IDENTIFYING COMPLEXITIES AND BARRIERS ASSOCIATED WITH THE RETURN-TO-WORK PROCESS FOR FIREFIGHTERS AND THE DISABILITY MANAGEMENT STRATEGIES USED TO PROMOTE A SUCCESSFUL RETURN-TO-WORK FOR FIREFIGHTERS

Abstract

Background: Firefighters have a high risk of injuries or illnesses, which can result in workplace absences. Considering the unique occupational context of firefighting, firefighters may require unique disability management strategies to promote a successful and timely return-to-work. Objectives: To explore the facilitators, barriers and complexities of return-to-work for firefighters, and the current strategies used to promote return-to-work for firefighters. We also explored generic return-to-work strategies as they are applicable to all occupations. Methods: For the integrative review, we searched databases, grey literature and online resources to identify strategies, facilitators and barriers of return-to-work for firefighters. We used qualitative methods for the other studies, including interviews about return-to-work processes. For second and third studies, we used interpretive descriptions to analyze the interviews with disability management professionals. For the fourth study, we used qualitative descriptive methods to analyze the interviews with career firefighters. Results: We identified return-to-work strategies barriers for firefighters from our review including occupation-specific exercises and return-to-work readiness assessments. For the second study, disability management professionals discussed the need for accurate medical documentation and communication with stakeholders to identify suitable modified duties and return-to-work plans. In the third study, disability management professionals identified that firefighters required standard and firefighter-specific return-to-work principles, including prioritizing the recovery process over a timely return to modified duties. In the fourth study, firefighters agreed that rehabilitation was important because they must be physically able to perform their firefighting tasks. Firefighters disliked sedentary modified duties. Conclusions: The return-to-work process for firefighters may be complex due to their unique occupational context, and disability management professionals should implement occupation-specific strategies with standard strategies. It is important for disability management personnel who are not aware of the unique occupational context of firefighting to collaborate with firefighters to identify firefighter-specific return-to-work strategies.