Teleworkers with disabilities: characteristics and accommodation use.

BACKGROUND: The prevalence of telework among people with disabilities is not as great as the general population, despite the accommodative benefits of telework. OBJECTIVE: This study of employment and accommodation use patterns of people with disabilities investigates relationships between functional abilities, work location and nature, and accommodation use. PARTICIPANTS: Currently employed subjects with disabilities were recruited from client lists of research, technical assistance, and service provision centers, as well as through over 100 social networking venues focused on individuals with disabilities. METHODS: A national, cross-sectional survey was administered electronically. Details of accommodation use for 373 individuals were compared using Chi-Square distribution analysis. RESULTS: Those in white-collar and knowledge-based jobs were twice as likely to telework as other worker types, and teleworkers were twice as likely to use flexible scheduling. Only 47% of teleworkers reported telework as a job accommodation. Of those, 57% were satisfied with telework and 76% reported it as important to job task completion. CONCLUSIONS: Increased use of flexible scheduling, particularly among those who view telework as an accommodation, suggests the primary accommodative benefit of telework is to reduce pain and fatigue-related barriers to traditional employment. Relatively low satisfaction with telework suggests that it presents other employment-related barriers.

Telework rationale and implementation for people with disabilities: considerations for employer policymaking.

BACKGROUND: Telework has been promoted as a viable workplace accommodation for people with disabilities since the 1990s, when information and communication technologies (ICT) had developed sufficiently to facilitate its widespread adoption. This initial research and accompanying policy recommendations were prescriptive in nature and frequently aimed at employers. OBJECTIVE: This article adds to existing policy models for facilitating successful telework outcomes for people with disabilities. Drawing upon two studies by the Rehabilitation Engineering Research Center on Workplace Accommodations, we expound on employee-side considerations in the implementation of telework. METHODS: Our policy model utilizes established typologies for policy evaluation to develop a process model that considers rationales and implementation factors for telework among people with physical disabilities. RESULTS: Telework may be used as an accommodation for disability, but employee rationales for telework are more complex, involving work-life balance, strategies for pain and fatigue not formally recognized as disability, and expediency in travel and transportation. Implementation of telework as a component of workplace operations is similarly multifaceted, involving non-technology accommodations to realize job restructuring left incomplete by telework. CONCLUSIONS: Our model grounds new empirical research in this area. We also renew our call for additional research on effective telework practices for people with disabilities.

Workplace accommodations and unmet needs specific to individuals who are deaf or hard of hearing.

PURPOSE: The purpose of this paper is to identify the workplace accommodations used by individuals who are deaf or hard of hearing, to report the perceived impact of the accommodations and to identify unmet needs with respect to workplace accommodations. METHOD: Individuals who are deaf or hard of hearing participated in an online survey. Respondents identified with one of four levels of functional hearing ability and selected from descriptions of workplace accommodations. Each selection was ranked according to perceived importance, satisfaction and frequency of use. Respondents also commented on unmet needs. RESULTS: The most common accommodations were telephone aids (55%), co-worker helps (34%) and electronic communication (31%). Importance and frequency of use ranked high among most respondents (76% and 87%, respectively). However, perceived satisfaction ranked high among only 50% of respondents. The most common unmet needs were effective communication in groups and lack of co-worker support. CONCLUSIONS: Workplace accommodations are viewed as important and frequently used by individuals who are deaf or hard of hearing. However, satisfaction with the accommodations is marginal at best. Unmet needs remain in the areas of communication in meetings, support of co-workers and the development of a more universally accessible workplace environment.

Analysis of localized erythema using clinical indicators and spectroscopy.

Localized erythema is regularly used as an indicator of post-ischemic events, including reactive hyperemia and Stage I pressure ulcers. The National Pressure Ulcer Advisory Panel definition of a Stage I ulcer includes both visual and nonvisual indicators in part to improve identification in darkly pigmented skin. A prospective, repeated-measures design was used to collect information on pressure-induced erythema that includes reactive hyperemia and Stage I pressure ulcers with an emphasis on distinguishing indicators in light and dark skin The relationships among clinical indicators (skin assessments) and results from tissue reflectance spectroscopy, as well as the clinical utility of spectroscopy for discerning tissue blanching status, were examined in a convenience sample of 76 inpatients and outpatients (95 test/control site pairs). Chi-square analysis and generalized logistic models were used to identify relationships and distinguishing characteristics of erythema. Analysis of variance was used to analyze blanching using spectroscopy. Nonblanching sites were more likely to be persistent erythema (c2=5.3; P = 0.021) but exhibited no relationships to temperature, tissue resilience, or disability. Erythema in subjects with dark skin was more likely to be nonblanching and have poor resilience. Spectrographic analysis of blanching found significant differences across skin pigmentation (P = 0.0001) and blanching status (P = 0.019). These results reinforce the belief that dark skin must be assessed differently than light skin and indicate that clinicians should use persistence of erythema rather than blanching status to judge incipient pressure ulcers. These results validate the use of visual and nonvisual indicators included in the National Pressure Ulcer Advisory Panel Stage I pressure ulcer definition.

Characterizing reactive hyperemia via tissue reflectance spectroscopy in response to an ischemic load across gender, age, skin pigmentation and diabetes.

PURPOSE: Pressure ulcers represent a major secondary complication for amputees with diabetes and further complications may arise since ulcers are particularly hard to heal in this population. This study characterized the hyperemic response to a localized ischemic load in people with diabetes and amputation and compared it to that of subjects without diabetes or amputation. SUBJECTS: Case-control study matching subjects by gender, age, skin pigmentation, and smoking status. METHODS: Applying 150 mmHg to the patellar tendon for 10 minutes induced reactive hyperemia (RH). Tissue reflectance spectroscopy measured hemoglobin (HbO(2)) concentration in tissue before, during and after application of pressure. Refill time, Maximum HbO(2), Time@Max HbO(2), RH area and RH half-life characterized the RH response and were analyzed using ANOVA. All values up to a level of p <0.1 are presented. RESULTS: Analysis included responses from 88 subjects. RH magnitude and temporal parameters varied across skin pigmentation; smokers showed a decreased RH magnitude; vasodilator users had greater RH temporal parameters; no evidence of differences were found across disease state or age. CONCLUSION: Decreased RH response in smokers and subjects with dark skin might indicate a reduced ability to recover from ischemia. The lack of difference in RH response between subjects with and without diabetes was consistent with studies using other disability groups and corroborates the theory that RH is locally mediated.