What works (or doesn't) in return to work after physical injury? A qualitative study on the perspectives of trauma patients and health care professionals on barriers and facilitators in return to work

PURPOSE: Return to work (RTW) after physical injury may be challenging. This study aims to gain insight into barriers and facilitators in RTW, using a multi-stakeholder perspective from trauma patients with diverse injuries and health care professionals (HCPs).

METHODS: Three focus groups (n = 13) and four interviews were conducted with patients who sustained an extremity injury, spinal injury, or traumatic brain injury. Four focus groups (n = 19) were conducted with HCPs (e.g., occupational physicians, trauma surgeons). Data were transcribed verbatim and thematically analyzed for patients and HCPs separately.

RESULTS: Both patients and HCPs emphasized that RTW can be influenced by the extent to which core work tasks are affected by the injury. Barriers in RTW related to lack of RTW follow-up care, limited consultation time, and lack of support in the work environment. Shared facilitators were found in work not affecting the injury, and when adequate support is provided by HCPs and the work environment. While patients and HCPs shared similar ideas, perspectives diverged on RTW follow-up care, provided by HCPs in hospital. HCPs in hospital perceive physical recovery as their core task instead of RTW follow-up care, which is perceived by patients to detract attention to life after injury.

CONCLUSION: According to patients and HCPs, regardless of the injury, the combination of injury type and job type influences RTW. Across injuries, receiving RTW follow-up care from HCPs in hospital was often missed, while perceived to facilitate RTW. Tailored RTW information could be useful to patients in resuming life after injury.