Employment and Disability management: results of a survey on Functioning of Persons with Disability in Work Sector
Erika Guastafierro, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
Venusia Covelli, e-Campus University, Novedrate, Italy
Matilde Leonardi, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
In the work sector, as shown by recent studies, persons with disabilities (PwDs) are frequently considered for their impairments and in general for their certificates of disability more than for their abilities. Therefore, the need to focus on the capacities and skills of individuals is crucial to enable companies to offer adequate job opportunities. According with the bio-psychosocial perspective, disability is an interaction between a person with a health condition and his/her environment that could represent a barrier or a facilitator. So, also in the workplace, what counts is the functioning of the person in relation to the environment intended as a broad definitions that includes not only the physical environment but also colleagues, employers, legislation and in general the working group climate.
Within a broad project on Disability management supported by Regione Lombardia the present study aimed to present strategies to implement the use of the WHO International Classification of Functioning Disability and Health (ICF) in the work sector by collecting information on functioning and on environmental factors encountered by a selected group of PwDs. The analysis of data collected during the study allowed to provide tools useful for job placement, in order to improve the matching between worker and job position and to better define where actions of disability management are require to improve this matching.
A cross-sectional longitudinal study has been conducted in 2017/2018, using a protocol that included the ICF check-list dedicated to labor policies and the WHO DAS 2.0 (Disability assessment Schedule). 50 adults with certification of disability and that entered in the labor sector thanks to specific Italian legislation that sets quotas for PwDs, Law 68/99, and with different kind of impairments have been enrolled. 30 of them in situation of job maintenance and 20 in situation of job placement. Job maintenance means a situation in which PwDs worked for several years in the same work position, while job placement is the first experience of PwDs in a new work position. PwDs in job placement have been interviewed 3 times (at the start of the project, after 3 months and after 6 months) while PwDs in job maintenance have been interviewed in 2 steps (at the start of the project and after 6 months).
All PwDs of our sample reported mild impairments and low levels of activity limitations. Despite this, only few persons managed to obtain a fixed-term contract after one or several stages. Almost the whole sample reported a non-organized pathway to enter into the labor sector, mostly based on personal contacts, friends and casual encounters. For the whole sample, it has been reported that a welcoming work environment, especially in terms of work group climate, that looks at the needs of the workers, can promote a better work performance and improve functioning of the person.
Another relevant result is that all PwDs did not report particular environmental factors as barrier or facilitator. This could be interpreted in two perspectives: positive, because the PwD is well integrated in the workplace, negative if the PwD considers as normal attitudes of employers or of colleagues that instead could hide discrimination or insufficient inclusion.
Results of our study show that a comprehensive Disability Management in the work sector is needed both at the level of systems and services. By considering the intrinsic capacities and the functioning of the worker in relation to his/her environment the matching between personal needs and capacities with employment needs must to be increased. The bio-psychosocial approach allows to reduce disability changing at least one of the terms of the interaction that defines disability, that is the environmental factors. Since often the diagnosis is not modifiable, we could act trying to make environmental factors as much facilitators as possible. Workplace changes, job adaptation and changes in stigmatization behaviors can and must be put in place to create an inclusive work environment. The full inclusion and participation of persons in the labor sector could also be facilitated by actions aimed at improve the workplace, with reasonable accommodation able to make the workplace more inclusive, as well as supporting employers, companies and PwDs with tailored training tools. Both training tools and workplace adaptation toolkit are under development within the Joint Action Chrodis PLUS (www.chrodisplus.eu) that dealing with employment and chronic conditions.
ICF, WHO DAS 2.0, employment, Disability Management, capacity, functioning, environmental factors, Chrodis Plus.
This project has been supported by Provincia di Monza e Brianza – Progetto MB1005298.