Vocational Rehabilitation To Enhance Return to Work After Trauma: Findings From A Non-Randomised Feasibility Study

Abstract

<h3>Research Objectives</h3> To assesses the feasibility of delivering a telehealth vocational rehabilitation (VR) intervention to enhance return to work and improve quality of life and wellbeing in people post-trauma. <h3>Design</h3> Non-randomised single-arm mixed-methods feasibility study. <h3>Setting</h3> Participants were recruited from two UK major trauma centres (MTCs). The intervention was delivered virtually (or face-to-face where necessary) in participants' homes. <h3>Participants</h3> Adult patients (n=10) 16-69 years, admitted to participating UK MTCs with Injury Severity Score (ISS) >8, recruited ≤12 weeks post-injury. Eligible participants were employed (paid or unpaid) or in full-time education at injury onset. Treating occupational therapists (OTs) and clinical psychologists (CPs) (n=6) trained in ROWTATE VR. <h3>Interventions</h3> ROWTATE is an individually-tailored job retention intervention, delivered by OTs, who act as case-coordinators, and CPs. It commences 12-weeks post-injury and is delivered for up to 12 months. It involves: assessing impact of injury; work-focused rehabilitation; planning/monitoring phased return-to-work; liaising with employers/healthcare team; educating patients/employers about injury impact; early identification, monitoring and support for psychological problems. Due to COVID-19, the intervention was adapted for remote delivery (video/phone call) and OTs/CPs trained in remote delivery. <h3>Main Outcome Measures</h3> Study completion. Intervention fidelity, barriers and enablers to delivery, acceptability and usefulness; acceptability of remote intervention training. <h3>Results</h3> At 6 months: 90% started intervention ≤12 weeks post-injury, 103 OT sessions (M=10.3, range 5-19); 99% OT sessions delivered remotely, 6 patients referred to CP; 22 sessions (M=3.7, range 1-5), 100% remote. Fidelity: OT: 90%-100% across patients, CP: 82%-100% across patients. No participant withdrawals. Treating therapists and all participants found the intervention acceptable. <h3>Conclusions</h3> Remote VR training and delivery is feasible and acceptable to OTs/CPs and trauma survivors. Findings have informed a definitive randomised controlled trial. <h3>Author(s) Disclosures</h3> No conflicting interests.