Mild traumatic brain injury and occupational rehabilitation, is the presence of an insurer adding complexity? The perspective of workers and their occupational therapists

Autor: C. Sylvain, M. Belanger-Douet, Marie-José Durand
Rok vydání: 2018
Předmět:
Zdroj: Annals of Physical and Rehabilitation Medicine. 61:e523
ISSN: 1877-0657
DOI: 10.1016/j.rehab.2018.05.1217
Popis: Introduction/Background Work is an essential activity that could be significantly disrupted by a mild traumatic brain injury (MTBI). Returning to work (RTW) is a complex process involving different actors including occupational therapists (OT) and insurers. The current knowledge indicates that insurer's compensation is related to persistent symptoms after MTBI which can result in a delayed RTW. The reasons behind this association are still not well documented. The aim of this study is to better understand the insurer's influence on the occupational rehabilitation process after MTBI from the perspective of injured workers and their OT. A framework was developed based on literature. Material and method A descriptive qualitative interpretative approach was used with a purposive sampling of 8 dyads of worker-OT. An interview guide was developed and pre-tested. Semi-structured interviews were conducted with both the OT and the workers 6–24 month post-accident. A thematic analysis by dyads was completed using a mixed coding method. Results Results showed three dimensions to the context of interactions with an insurer: 1.recognition of the worker's complaints legitimacy, 2.quality of the interactions, 3.accessibility to proper healthcare services. The participants identified many elements belonging to those dimensions as key to the evolution of RTW: knowledge of the insurer on MTBI as being good, recognition of the link between MTBI, symptoms and occupational incapacities, insurer's positive characteristics such as helpful behaviours and access to professionals as being facilitated. Only a lack of knowledge about insurer's system and unclear written communications were judged unfavorable by workers. Conclusion Influences from the insurer on RTW were mainly positive, which contradicts existing literature. This distinction can be partially explained by a favorable context whereas specialised OT were providing teaching on regular basis to insurers. This study offers reflections on factors susceptible of influencing RTW in presence of an insurer and ultimately aims at improving collaboration between actors.
Databáze: OpenAIRE
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