Exploring the lived return-to-work experience of individuals with acquired brain injury: use of vocational services and environmental, personal and injury-related influences

Abstract

Purpose

To explore work outcomes, vocational services, barriers and facilitators for returning to work in individuals with acquired brain injury (ABI) in Queensland, Australia and to identify areas for improvement.

Design and methods

Ten semi-structured interviews were conducted with individuals with ABI (stroke, traumatic brain injury, tumour). Interviews were analysed using a realist thematic analysis approach.

Results

Participants either returned to the same work, different work, did not maintain work or did not have any work since their injury. Use of vocational services depended on participants’ needs and insurance. Facilitators for return to work (RTW) were a supportive workplace and family, vocational rehabilitation that met the individual’s needs, insurance coverage and self-motivation. Workplaces that were not understanding of brain injury, employment service providers who were unable to find work for participants, and physical and cognitive deficits were barriers to RTW. Workplaces, employment service providers and individuals require more information about the deficits associated with brain injury.

Conclusions

The use and effectiveness of vocational services were variable across participants and depended on insurance coverage and needs. Barriers and facilitators for RTW were affected by both the environment and the individual. Implications for vocational rehabilitation were identified.

Implications for Rehabilitation

• A supportive workplace and family, and access to appropriate vocational rehabilitation are important environmental facilitators for RTW in individuals with ABI.

• Workplaces with a poor understanding of ABI and employment service providers unable to find work for individuals with ABI are environmental barriers to RTW.

• Workplaces, employment service providers and individuals with ABI require more information about the physical and cognitive deficits associated with ABI.

• Employment service providers need more training to develop comprehensive strategies to help individuals with ABI find new employment.

Keywords:

• Acquired brain injury
• stroke
• traumatic brain injury
• return to work
• vocational rehabilitation
• qualitative research

Acknowledgements

The authors acknowledge and thank the participants for taking their time to participate in this study.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The data from this study is stored in a folder accessible only to members of the research team due to ethical requirements. Participant consent was not given for this data to be shared publicly.

Additional information

Funding

This work is supported by funding from the Motor Accident Insurance Commission (MAIC). MAIC had no role in the design, analysis or writing of this manuscript.