Getting a grip: a study of the psychosocial factors that impact on the rehabilitation of people with traumatic hand injury

Abstract

Those involved in the field of rehabilitation are being encouraged to think of it as a dynamic process in which the disabled person plays a central role. As it is increasingly acknowledged that a multiplicity of factors impact on a person's ability to function or recover after injury, an holistic approach to rehabilitation is advocated. There is a question about how well this theory is being put into practice, as there appears to be a continued focus on the physical rather than the emotional aspects of injury. It is well documented that severe injury to the hand affects a person both physically and psychologically much more than might be expected. However, little has been written about how this impacts on rehabilitation following such an injury. The complex issues related to adjustment and appropriate rehabilitation service provision, together with the high incidence of work-related hand injury provide the platform for this study This research focused on exploring the psychosocial factors that impact on rehabilitation following traumatic, work-related hand injury and will discuss how such factors are related to service delivery. As the participants had sustained their injury by accident they received compensation through the Accident Rehabilitation and Compensation Insurance Corporation (ACC) and it was through this organisation that they accessed rehabilitation services. Case management was the service delivery model used by ACC. The qualitative study involved ten people who shared their experiences of an accident, resulting in a traumatic hand injury, in individual interviews and a focus group. The cause of the accident, its impact on themselves and those around them and the rehabilitation involved was explored. Their stories revealed insights that do not seem to be appreciated or understood by many of those involved in the day-to-day provision of rehabilitation services. Workplace safety and psychosocial factors were significant predisposing factors related to the accidents. Most participants experienced a satisfactory return to work. Physical limitations had diminished certain aspects of their social life but the emotional implications of a traumatic injury were not adequately addressed. The consequences of a traumatic hand injury are far reaching and an improvement in accident prevention strategies is vital. In order to maximise the potential for an optimum recovery, all those involved in the rehabilitation process need to understand the wide ranging effects of a traumatic hand injury. This understanding may then lead to a greater commitment to holistic assessment and service provision, underpinned by actively listening to the client. The result will be a more positive approach to rehabilitation with greater client satisfaction and durable outcomes.