Post-burn Occupational Disruption:Employment Status, Job Change, and Perceived Career Impact

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.

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.

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).

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.