An exploration of the return to work experiences of individuals who are managing a traumatic hand injury and the development of a return to work intervention.

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.