Sumud at Work: Theory-Based Development of an Occupational Therapy Intervention for Staying at Work with Chronic and Episodic Hand Conditions in Palestine.

Authors

Husam Taha

Published in

Journal of occupational rehabilitation. Oct 26, 2026. Epub Oct 26, 2026.

Abstract

Work disability prevention research presumes formal systems (sick leave, graded return to work, accommodation legislation, disability insurance) that are absent for workers in informal and conflict-affected labor markets. This paper reports the theory-based development of Sumud at Work, a prototype occupational therapy intervention for staying at work among Palestinian workers with chronic and episodic hand conditions.
An intervention development study using a combined theory- and evidence-based approach within the development phase of the Medical Research Council framework, reported per GUIDED. Three steps were followed: synthesis of stay-at-work, self-management, and contextual evidence; theoretical modeling using the Sumud-MOHO framework mapped against the work disability arena model; and specification of a program theory, logic model, and manualized intervention described per TIDieR.
The prototype specifies four modules for approximately four occupational therapy contacts after a joint surgeon and occupational therapist first visit: a narrative module intended to reframe protective work strategies as strategic steadfastness (Sumud); a protection module operationalizing flare-contingent two-track work routines, splinting, and tool adaptation (Sutra); a mutual-help module mobilizing family and community labor exchange as a proposed substitute for formal accommodation ('Awna); and a documentation module recording structural barriers, including checkpoint-related disruption, within routine care. All mechanisms are hypotheses; guardrails distinguish sustainable from sacrificial steadfastness and keep disclosure worker-controlled.
The prototype proposes relocating accommodation from absent institutions to cultural and collective practices and adds a political landscape layer to the work disability arena model. Its mechanisms are untested and its transferability beyond Palestine unestablished. Co-design, feasibility testing, and evaluation follow.

PMID:
42932149
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.

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