Dalarna University's logo and link to the university's website

Background: Acquired brain injury (ABI) is often a lifelong disability that entails a marked change in a person’s life. It involves biopsychosocial levels and return to work (RTW) is one of the main goals for the person. Several of those suffering an ABI are of working age. The society and the individuals are both winners if the person could get back to work and sustain working.

Objective: The aim of this study was to increase knowledge about the opportunities and barriers for successful RTW among individuals with ABI.

Methods: Adults who have ABI and had participated in work rehabilitation were interviewed in regard to their experiences of the process. The informants (five females, five males) had participated in work rehabilitation, had successfully RTW and had worked at least 50% in at least a year after the injury. The interviews were transcribed, structured and analysed by latent content analysis with a hermeneutic approach.

Results: Three main themes that influenced RTW after ABI were identified: (i) individually adapted rehabilitation process, (ii) motivation for RTW and (iii) cognitive abilities and inabilities. The results indicate that an individually adapted vocational rehabilitation (VR) process was an important issue. The individuals with ABI actively involved in their own rehabilitation process also required continuous support from the society, the specialists, their employers and colleagues; this support has to be designed for each individual. A moderate level of motivation for RTW was necessary for the best result to RTW, in other words it was important to achieve a balance between too high and too low motivation. Finally, a comprehensive knowledge about the cognitive abilities and inabilities of the individual after ABI helped the individuals and their employers to find compensatory strategies to handle their work tasks. One implication of the findings was the necessity of a good support system and a good VR that functions well and lasts for a longer period. When there are obstacles in the VR process, it is important to have strategies and awareness of how to proceed further.

Conclusions: Consequently, the support built for a person individually, with a balanced motivation, knowledge about the cognitive abilities and awareness of how to proceed further in the process will help to build a successful and sustainable RTW.