Financial Burden, Worry, and Return-to-Work Outcomes After Peripheral Nerve and Brachial Plexus Injuries: A Preliminary Exploration

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Abstract
Background: Despite the well-known functional impacts of peripheral nerve injury (PNI), little is understood about its financial burden (monetary strain), financial worry (stress), and return-to-employment outcomes. Financial toxicity has been studied in many different patient populations, but little is known in PNI patients. We aimed to use validated questionnaires to assess these aspects following PNI. Methods: In this retrospective study, we surveyed patients (≥18 years) who underwent operative treatment for PNI between May 2021 and November 2023 at a single institution. Data on employment status, financial difficulties, and disability applications were collected. Two validated scales, the Financial Burden Composite Score and Financial Worry Scale, were used to collect data on financial burden and worry. Participants were included if they were 6 to 36 months postsurgery. Univariate analyses were performed to identify factors associated with financial burden and worry. Results: Among 35 respondents in a 6- to 36-month postoperative timeframe, 51.4% had a financial burden score ≥4, and 45.7% had a financial worry score ≥4. Participants aged 40 to 60 years experienced the highest burden (mean = 4.5), compared with those aged 60 to 80 years (mean = 1.4, P < .01). High financial worry was significantly linked to employment status, job modifications, and inability to return to work ( P < .05). Overall, 61% of participants returned to work after an average absence of 7.3 months; 57.1% required job modifications, and 30% changed professions. Conclusions: Financial burden and worry are common among individuals recovering from PNI, particularly in those unable to return to work. This exploratory study begins to describe the interplay between financial burden and worry, return-to-work outcomes, and rehabilitation barriers. Beyond improving limb function, care teams may collaborate with social workers, community health workers, and vocational rehabilitation experts to support patient well-being and facilitate a successful return to employment.

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