Configuration of accident trajectories after a rehabilitation programme: on the sharp edge between reintegration and socio-professional exclusion.

Purpose: To analyse the factors influencing the configuration of accident trajectories from de perspective of patients and assess the role of rehabilitation in managing pain and functional limitations autonomously.

Material And Methods: Using a qualitative, longitudinal, interdisciplinary approach, we conducted two comprehensive interviews (one year apart) with patients experiencing chronic pain and functional limitations following orthopaedic trauma. Thematic analysis was conducted utilising MaxQDA software to systematically analyse the data.

Results: Twenty-four patients participated (4 ♀; 20 ♂; 44.9 ± 10.6, min. 19; max. 63.5 yo; 1.0 ± 4.0 years duration; pain 4.6 (1.8) severity subscale (0-10) [mean (SD)]). Through reconstruction their experiences we identified three types of accident trajectories: socio-professional reintegration, ongoing reintegration, and exclusion. Factors influencing these trajectories included physical and psychological health status, occupational status, private and social context, and insurance and therapeutic aspects. Patients' perceptions and socio-demographic characteristics also contributed to trajectories specificities.

Conclusion: Understanding the factors that influence accident trajectories links individual and social dimensions, offering an overall comprehension of patients' situations and structural constraints. This understanding enables the factors influencing trajectories to be considered during rehabilitation, thereby promoting the patient's socio-professional reintegration through targeted interventions.