SiNing Zhao, Yongpei Yu, Zhiqing Zhou, Katherine P Frey, Stephen T Wegener, Renan C Castillo
Employment status, job change, and career appraisal together characterized post-burn occupational disruption beyond workforce detachment alone. High occupational impact identified survivors with greater burn severity, higher baseline distress, and concurrent work-related barrier endorsements. These findings support a broader vocational recovery framework that links sustained work participation, role adaptation, and career appraisal to differentiated rehabilitation and vocational support.
BACKGROUND: Burn injury may have lasting effects on work participation because of prolonged rehabilitation, functional limitations, appearance-related concerns, and psychological distress. Return-to-work status alone may obscure ongoing disruption in work roles, career appraisal, and support needs. How these elements cluster during post-burn occupational recovery remains insufficiently characterized.
METHODS: We analyzed 166 adult burn survivors with baseline demographic, clinical, and psychosocial assessments and occupational follow-up data collected 24 months later. Outcomes included employment status, job change among employed survivors, perceived career impact, and predefined return-to-work barriers and facilitators. High occupational impact was defined a priori as burn-attributed workforce detachment or negative perceived career impact among employed survivors. Baseline correlates were examined using multivariable logistic regression. Positive perceived career impact was examined descriptively.
RESULTS: Ongoing work participation was reported by 51.2%, burn-attributed workforce detachment by 41.0%, and other unrelated changes by 7.8%. Among those who remained employed, job change was common (60.0%). Overall, 43.4% reported negative perceived career impact, and 54.2% met the definition of high occupational impact. Greater burn severity, higher baseline distress, and older age were associated with higher odds of high occupational impact; baseline posttraumatic growth showed an inverse exploratory trend. Model discrimination was moderate (AUC=0.733; 95% CI, 0.656-0.810).
CONCLUSIONS: Employment status, job change, and career appraisal together characterized post-burn occupational disruption beyond workforce detachment alone. High occupational impact identified survivors with greater burn severity, higher baseline distress, and concurrent work-related barrier endorsements. These findings support a broader vocational recovery framework that links sustained work participation, role adaptation, and career appraisal to differentiated rehabilitation and vocational support.