Patients' perspectives of receiving an early vocational rehabilitation following major traumatic injury.

Abstract

Return to work (RTW) after a major traumatic injury (MTI; traumatic brain injury, spinal cord injury, multi-trauma orthopaedic injury) is an important rehabilitation outcome. This study aimed to explore the experience of early vocational rehabilitation (EVR) after MTI, and RTW barriers/facilitators. Adopting a qualitative design, 24 people with MTI were interviewed about participating in the Early Intervention Vocational Rehabilitation Service (EIVRS). Perceptions of EIVRS timing and RTW barriers/facilitators were explored. Data were analysed using reflexive thematic analysis. Participants experienced EIVRS as positive. The intervention's early timing was mostly appropriate, determined by individual factors. RTW barriers included injury impairments; difficulties adapting work roles and unstable employment; and psychological difficulties. RTW facilitators included ongoing recovery, employer flexibility, and feeling supported. Reported EIVRS benefits centred around three themes: gaining optimism and motivation through increased understanding; having a sense of control through the individualised program and vocational expertise; and feeling less worry and stress. Participants recommended long-term EIVRS availability. Participants experienced EIVRS as an important component of their rehabilitation. Timing of vocational interventions needs to be individualised according to medical, cognitive, psychological, and employment factors. Embedding EVR within rehabilitation teams would facilitate this individualisation and may improve long-term rehabilitation outcomes.