|dc.description.abstract||Traumatic brain injury (TBI) is a common injury, which has a substantial effect on people’s ability to return to their daily activities including work. Fatigue is one of the most prevalent TBI symptoms impacting on an individual’s ability to return to work. There is no published evidence investigating fatigue-specific strategies that might be used to help people post-TBI manage their fatigue successfully at work to allow them to return to paid employment or the same number of pre-injury work hours. This research addresses the question ‘How do people manage fatigue, which they attribute to TBI, to enable them to successfully return to and maintain paid work?’
A qualitative descriptive approach was taken to explore how people managed their post-TBI fatigue at work – including what they did and how it worked. Eight participants, 3 men and 5 women, participated in a semi-structured interview at their place of choice. Participants were aged between 24-66 years old, had sustained a TBI of any severity, returned to their pre-injury employment, and attributed fatigue symptoms to their TBI. The time from the participant’s injury to interview was between 6 months and 22 months. The interviews were transcribed and analysed inductively using thematic analysis.
Participants learned through trial and error how to recognise the point at which their fatigue symptoms indicated that they needed to make a change to remain productive at work. At this change point, participants selected the appropriate strategy from a continuum of strategies ranging from those that minimally disrupted work productivity through to considerable disruption to work productivity. Least disruption resulted from strategies that reduced task intensity or demand, with increasing disruption as a participant chose one of three types of break. These ranged from ‘super mini breaks’ where activity was minimally disrupted, to ‘mini breaks’ consisting of a short removal from activity, to ‘long breaks’ which meant a prolonged interruption of the activity. Participants became increasingly skilled at anticipating fatigue and avoiding it and, when a change point was reached, choosing the strategy that worked best for the level of fatigue they experienced. Participants also altered activities outside work to manage fatigue at work as well as balancing their tasks over the week to ensure they could perform at work throughout the week.
Participants with TBI learned how to managed their fatigue at work. This fatigue management became increasingly sophisticated over time as participants developed an understanding of their fatigue symptoms and when and what type of fatigue management strategies to use to maximise their productivity at work. An infographic representing the participants learning about successful fatigue management at work was developed and further research could test how useful this is in the work setting.||