Back to work: exploring barriers and facilitators to return to work and work participation following traumatic amputation

Purpose: To explore barriers and facilitators to returning to work and work participation experienced by people following traumatic amputation. Methods: An exploratory qualitative study was conducted with nineteen adults in Australia with major upper (n = 10) or lower (n = 9) amputation due to trauma. Data from individual, semi-structured interviews was analysed using Braun and Clarke’s reflexive thematic analysis. Results: The role of a worker was entrenched in participants’ identities, its value reflected in the sense of loss and destabilising of self, experienced following amputation. Lack of productivity and routine was distressing, but also motivating for returning to work. Participants felt secondary health complications, complex return to work systems, and perceptions of unemployability hindered their return. Facilitative strategies included prosthetic use, environmental modifications, delegating tasks and transition to less physically demanding roles. Re-establishing capacity and identity in the workplace also included re-negotiating workplace relationships. Supportive workplace culture and colleagues were invaluable to this process. Whilst some participants were unable to return to work, for others the process was an opportunity for positive change. Conclusion: Traumatic amputation has a significant impact on work participation. Recommendations based on the study’s findings will inform the role of clinicians supporting vocational rehabilitation for people following traumatic amputation.