Negotiating the return to work journey after an earthquake injury

Background: Earthquakes are inevitable natural occurrences. When they occur in populated areas the effects can be devastating, often causing multiple casualties. Little is known about the long-term health and wellbeing outcomes of individuals with trauma as the result of an earthquake. However, there is growing evidence that up to 80% of individuals with traumatic injuries have long term disruption of social roles and participation. Successful return to work following injury improves quality of life, restores important pre-injury roles and is a means of social interaction, although the return to work rate in the trauma population group is comparatively low. Little is known about the return to work outcomes after earthquake injury. Aims: The aims of this study were to explore the influences on return to work for the injured survivors of the Christchurch, New Zealand February 22nd 2011 earthquake. Methodology: A constructivist grounded theory methodology was used to explore the influences on return to work for the injured survivors of the Christchurch, New Zealand February 22nd 2011 earthquake. Methods: Fourteen injured survivors of the Christchurch earthquake were interviewed twice between July 2012 and January 2014. In addition, single interviews were carried out with twelve professionals involved in the return to work process for the injured earthquake survivors (six vocational professionals and six Accident Compensation Corporation staff). Data analysis focused on the differences in the return to work processes and outcomes as a result of the earthquake. Results: Four themes were identified: rebuilding normality, negotiating the return to work journey, working within the system and the earthquake experience. Three separate stages of return to work were identified with specific barriers and facilitators at each stage: (1) planning and preparing work; (2) achieving work; and (3) maintaining work. Across these stages, the earthquake appeared to have greatest impact on the first phase: planning and acquiring work. This seemed to connect to contextual factors, such as, environmental (earthquake damage to the area, services systems and policies) and relational (empathy and connection between the injured person and their employer and co-workers with a shared experience of the earthquake within the workplace). Conclusion: Return to work following earthquake injury followed a similar process to other trauma populations in many ways. However, it was complicated by factors that other injured workers (and employers) do not have to negotiate. However, the influence of a shared experience with the employer and co-worker appeared to impact positively on the experiences and outcomes of return to work. The results of this thesis provides new information about the barriers and facilitators to work after an earthquake injury and has potential impact for other major disasters