Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach
Objectives Major trauma centres (MTCs) save lives but rehabilitation to support return-to-work (RTW) is lacking. This paper describes development of a vocational rehabilitation intervention (the ROWTATE intervention) to support RTW following traumatic injury.Design Sequential and iterative person-ba...
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BMJ Publishing Group
2024-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/10/e085724.full |
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| author | Roshan das Nair Trevor Jones Richard Morriss Marilyn James Denise Kendrick Stephen Timmons Blerina Kellezi Priya Patel Jain Holmes Jade Kettlewell Kate Radford Kay Bridger Rebecca Lindley Hereward Tresidder Isobel Andrews Blanca De Dios Perez Abigail Statham Tadeusz Jones Karen Hoffman |
| author_facet | Roshan das Nair Trevor Jones Richard Morriss Marilyn James Denise Kendrick Stephen Timmons Blerina Kellezi Priya Patel Jain Holmes Jade Kettlewell Kate Radford Kay Bridger Rebecca Lindley Hereward Tresidder Isobel Andrews Blanca De Dios Perez Abigail Statham Tadeusz Jones Karen Hoffman |
| author_sort | Roshan das Nair |
| collection | DOAJ |
| description | Objectives Major trauma centres (MTCs) save lives but rehabilitation to support return-to-work (RTW) is lacking. This paper describes development of a vocational rehabilitation intervention (the ROWTATE intervention) to support RTW following traumatic injury.Design Sequential and iterative person-based approach in four stages—Stage 1: review of evidence about the efficacy and mechanisms of RTW interventions; Stage 2: interviews (n=38) and focus groups (n=25) with trauma survivors and service providers in five UK MTCs to identify the issues, and challenges faced postinjury; Stage 3: codesign workshops (n=43) with trauma stakeholders in MTCs to conceptually test and identify intervention delivery barriers/enablers; Stage 4: meetings (n=7) with intervention development working group (IDWG) to: (1) generate guiding principles, (2) identify key intervention features (process, components, mechanisms) to address unmet rehabilitation needs; (3) generate a logic model and programme theory to illustrate how the intervention works; and (4) develop a training package to support delivery.Results Trauma survivors described unmet needs relating to early advice about RTW; psychological support; pain management; hidden disabilities (eg, fatigue); estimating recovery; and community, amputee and musculoskeletal rehabilitation. Mechanisms of effective interventions identified in the review included early intervention, colocation, employer engagement, case coordination and work accommodations. Intervention features identified by IDWG members (n=13) from stages 1 and 2 were use of stepped-care approaches by occupational therapists (OTs) and clinical psychologists (CPs), OT/CP formulation for complex cases, assessment of mental health problems, individually tailored rehabilitation including vocational goal setting, cross-sector coordination/communication, employer engagement, phased RTW, education/advice for family/employers, exploration of work alternatives, ongoing review of physical and mental health needs, work stability monitoring. Conceptual testing ratified the logic model. Geography and long waiting lists were identified as potential delivery barriers.Conclusions Real-world testing of the intervention is underway in a randomised controlled trial. |
| format | Article |
| id | doaj-art-dceca8d458b941aaaabdb473410312af |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dceca8d458b941aaaabdb473410312af2025-08-20T03:11:54ZengBMJ Publishing GroupBMJ Open2044-60552024-10-01141010.1136/bmjopen-2024-085724Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approachRoshan das Nair0Trevor Jones1Richard Morriss2Marilyn James3Denise Kendrick4Stephen Timmons5Blerina Kellezi6Priya Patel7Jain Holmes8Jade Kettlewell9Kate Radford10Kay Bridger11Rebecca Lindley12Hereward Tresidder13Isobel Andrews14Blanca De Dios Perez15Abigail Statham16Tadeusz Jones17Karen Hoffman18Health Division, SINTEF, Trondheim, NorwayCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK2 Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UKNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK6 Business School, University of Nottingham, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UKMental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UKCentre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK4 School for Primary Care Research, University of Nottingham, Nottingham, UKNottingham Biomedical Research Centre, Nottingham, UKDivision of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UKCentre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UKCentre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UKCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UKBarts and the London NHS Trust, London, UKObjectives Major trauma centres (MTCs) save lives but rehabilitation to support return-to-work (RTW) is lacking. This paper describes development of a vocational rehabilitation intervention (the ROWTATE intervention) to support RTW following traumatic injury.Design Sequential and iterative person-based approach in four stages—Stage 1: review of evidence about the efficacy and mechanisms of RTW interventions; Stage 2: interviews (n=38) and focus groups (n=25) with trauma survivors and service providers in five UK MTCs to identify the issues, and challenges faced postinjury; Stage 3: codesign workshops (n=43) with trauma stakeholders in MTCs to conceptually test and identify intervention delivery barriers/enablers; Stage 4: meetings (n=7) with intervention development working group (IDWG) to: (1) generate guiding principles, (2) identify key intervention features (process, components, mechanisms) to address unmet rehabilitation needs; (3) generate a logic model and programme theory to illustrate how the intervention works; and (4) develop a training package to support delivery.Results Trauma survivors described unmet needs relating to early advice about RTW; psychological support; pain management; hidden disabilities (eg, fatigue); estimating recovery; and community, amputee and musculoskeletal rehabilitation. Mechanisms of effective interventions identified in the review included early intervention, colocation, employer engagement, case coordination and work accommodations. Intervention features identified by IDWG members (n=13) from stages 1 and 2 were use of stepped-care approaches by occupational therapists (OTs) and clinical psychologists (CPs), OT/CP formulation for complex cases, assessment of mental health problems, individually tailored rehabilitation including vocational goal setting, cross-sector coordination/communication, employer engagement, phased RTW, education/advice for family/employers, exploration of work alternatives, ongoing review of physical and mental health needs, work stability monitoring. Conceptual testing ratified the logic model. Geography and long waiting lists were identified as potential delivery barriers.Conclusions Real-world testing of the intervention is underway in a randomised controlled trial.https://bmjopen.bmj.com/content/14/10/e085724.full |
| spellingShingle | Roshan das Nair Trevor Jones Richard Morriss Marilyn James Denise Kendrick Stephen Timmons Blerina Kellezi Priya Patel Jain Holmes Jade Kettlewell Kate Radford Kay Bridger Rebecca Lindley Hereward Tresidder Isobel Andrews Blanca De Dios Perez Abigail Statham Tadeusz Jones Karen Hoffman Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach BMJ Open |
| title | Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach |
| title_full | Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach |
| title_fullStr | Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach |
| title_full_unstemmed | Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach |
| title_short | Development of a vocational rehabilitation intervention to support return-to-work and well-being following major trauma: a person-based approach |
| title_sort | development of a vocational rehabilitation intervention to support return to work and well being following major trauma a person based approach |
| url | https://bmjopen.bmj.com/content/14/10/e085724.full |
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