Date Presented 04/04/19
We developed the Employment Barriers Questionnaire, which identifies obstacles that people with disabilities face when trying to obtain work and maintain employment. Thirty-five participants attended this study (18 participants were employed and 17 unemployed). The questionnaire has been found to be reliable and valid. The questionnaire has been found to be an effective evaluation tool throughout the rehabilitation sequence, from the subacute hospitalization stage to the chronic stage.
Primary Author and Speaker: Maya Huber
Contributing Authors: Navah Ratzon, Tal Starik, Gabi Zeilig
PURPOSE: Employment offers many benefits to people with disabilities, yet their employment rate is much lower than that of the general population. Understanding the barriers that hinder participation at work can enhance the vocational rehabilitation. To address the lack of a comprehensive tool for identifying barriers at work, we developed the Employment Barriers Questionnaire (EBQ), which identifies obstacles that people with disabilities face when trying to obtain work and maintain employment. The questionnaire has two versions; a self-report questionnaire for people with disabilities and an observation-based questionnaire for the occupational therapists (OTs). The purpose of the present study was to examine the reliability and validity of the EBQ in identifying barriers to employment among people with disabilities.
DESIGN: The study used a cross-sectional convenience sample that included a total of 35 participants from a rehabilitation center, 29 with neurologic and 6 with orthopedic damage. Inclusion criteria were age range of 18-67 years, Montreal Cognitive Assessment score >23, self-report indicating that the disability disrupted the participant’s daily living, and motivation to work (for those who were not employed). The average age of participants was 46.1 years (SD 10.6 years). Eighteen of the participants were employed and 17 unemployed during the study period. Eighteen of the participants were inpatients, 13 were outpatients, and four received ambulatory treatment elsewhere. To enable the OT to observe work tasks of the disabled employees in their absence, seven employees without disability were also recruited for the study to substitute for the participants with disabilities.
METHOD: Participants completed (a) the employee version of the EBQ, including screening for environmental, physical, cognitive, and communication barriers, (b) the Short Form Health Survey Questionnaire, which measures health-related quality of life, and (c) the Work Self-Efficacy Scale, which examines self-efficacy at work. To examine the test-retest reliability of the EBQ, 18 participants with disabilities completed the EBQ twice, with a one-week interval. To examine the convergent validity of the EBQ, the self-report version was compared with the OT version. The OT version was completed after the OT visited and observed the workplace of 15 participants (either participants with disability or persons who replaced the participants at the workplace). Construct validity was determined by examining the differences in barriers revealed by the EBQ between disabled employees and unemployed disabled participants.
RESULTS: Internal reliability (α=.89-.95) and test-retest reliability (ICC=.91, p <.001) were high for the environmental, physical, and cognitive parts of the EBQ, but not for the communication part. A significant moderate convergent validity was revealed by the correlation between the two versions (r = .57-.86, p <.05). The construct validity of the EBQ showed a significant difference between disabled employees and unemployed disabled participants (t=-3.96, p<.001). Weak to moderate significant correlations were found between occupational self-efficacy and EBQ results (r=-.34-.57, p<.05), and between health perception and the EBQ (r=.-34-.50, p<.05).
CONCLUSION: The EBQ can help identify specific barriers at the worksite of individuals with disabilities, and therefore has the potential to enhance the integration of people with disabilities in the workplace by addreessing or removing these barriers. The questionnaire has been found to be an effective evaluation tool throughout the rehabilitation sequence, from the sub-acute hospitalization stage to the chronic stage.
References
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Jurisic, M., Bean, M., Harbaugh, J., Cloeren, M., Hardy, S., Liu, H., ... & Christian, J. (2017). The Personal Physician's Role in Helping Patients With Medical Conditions Stay at Work or Return to Work. Journal of Occupational and Environmental Medicine, 59(6), e125-e131.
