Vocational rehabilitation to enhance return to work after trauma (ROWTATE): protocol for a non-randomised single-arm mixed-methods feasibility study

Kendrick, Denise; das Nair, Roshan; Kellezi, Blerina; Morriss, Richard; Kettlewell, Jade; Holmes, Jain; Timmons, Stephen; Bridger, Kay; Patel, Priya; Brooks, Adam; Hoffman, Karen; Radford, Kathryn

Abstract

Background
Traumatic injuries are common amongst working age adults. Survivors often experience physical and psychological problems, reduced quality of life and difficulty returning to work. Vocational rehabilitation improves work outcomes for a range of conditions but evidence of effectiveness for those with traumatic injuries is lacking. This study assesses feasibility of delivering a vocational rehabilitation intervention to enhance return to work and improve quality of life and wellbeing in people with at least moderate trauma to inform design of a definitive randomised controlled trial (RCT).

Methods
Non-randomised, single arm, multi-centre mixed-methods feasibility study with nested case studies and qualitative study. The case studies comprise interviews, observations of clinical contacts and review of clinical records. The qualitative study comprises interviews and/or focus groups. Participants will be recruited from two UK major trauma centres. Participants will comprise 40 patients aged 16-69 with an injury severity score of >8 who will receive the intervention and complete questionnaires. Interviews will be conducted with 10 patients and their occupational therapists (OTs), clinical psychologists (CPs), employers and commissioners of rehabilitation services. Fidelity will be assessed in up to six patients by observations of OT and CP – patient contacts, review of patient records and intervention case report forms. OT and CP training will be evaluated using questionnaires and competence to deliver the intervention assessed using a team objected structured clinical examination and written task. Patients participating in and those declining participation in the study will be invited to take part in interviews/focus groups to explore barriers and facilitators to recruitment and retention. Outcomes include recruitment and retention rates, intervention fidelity, OT and CP competence to deliver the intervention, experiences of delivering or receiving the intervention and factors likely to influence definitive trial delivery.

Discussion
Effective vocational rehabilitation interventions to enhance return to work amongst trauma patients are urgently needed because return to work is often delayed, with detrimental effects on health, financial stability, healthcare resource use and wider society. This protocol describes a feasibility study delivering a complex intervention to enhance return to work in those with at least moderate trauma.

Citation

Kendrick, D., das Nair, R., Kellezi, B., Morriss, R., Kettlewell, J., Holmes, J., Timmons, S., Bridger, K., Patel, P., Brooks, A., Hoffman, K., & Radford, K. (2021). Vocational rehabilitation to enhance return to work after trauma (ROWTATE): protocol for a non-randomised single-arm mixed-methods feasibility study. Pilot and Feasibility Studies, 7(1), Article 29. https://doi.org/10.1186/s40814-021-00769-4

• Journal Article Type: Article
• Acceptance Date: Jan 7, 2021
• Online Publication Date: Jan 20, 2021
• Publication Date: Jan 20, 2021
• Deposit Date: Jan 12, 2021
• Publicly Available Date: Jan 25, 2021
• Journal: Pilot and Feasibility Studies
• Electronic ISSN: 2055-5784
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 1
• Article Number: 29
• DOI: https://doi.org/10.1186/s40814-021-00769-4
• Keywords: Vocational rehabilitation, Work, Occupation, Trauma, Injury, Psychological outcomes
• Public URL: https://nottingham-repository.worktribe.com/output/5222867
• Publisher URL: https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-021-00769-4
• Additional Information: Received: 30 June 2020; Accepted: 7 January 2021; First Online: 20 January 2021; : The North of Scotland Research Ethics Committee (REC) has given approval for the study (Reference number: 19/NS/0130). Substantial amendments that require review by the REC will not be implemented until the REC and Health Research Authority has granted approval. The ISRCTN will be notified of protocol modifications. Study participants will be notified of protocol modifications where appropriate.; : Not applicable; : None