The factors influencing the return to work of individuals having sustained severe traumatic brain injuries in South Africa.

Abstract

A traumatic brain injury (TBI) is a complex phenomenon where the ability to return to work (RTW) following injury is not always successful. Vocational rehabilitation (VR) is process that facilitates the RTW. Previous skills, habits and a familiar working environment need to be considered to ensure a successful client-centred intervention. The purpose of this study was to identify and explore factors influencing RTW of severe TBI’s who were employed in a stable, secure environment for more than three years prior to the injury. A qualitative approach was used to explore the lived experience of severe TBI’s. The aims and objectives were to identify and explore personal attributes, developed habits and routines, residual performance skills and environmental factors that enhanced or impeded the RTW of severe TBI’s. A semi-structured interview was guided by the worker role questionnaire and used as a gathering tool. The audio-taped interviews were transcribed and then thematically analysed using Braun and Clark’s six phase process. Two major themes emerged from the study namely; “It’s all about me” and The support for me”. The sub-themes from the first theme included my role as a worker, my abilities in the role and my emotions in the role. Sub-themes from the second theme included personal, work and rehabilitative support. The findings indicate that participating in work was of great importance to participants. Factors that enhanced the RTW were; developing and fulfilling the worker role, positive support, the ability to draw on past experience, knowledge and skills and VR intervention. Additionally, a previous stable and secure work environment emerged as a strong factor in enhancing RTW. Factors that impeded the RTW were a lack of support and uncertainty regarding residual abilities and the working environment. It highlighted that these factors were unique, inter-related and crucial in the fulfilment of self-worth. Although only two participants in this study received VR, there was strong emphasis on its impact on RTW and the need for this to be client-centred. This finding supports literature indicating VR in South Africa is limited. If readily available, it could have a positive effect on RTW of people with severe TBI’s.