eu/eurostat/statistics-explained/index.php/Disability_statistics_-_labour_market_access
20.
EvansJ., GalambosN., DarrahJ., & NickersonC. (2008). Predictors of employment for young adults with developmental motor disabilities. Work: Journal of Prevention, Assessment & Rehabilitation, 31, 433–442.
21.
Finfgeld-ConnettD. (2010). Generalizability and transferability of meta-synthesis research findings. Journal of Advanced Nursing, 66(2), 246–254.
22.
FrenchS. (2004). Disabled health and caring professionals: The experiences of visually impaired physiotherapists. In
SwainJ.,
FrenchS.,
BarnesC., & ThomasC. (Eds.), Disabling barriers, enabling environments (p. 213–218). London, UK: Sage.
23.
FrancheR. L., CullenK., ClarkeJ., IrvinE., SinclairS., & FrankJ. (2005). Workplace-based return-to-work interventions: A systematic review of the quantitative literature. Journal of occupational rehabilitation, 15(4), 607–631.
24.
GignacM. A., BadleyE. M., LacailleD., CottC. C., AdamP., & AnisA. H. (2004). Managing arthritis and employment: Making arthritis-related work changes as a means of adaptation. Arthritis Care & Research, 51(6), 909–916.
25.
HahnH. D., & BeltT. L. (2004). Disability identity and attitudes toward cure in a sample of disabled activists. Journal of Health and Social Behavior, 45(4), 453–464.
HennesseyJ. C., & MullerL. S. (1995). The effect of vocational rehabilitation and work incentives on helping disabled-worker beneficiary back to work. Social Security Bulletin, 58, 15–28.
28.
HoefmitN., HoukesI., & NijhuisF. (2012). Intervention characteristics that facilitate return to work after sickness absence: A systematic literature review. Journal of Occupational Rehabilitation, 22, 462–477.
29.
HydeM. (1998). Sheltered and supported employment in the s: The experiences of disabled workers in the UK. Disability & Society, 13(2), 199–215.
30.
JakobsenK. (2001). Employment and the reconstruction of self. A model of space for maintenance of identity by occupation. Scandinavian Journal of Occupational Therapy, 8(1), 40–48.
31.
JansL. H., KayeH. S., & JonesE. C. (2012). Getting hired: Successfully employed people with disabilities offer advice on disclosure, interviewing, and job search. Journal of Occupational Rehabilitation, 22(2), 155–165.
32.
JonesM. K., & SloaneP. J. (2010). Disability and skill mismatch. Economic Record, 86, 101–114.
33.
KayeH. S. (2009). Stuck at the bottom rung: Occupational characteristics of workers with disabilities. Journal of Occupational Rehabilitation, 19(2), 115–128.
34.
KayeH. S., JansL. H., & JonesE. C. (2011). Why don’t employers hire and retain workers with disabilities?Journal of Occupational Rehabilitation, 21(4), 526–536.
35.
KinnL. G., HolgersenH., AasR. W., & DavidsonL. (2014). Balancing on skates on the icy surface of work: A Metasynthesis of work participation for persons with psychiatric disabilities. Journal of Occupational Rehabilitation, 24(1), 125–138.
36.
KitchinR., ShirlowP., & ShuttleworthI. (1998). On the margins: Disabled people’s experience of employment in Donegal, West Ireland. Disability & Society, 13(5), 785–806.
37.
LacailleD., & HoggR. S. (2001). The effect of arthritis on working life expectancy. Journal of Rheumatology, 28(10), 2315–2319.
38.
LiedbergG. M., & HenrikssonC. M. (2002). Factors of importance for work disability in women with fibromyalgia: An interview study. Arthritis Care & Research, 47(3), 266–274.
39.
LipowV. (2015). Don’t let disabilities get in the way of getting the job. Retrieved from http://www.monster.com/career-advice/article/job-hunting-with-a-disability
40.
LyonsB. J., MartinezL. R., RuggsE. N., HeblM. R., RyanA. M., O’BrienK. R., & RoebuckA. (2016). To Say or Not to Say Different Strategies of Acknowledging a Visible Disability. Journal of Management, 0149206316638160.
