Barriers to Return to Work After Burn Injuries

Esselman PC, Wiechman Askay S, Carrougher GJ, Lezotte DC, Holavanahalli RK, Magyar-Russell G, Fauerbach JA, Engrav LH. Barriers to return to work after burn injuries. Objective: To identify barriers to return to work after burn injury as identified by the patient. Design: A cohort study with telephone interview up to 1 year. Setting: Hospital-based burn centers at 3 national sites. Participants: Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Intervention: Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. Main Outcome Measures: A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. Results: By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. Conclusions: The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.