Abstract
Teachers face unique challenges when returning to work after mild traumatic brain injury (mTBI), due to the inherent demands of their work role. This qualitative study explored the barriers and facilitators experienced by primary school teachers returning to work after mTBI in Aotearoa New Zealand. Seven participants were recruited from a target population of New Zealand-based teachers working in primary education settings, who had sustained an mTBI within two years of study enrolment. Participants self-reported that their ability to fully engage in their pre-injury work role was affected by mTBI-related difficulties. Semi-structured interviews were employed to collect data, and reflexive thematic analysis methods were used to understand the perspectives of the participants within their context. Three themes were identified: My classroom never stops; Invisible injury: understanding affects expectations; and Trying to link everyone together. The findings indicated that participants felt significant pressure to return to work (RTW) as quickly as possible after their injury in order to minimise disruption to others, despite their own limitations. Pressure to RTW was explicit from employers, whom participants perceived as lacking an understanding of mTBI. Furthermore, teachers face challenges in implementing accommodations to their usual work tasks and routines, due to the lack of flexibility in work hours and the need for additional teaching staff. To improve outcomes, accommodations need to be tailored to the physical, cognitive, and emotional demands of the role, with an understanding of the wider systemic factors influencing the availability of accommodations. The rehabilitation team plays an important role in advocating for the injured person and providing appropriate support, education, and guidance throughout the RTW process, as participants felt isolated while trying to coordinate the competing priorities of stakeholders. Overall, the barriers and facilitators experienced by teachers as they RTW after mTBI are not merely at the level of the individual and their work tasks, but are embedded within the complex interactions between the individual, personal, workplace, healthcare, and insurance/legislative systems. To effect change, all systems need to work cohesively together to improve outcomes for primary teachers returning to work after mTBI in NZ.