41.
MacEachenE., ClarkeJ., FrancheR. L., & IrvinE. (2006). Systematic review of the qualitative literature on return to work after injury. Scandinavian Journal of Work, Environment and Health, 32, 257–269.
42.
Magill-EvansJ., GalambosN., DarrahJ., & NickersonC. (2008). Predictors of employment for young adults with developmental motor disabilities. Work, 31(4), 433–442.
43.
MartinD. J., BrooksR. A., OrtizD. J., & VeniegasR. C. (2003). Perceived employment barriers and their relation to workforce-entry intent among people with HIV/AIDS. Journal of Occupational Health Psychology, 8, 181–194.
44.
MattS. B. (2008). Nurses with disabilities: Self-reported experiences as hospital employees. Qualitative Health Research, 18(11), 1524–1535.
45.
McDonoughP. A. (1997). The social patterning of work disability among women in Canada. Journal of Disability Policy Studies, 8, 75–95.
46.
MinisM. A. H., SatinkT., KinébanianA., EngelsJ. A., HeerkensY. F., van EngelenB. G., & Nijhuis-van der SandenM. W. (2014). How persons with a neuromuscular disease perceive employment participation: A qualitative study. Journal of Occupational Rehabilitation, 24(1), 52–67.
47.
MoherD., LiberatiA., TetzlaffJ., & AltmanD. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264–269.
48.
MunirF., LekaS., & GriffithsA. (2005). Work limitations and employer adjustments for employees with chronic illness. Journal of Rehabilitation Research, 28, 111–117.
49.
NoblitG. W., & HareR. D. (1988). Meta-ethnography: Synthesizing qualitative studies. Newbury Park, CA: Sage.
50.
Neal-BoylanL., & GuillettS. E. (2008). Work experiences of RNs with physical disabilities. Rehabilitation Nursing, 33(2), 67–72.
51.
Neal-BoylanL., HopkinsA., SkeeteR., HartmannS. B., IezzoniL. I., & Nunez-SmithM. (2012). The career trajectories of health care professionals practicing with permanent disabilities. Academic Medicine, 87(2), 172–178.
52.
NoonanB. M., GallorS. M., Hensler-McGinnisN. F., FassingerR. E., WangS., & GoodmanJ. (2004). Challenge and Success: A qualitative study of the career development of highly achieving women with physical and sensory disabilities. Journal of Counseling Psychology, 51(1), 68–.
53.
OeztugO., & CowieH. (2011). Coping with musculoskeletal pain: Implications for office workers. TOJET: The Turkish Online Journal of Educational Technology, 10(1).
54.
PiggottL., SapeyB., & WileniusF. (2005). Out of touch: Local government and disabled people’s employment needs. Disability & Society, 20(6), 599–611.
55.
PopayJ., RogersA., & WilliamsG. (1998). Rationale and standards for the systematic review of qualitative literature in health services research. Qualitative Health Research, 8(3), 341–351.
56.
PosthumaR. A., MorgesonF. P., & CampionM. A. (2002). Beyond employment interview validity: A comprehensive narrative review of recent research and trends over time. Personnel Psychology, 55(1), 1–81.
57.
RandolphD. S. (2005). The meaning of workplace discrimination for women with disabilities. Work, 24(4), 369–380.
58.
ReisS., HermoniD., Van-RaalteR., DahanR., & BorkanJ. M. (2007). Aggregation of qualitative studies - From theory to practice: Patient priorities and family medicine/general practice evaluations. Patient Education and Counseling, 65(2), 214–222.
59.
SantuzziA. M., WaltzP. R., FinkelsteinL. M., & RuppD. E. (2014). Invisible disabilities: Unique challenges for employees and organizations. Industrial and Organizational Psychology, 7(2), 204–219.
60.
SchröerC. A., JanssenM., van AmelsvoortL. G., BosmaH., SwaenG. M., NijhuisF. J., & van EijkJ. (2005). Organizational characteristics as predictors of work disability: A prospective study among sick employees of for-profit and not-for-profit organizations. Journal of Occupational Rehabilitation, 15, 435–445.
