An exploration of the experiences and perceptions of employers and caregivers of individuals with mild-moderate traumatic brain injury returning to work

Abstract

An estimate of 89 000 cases of new traumatic brain injuries (TBI) are reported annually in South Africa. South African legislation advocates for the employment of persons with a disability. Individuals with mild-moderate TBI that do qualify to return-to-work (RTW) often do not have access to vocational rehabilitation (VR) and, as a result, return to the occupational therapy work assessment units for Disability Grant assessments. Not having the necessary insight and understanding about the condition influences the affected individual’s chances of returning to work. Failing to return to work results in dependency on a caregiver. The aim of this study was to explore the perceptions and experiences of employers and caregivers of individuals with mild traumatic brain injury returning to work after completing a VR programme, using the Model of Occupational Self-Efficacy. A purposive sample comprising employers and caregivers of 10 individuals with mild TBI was selected. Semi-structured interviews were completed and data manually managed, with confidentiality and anonymity strictly ensured. The findings of the study were analysed by means of thematic analysis, from which five themes emerged. Themes one and two described the employers’ and caregivers’ experiences and perceptions that hindered the RTW process. Theme three related to the enabling aspects they derived from engaging in the VR process, along with the individual with mild-moderate TBI. Themes four and five presented the coping strategies that aided the employer and caregiver in playing a continued role in the RTW process. The International Classification of Function, Disability and Health (ICF) was used to conceptualise the findings and interpret the perspective of the barriers, enablers and coping strategies as seen through the lens of the employer and caregiver. The results of the study can be used to help individuals with TBI adapt to the work environment, as well as inform policy development regarding social grants and access to rehabilitation services for TBI survivors. Occupational therapists (OT) using the MoOSE should regard the employer and caregiver as key role players during therapy. Employers should gain a better understanding of TBI and allow for sick leave during rehabilitation. Caregivers would benefit from finding or establishing a support network for themselves, and by connecting with employers of the individual with TBI in order to understand the individual’s work environment.