Traumatic brain injury (TBI) is becoming more prevalent in an age of increased motorization and violence. The majority of patients are young adults previously in paid employment. Life expectancy is usually unaffected once past the acute stage of recovery. The reported statistics for successful return to work (RTW) vary from 15% to 77%. However no literature was sourced which examines or discusses the most central component of successful return to work rehabilitation for these individuals - what the individuals themselves have found to be of assistance from their experience of return to work rehabilitation in attempting to return to work. This study explored the lived experience of return to work rehabilitation from the perspective of individuals who had sustained TBI and who had actively engaged in a return to work programme as part of their rehabilitation. A phenomenological approach, with an interpretative focus was utilized to explore and obtain an enhanced understanding from data gained in semi-structured interviews conducted with ten participants. The interviews were audio-recorded. The position of the researcher was situated within the research, and a reflexive component was interwoven throughout the process. Interpretative Phenomenological Analysis (IPA) was undertaken to elicit themes to enhance my understanding. Findings formed five main themes; personal cost of lifestyle losses, impact of TBI on perceptions of RTW, factors impacting on engagement in RTW rehabilitation, participants' perceptions of assistive elements of RTW rehabilitation, impact of RTW rehabilitation on participant. Each master theme comprised a group of sub themes, discussed within the thesis. The meaning of work pre-morbidly for individuals who sustain TBI characterizes their social and familial roles and responsibilities. Upon attempting to RTW following rehabilitation the definition of work often changes in conjunction with the individual's world views and perceptions of self. Whilst RTW rehabilitation may be an important goal for the individual and his/her family, because he/she accesses rehabilitation through a community based service, other, external, factors often impact on their ability to fully engage in a RTW rehabilitation programme. Little acknowledgement of this is made by clinicians, and more flexibility and further additional one to one interventions during times of difficulty would be assistive in optimizing the chances of success for individuals. Whilst all participants in this study were able to verbalize positive experiences of the outcomes of RTW rehabilitation, none had returned to their previous employment resuming their previous roles. Thus the core message of this thesis is that the role of the occupational therapist in RTW rehabilitation needs to incorporate many elements including group rehabilitation, one to one rehabilitation and clinical liaison with work places. This can be potentially achieved through adopting Mosey's (1986) Acquisitional Frame of Reference as a working practice model. In addition, facilitated longterm peer and clinical support is required to ensure individuals maintain success in their attempts to RTW. Clinicians involved in this area of work need to work within an interdisciplinary team approach, recognise and assist with a defined grief reaction that presents in individuals when they attempt to RTW, and be flexible and accommodating in the delivery of RTW rehabilitation to patients.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:511620 |
| Date | January 2010 |
| Creators | Hooson, Marian J. |
| Publisher | University of Brighton |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://research.brighton.ac.uk/en/studentTheses/30bca9f0-ee62-45b6-82c5-f7445d407864 |
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