61.
SidellN. L. (1997). Adult adjustment to chronic illness: A review of the literature. Health & Social Work, 22(1), 5–11.
62.
Statistics Canada (2008). Participation and activity limitation survey 2006: Labour force experience of people with disabilities in Canada. Retrieved from http://www.statcan.gc.ca/pub/89-628-x/89-628-x2008007-eng.htm
63.
Statistics Canada (2013). Canadian survey on disability Canada, 2012. Retrieved from http://www.statcan.gc.ca/daily-quotidien/131203/dq131203a-eng.htm
64.
StrykerS. (1968). Identity salience and role performance. Journal of Marriage and the Family, 4, 558–564.
65.
StrykerS., & BurkeP. J. (2000). The past, present, and future of an identity theory. Social Psychology Quarterly, 63, 284–297.
66.
StoneD. L., & ColellaA. (1996). A model of factors affecting the treatment of disabled individuals in organizations. Academy of Management Review, 21(2), 352–401.
67.
SchurL., KruseD., BlasiJ., & BlanckP. (2009). Is disability disabling in all workplaces? Workplace disparities and corporate culture. Industrial Relations: A Journal of Economy and Society, 48(3), 381–410.
68.
ShihM., YoungM. J., & BucherA. (2013). Working to reduce the effects of discrimination: Identity management strategies in organizations. American Psychologist, 68(3), 145.
69.
ToldráR. C., & SantosM. C. (2013). People with disabilities in the labor market: Facilitators and barriers. Work, 45(4), 553–563.
70.
ToyeF., SeersK., AllcockN., BriggsM., CarrE., AndrewsJ., & BarkerK. (2013). Trying to pin down jelly’ Exploring intuitive processes in quality assessment for meta-ethnography. BMC Medical Research Methodology, 13(1), 46.
71.
TveitoT. H., ShawW. S., HuangY. H., NicholasM., & WagnerG. (2010). Managing pain in the workplace: A focus group study of challenges, strategies and what matters most to workers with low back pain. Disability and Rehabilitation, 32(24), 2035–2045.
72.
US Bureau of Labor Statistics (2015). Persons with a disability: Labor force characteristics summary. Retrieved from http://www.bls.gov/news.release/disabl.nr0.htm
73.
van CampenC., & CardolM. (2009). When work and satisfaction with life do not go hand in hand: Health barriers and personal resources in the participation of people with chronic physical disabilities. Social Science & Medicine, 69, 56–60.
74.
VedelerJ. S. (2014). Disabled persons’ job interview experiences: Stories of discrimination, uncertainty and recognition. Disability & Society, 29(4), 597–610.
75.
VedelerJ. S., & MossigeS. (2010). Pathways into the labour market for Norwegians with mobility disabilities. Scandinavian Journal of Disability Research, 12(4), 257–271.
76.
VedelerJ. S., & SchreuerN. (2011). Policy in action: Stories on the workplace accommodation process. Journal of Disability Policy Studies. DOI: 10.1177/1044207310395942
77.
WatsonN. (2002). Well, I know this is going to sound very strange to you, but I don’t see myself as a disabled person’: Identity and disability. Disability & Society, 17(5), 509–527.
78.
WellsM., WilliamsB., FirniglD., LangH., CoyleJ., KrollT., & MacGillivrayS. (2013). Supporting ‘work-related goals’ rather than ‘return to work’ after cancer? A systematic review and meta-synthesis of 25 qualitative studies. Psycho-Oncology, 22(6), 1208–1219.
79.
Wilson-KovacsD., RyanM. K., HaslamS. A., & RabinovichA. (2008). Just because you can get a wheelchair in the building doesn’t necessarily mean that you can still participate’: Barriers to the career advancement of disabled professionals. Disability & Society, 23(7), 705–717.
80.
World Health Organization (2001). International classification of functioning, disability and health checklist. Retrieved from http://www.who.int/classifications/icf/icfchecklist.pdf?ua=1
