An exploration of the return to workexperiences of individuals who aremanaging a traumatic hand injuryand the development of a return towork intervention.

Abstract

The effect of a traumatic hand injury on an individual can be wide ranging and include both physical and psychological dimensions. Getting back to work following such an injury is often challenging. This study aimed to explore individuals’ experiences of returning to work following a traumatic hand injury and to use insights gained to develop and pilot a return to work intervention. The study comprised two stages. A reflective lifeworld research methodology, with a longitudinal perspective, was used to underpin the first stage. Seven adults in fulltime work were interviewed at three distinct time points following their traumatic hand injury. Many participants continued to engage in their usual daily activities, including being at work, and most of them initially expected to make a full and speedy recovery. It was with this view that participants made decisions concerning their return to work. Once back at work it became clear that the impact of the injury was wider ranging than they anticipated and difficulties arose with managers and colleagues regarding participants’ ability to comply with their rehabilitation programme within the context of work. The second stage used findings from stage one to extend the scope of the rehabilitation interventions, moving away from a hand therapy programme that focused solely on the healing structure to a rehabilitation programme that also included patient concerns in line with occupational therapy principles. A return to work intervention was developed which was integrated with the existing rehabilitation programme. This intervention was piloted with seven people in full-time employment. Reflective lifeworld research was used to analyse their experiences within the context of the phenomenon under investigation. Results indicated that participants’ return to work experience was more positive and controlled following the return to work intervention. Therapists’ involvement in the development of the return to work plan provided an authoritative and independent way for managers and participants to implement the return to work intervention. An ability to manage their return to work and their exercise programme at the same time was reported by participants. This research has illuminated the complexity of the life and work journey of individuals with traumatic hand injury, the stages of the adaptation process and their rehabilitation needs. Inclusion of other stake holders such as the manager and GP could be useful in developing the return to work intervention further through a randomised control trial.