Overcoming barriers through an intersectional lens: return-to-work and work participation of people with spinal cord injury in Spain.

Purpose: People with spinal cord injuries (SCI) face reduced access to work opportunities compared to individuals without disabilities. This study explored how people with SCI experience barriers and facilitators to work participation during return-to-work (RTW) and their quality of work participation in Spain's post-COVID-19 context.

Methods: A qualitative phenomenological design was used. Eight women and nine men participated in three focus groups between February and June 2023. Data was video and audio recorded and analysed using a six-step Interpretative Phenomenological Analysis approach.

Results: Three main themes emerged: (1) intersectional factors contributing to unemployment and poverty risks, (2) lack of post-rehabilitation services and RTW planning, and (3) the need for policy reforms. Findings highlighted inequities such as inadequate job search support, inaccessible work environments, and insufficient subsidies for technical aids, adaptations, and teleworking. The post-COVID-19 context legitimised teleworking, which was previously unfeasible. Intersectional analysis revealed heightened unemployment and work precarity among young adults, women, and migrants.

Conclusions: Personalised RTW programs are essential for people with SCI, addressing systemic barriers and incorporating an intersectional approach to transform policies and improve employment outcomes.