gms | German Medical Science

Objective: The aim of this qualitative study was to explore the return to work experiences of patients undergoing carpal tunnel release (CTR) surgery.

Materials and Methods: Semi-structured 1:1 interviews were conducted with a subgroup of participants recruited to a UK-based prospective cohort study. Interviewees were purposely selected to gain representation across different job roles, employment status, demographics and return to work times. All had recently undergone CTR and had returned to work. Interviews were audio recorded, transcribed verbatim and analysed using the Framework method. Participants were recruited until data saturation was achieved.

Results: Thirteen participants were interviewed: 10 women (median age 49 years, range 27-61) and 3 men (age range 51-68 years). Job roles included desk-based, light manual and heavy manual occupations. Median time to return to work was 21 days (range 1-100 days). Three key themes were identified. Theme 1 centred on the participants' surprise at the level of functional disability experienced in the immediate post-operative period. There was an expectation that CTR would be a small procedure, but this did not match the participants' experiences. Theme 2 centred on the prescription of sick leave, with participants reluctant to return to work any earlier than suggested by their clinician. Theme 3 focused on the practicalities of the return to work process, with participants reporting uncertainties about activity loads and durations.

Conclusions: Multiple factors contributed to participants' return to work processes; however, individual return to work decision-making was largely influenced by the initial recommendations received from the surgeon. Clinicians may be able to improve patients' post-operative experiences by discussing strategies to manage the initial period of reduced function and encouraging realistic expectations; in addition to tailoring recommendations for the practicalities of returning to individual work roles.