Synergistic connectedness - a foundation for resilience in return-to-work after injury

Traumatic injury has substantial effects on survivors' overall functioning, including at work. In low-income settings, trauma care and rehabilitation services are weak, which can complicate the recovery and return-to-work process of injury survivors. This study aimed to construct a substantive theory on the return to work (RTW) experiences of injury survivors, people who sustained traumatic physical injuries in Ethiopia.

A qualitative constructivist grounded theory (CGT) study was conducted, using data collected through in-depth interviews with fourteen adult injury survivors. We followed Charmaz's CGT approach for data coding and analysis.

We constructed the core theme, "Synergistic Connectedness," characterized by three subthemes: spiritual-, social-, and self- connection, which catalyzed survivors' lives after injury. Participants' experiences were captured in three progressive, iterative and nonlinear recovery phases: 1) initial response - dealing with the reality; 2) disruptive recovery - negotiating uncertainty and meaning-making; and 3) RTW pathways - navigating capability to adapt, fit, accept or follow a new direction. Each survivor faced unique challenges and had resources to draw on for support, ultimately leading to a resilient recovery process.

Spiritual connection is the unique strength of participants that influences their connectedness to self and others. The findings underscore the importance of holistic support in enhancing RTW outcomes after injury.