Authors (including presenting author) :
Cheng EKN (1), Heung KLK (2), Ip KWM (2), Chang VSP (1), Lau M (2), Ho ECM (1)
Affiliation :
(1) Tai Po Hospital, (2) Shatin Hospital
Keyword 1: :
Vocational Rebabilitation
Keyword 2: :
Stage of Change
Keyword 3: :
Motivational Enhancement
Keyword 4: :
Medical Social Collaboration
Introduction :
The worker role is crucial among adults. Traditional occupational therapy (OT), involving assessment, goal setting, and skill building, helps people return to work. However, challenges like client dropout persist. With Transtheoretical Model (TTM) as framework, it is hypothesized that misalignment present between intervention strategies and the client's readiness for change.
Objectives :
To investigate the factors influencing vocational rehabilitation and propose a tailored intervention to improve outcomes.
Methodology :
A retrospective review was conducted on service user data from the occupational therapy department of Shatin Hospital (SH) during October to December 2025. After excluding those who are retired, with intellectual or physical disabilities, 27 out of 67 (40.3%) needed work rehabilitation to pursue a worker role. Spearman's rank-order correlation was run to determine the relationship between demographic data, stage of change, and work function.
Result & Outcome :
Result: Over half (52%) of users were in Pre-contemplation, Contemplation, or Maintenance stages. Stage of change was positively correlated with level of work function (rs=.615, p=.001) and negatively correlated with duration of unemployment (rs=-.886, p=.000). Additionally, years of education showed a positive correlation with both stage of change (rs=.536, p=.004) and work function (rs=.592, p =.001). Meanwhile, earlier onset of illness correlated with lower education levels (rs= -.468, p=.014) and lower work function (rs=-.509, p=.007). Discussion: Traditional work rehabilitation programs predominantly serve clients in the Preparation and Action stages. However, over half of our mental health service users (52%) are in the Pre-contemplation, Contemplation, or Maintenance stages. The necessary motivational groundwork should be addressed and established. The strong negative correlation between duration of unemployment and stage of change indicated the longer the service user remains unemployed, the less "ready to change" they become. This suggests that early intervention in implementation of Motivational Enhancement (ME) strategies to break the cycle of passivity. The strong positive link between “Readiness” and “Level of Work Function” suggests improving one's readiness (stage of change) should theoretically improve their vocational outcome.
Clients in Maintenance stage may benefit from community support. Strong medical-social collaboration by making suitable referrals to Non-Governmental Organizations facilitate early engagement and community reintegration. Limitations: Small, single center sample. Empirical research is needed to test the TTM-informed OT interventions versus traditional approaches. Conclusion: Applying the TTM explains client difficulties and dropout. Tailoring interventions to readiness through early motivational strategies and medical-social collaboration may improve outcomes. Factors like illness onset and unemployment duration help predict needs and guide appropriate referrals.
