Return to work following acquired brain injury: the views of patients and employers.
OBJECTIVE
To investigate which factors are experienced as facilitators of or barriers to return to work (RTW), or as solutions to RTW-problems, by patients with acquired brain injury (ABI) and by employers.


METHODS
Qualitative study.


METHODS
Ten patients with ABI and seven employers participated in semi-structured interviews. Patients and employers were unrelated. Transcripts were open coded. Factors perceived to be facilitators, barriers, or solutions to RTW-problems were grouped on a thematic basis.


RESULTS
Both patients and employers distinguished patient-related and work-related facilitators. When questioned about barriers, both patients and employers emphasized the importance of work-related factors such as sensory overload at the workplace and condition-related factors such as fatigue. Patients regarded poor guidance and support as barriers, but employers did not. Employers and patients suggested that solutions to RTW-problems were work-related, if necessary backed up by professional supervision. Patients also mentioned the need for understanding and acceptance of the limitations resulting from ABI.


CONCLUSIONS
Both patients and employers mentioned work-related and patient-related facilitators, work-related and condition-related barriers, and work-related solutions to RTW-problems. Patients mentioned lack of guidance and support as barriers, and stressed the need for understanding and acceptance of the limitations resulting from ABI in any RTW-solution. Implications for rehabilitation •Patients and employers are important stakeholders in the return to work (RTW) process of a patient with acquired brain injury (ABI) •Professionals in rehabilitation practice, occupational and insurance physicians need to help patients and employers to realize RTW •Professionals have to be aware of the perspectives of patients and employers regarding RTW, such as: ^Little understanding of limitations resulting from ABI ^Work-related aspects hindering RTW, such as sensory overload and high work pressure ^Condition-related barriers to RTW such as (invisible) cognitive limitations and fatigue ^Need for professional assistance during the RTW process.
a Academic Medical Center, Department: Coronel Institute of Occupational Health , University of Amsterdam , Amsterdam , T he Netherlands.|b Research Center for Insurance Medicine , Amsterdam , The Netherlands.
Birgit H P M
BHPM
Donker-Cools
a Academic Medical Center, Department: Coronel Institute of Occupational Health , University of Amsterdam , Amsterdam , T he Netherlands.|b Research Center for Insurance Medicine , Amsterdam , The Netherlands.
Maria J E
MJE
Schouten
a Academic Medical Center, Department: Coronel Institute of Occupational Health , University of Amsterdam , Amsterdam , T he Netherlands.|b Research Center for Insurance Medicine , Amsterdam , The Netherlands.
Haije
H
Wind
a Academic Medical Center, Department: Coronel Institute of Occupational Health , University of Amsterdam , Amsterdam , T he Netherlands.|b Research Center for Insurance Medicine , Amsterdam , The Netherlands.
Monique H W
MHW
Frings-Dresen
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D036301:Qualitative Research; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data; D012938:Social Perception; D017132:Workplace / Q000458:organization & administration / Q000523:psychology
Acquired brain injury; barriers; facilitators; qualitative research; return to work; stroke; traumatic brain injury