Work transitions after serious hand injury: Current occupational therapy practice in a middle‐income country

Abstract

Introduction: Work-related transitions following serious hand injury can be complex for people with hand injuries and rehabilitation professionals supporting the return-to-work process. This study explored South African occupational therapy practice related to work transitions after a serious hand injury. Methods:In this collective case study, maximum variation sampling was used to select seven occupational therapists involved in facilitating work-related transitions for people with serious hand injuries. Participants selected at least five cases that illustrated the breadth of their practice in terms of work transitions; these cases formed the focus of the semi-structured interviews. Data were analysed using inductive content analysis. Exemplar quotations were extracted to support emergent key themes.Results: There was one overarching theme-Ongoing appraisal of the fit between function and inherent work demands-which comprised three stages:(1) determining and facilitating readiness to work; (2) managing the risk and trauma of returning to work, and (3) implementing reasonable accommodation. The central theme comprised six strategies that were used to optimise the transition process and achieve the best possible outcome. Conclusion:The study highlighted the importance of work-related transitions that are context-driven, flexible, and involve multiple stakeholders. The occupational therapists demonstrated how they drew on their knowledge of local contexts to solve problems and generate effective individual strategies over the rehabilitation period. The findings may be applicable to other low-or middleincome countries where the return-to-work process may not be as predictable as high-income countries.

Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists

“…This is consistent with findings from qualitative interviews with hand therapists in South Africa, which described the processes deployed to support the transition of return to work. 25 The primary factor encouraging therapists to discuss work recommendations with their patients was reported to be when the patients directly requested assistance. A similar finding was reported in interviews with physiotherapist and occupational therapists in the Netherlands.…”

“…This is consistent with findings from qualitative interviews with hand therapists in South Africa, which described the processes deployed to support the transition of return to work. 25 …”

Support factors contributing to successful start-up businesses by young entrepreneurs in South Africa

“…For occupational therapists practicing in LMICs this would include support in finding or creating new work. Because of limited formal work opportunities, the only viable option often would entail self-employment [43]. Occupational therapists who support self-employment initiatives could draw on the findings to enhance their services by recognizing, and educating on, the importance of support factors that could facilitate successful entrepreneurship and the social impact thereof.…”

“…However, in LMICs with high unemployment, obtaining work is not a realistic option for many occupational therapy service users. In such cases occupational therapists require competencies to facilitate work creation initiatives [41][42][43], including entrepreneurship [44]. The need for a broader range of competencies in facilitating work-related transitions has been identified, for example job seeking skills, training, and counselling to facilitate return to work or acquiring employment.…”