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Return to Work After Burn Injury: Burn-Injured Individuals' Perception of Barriers and Facilitators
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
2010 (English)In: Journal of burn care & research : official publication of the American Burn Association, ISSN 1559-0488, Vol. 31, no 4, 540-550 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore burn-injured individuals' perception of factors seen as facilitators or barriers in the process of returning to work after a severe burn injury. Semistructured interviews were prospectively conducted with 39 former burn injury patients, admitted to the Uppsala Burn Center between March 2000 and March 2007. The participants were employed or studying at the time of injury and were interviewed on average 4.6 years after the burn. The interview data were analyzed with qualitative content analysis. Factors acknowledged by the participants as facilitators and barriers to return to work (RTW) were identified and sorted into five categories: the Individual, Social Life, Health Care and Rehabilitation, the Workplace, and Social Welfare Agencies. Facilitators were perceived to a great extent as individual characteristics, such as own ability to take action, setting up goals in rehabilitation, having willpower, being persistent, and learning to live with impairments. The possibility of getting modified work tasks or a change of workplace, when having physical or psychological impairments, was also seen as facilitating factors. Some barriers experienced as delaying RTW were difficulties when ceasing pain medication, limited knowledge of wound care at primary health care facilities, lack of individualized rehabilitation plans, and lack of psychological support during rehabilitation. Former burn injury patients emphasized psychological resources and capabilities as facilitators in the RTW process. The need in rehabilitation for a coordinator and for assessment of work capacity, and not solely a focus on impairments, is discussed.

Place, publisher, year, edition, pages
2010. Vol. 31, no 4, 540-550 p.
Keyword [en]
Return to work, burn injury, content analysis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-132449DOI: 10.1097/BCR.0b013e3181e4d692ISI: 000279638400004PubMedID: 20616648OAI: oai:DiVA.org:uu-132449DiVA: diva2:358054
Available from: 2010-10-20 Created: 2010-10-20 Last updated: 2011-11-08Bibliographically approved
In thesis
1. Return to Work and Health-related Quality of Life after Severe Burn
Open this publication in new window or tab >>Return to Work and Health-related Quality of Life after Severe Burn
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A major burn is one of the most severe traumas a person can experience, and recovery can be a protracted process. The principal aim was to increase the knowledge base regarding factors related to return to work and health-related quality of life (HRQoL) after burns. Patients treated at the Uppsala Burn Center between 2000 and 2007 were included on a consecutive basis. Assessments were made at hospitalization, and thereafter and included a home visit 2 to 7 years after injury.

The psychometric properties of the generic HRQoL instrument EQ-5D were investigated. The results support the use of EQ-5D as an adjunct to burn-specific assessments of HRQoL. Most former patients exhibited a good HRQoL at 2 to 7 years postburn. Not working at the time of injury and having PTSD at 12 months, as well as having low scores on the EQ VAS at 12 months, were related to a worse EQ VAS score at 2 to 7 years after injury.

The majority of former patients had returned to work 2 to 7 years postburn. Time to return to work was predicted by length of hospital stay and a personality disorder diagnosis. Predictors for not returning to work were length of stay and having any anxiety or substance use disorder prior to injury. Those who were not back at work reported lower generic and burn-specific health, and exhibited more psychiatric morbidity at follow-up than those who were working. The latter group exhibited HRQoL that was comparable to that of the general population. Participants emphasized their own psychological resources and capabilities as facilitators in the process of returning to active work.

The findings suggest that an early and systematic approach for assessing recognized risk factors enhances the possibility of discovering patients at risk of developing problems during postburn adaptation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 62 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 614
Keyword
Burn, Return to work, Health-related quality of life, Outcome assessment, Rehabilitation, Injuries, Psychiatric Disorders, Personality Disorder
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-132454 (URN)978-91-554-7929-9 (ISBN)
Public defence
2010-12-10, Enghoffsalen, Entrance 50, Akademiska sjukhuset, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-11-15 Created: 2010-10-20 Last updated: 2011-01-13

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