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Craven K, De Dios Pérez B, Holmes J, Fisher R, Radford KA. Factors influencing employers' support for employees with acquired brain injuries or mental illness to return to- and stay in work: A qualitative systematic review. Work 2024:WOR230214. [PMID: 38217562 DOI: 10.3233/wor-230214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND People with acquired brain injuries (ABIs) often experience residual limitations and co-morbid mental illnesses that restrict work participation. Employers are key in enabling successful return-to-work and job retention. OBJECTIVE This review aimed to explore employers' perspectives of factors influencing their support for people with ABIs and/or mental illness to return to- and stay in work. Review questions focused on barriers and facilitators to their support, and contextual characteristics present at the time. METHODS Five databases were searched from October 2010 until November 2023 for relevant qualitative studies published in English. Findings from included studies (N = 25) were synthesised using thematic synthesis. RESULTS Included studies focused on employees with ABI or mental illness, rather than dually diagnosed ABI and mental illness. Employers' support was influenced by their awareness/knowledge of- and attitudes towards the employee's condition/illness; their skills and experience in supportive strategies; factors related to provision of work accommodations; and stakeholder influence. Similarities and differences in influential factors were observed across the ABI and mental illness literature. Contextual characteristics related to organisational characteristics, cultural taboo, and involvement of certain stakeholders. CONCLUSIONS ABI survivors (with and without co-morbid mental illness) and their employers may benefit from specialist support and resources to guide them through the return-to-work process. Further research is needed to investigate employers' knowledge of ABI and mental illness and supportive strategies. Exploration of the influence of other stakeholders, socio-demographic characteristics, and contextual factors on employers' return-to-work and retention support for ABI survivors with co-morbid mental illness is warranted.
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Affiliation(s)
- Kristelle Craven
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, United Kingdom
| | - Blanca De Dios Pérez
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, United Kingdom
| | - Jain Holmes
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, United Kingdom
| | | | - Kathryn A Radford
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, United Kingdom
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Abzhandadze T, Westerlind E, Palstam A, Sunnerhagen KS, Persson HC. Sick leave one year after COVID-19 infection: a nationwide cohort study during the first wave in Sweden. Sci Rep 2024; 14:572. [PMID: 38177214 PMCID: PMC10766961 DOI: 10.1038/s41598-023-50413-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
This study aimed to investigate the patterns of sick leave, as well as factors associated with sick leave due to COVID-19 during one year after the COVID-19 diagnosis, and sex-related aspects on sick leave. This nationwide study involved 11,902 individuals who received sickness benefits for COVID-19 during the first wave of the pandemic. Data from three Swedish registries were analyzed for sick leave that commenced between March 1 and August 31, 2020, with a follow-up period of 12 months. Sick leave due to COVID-19 was counted as the number of days with sickness benefits and required to include at least one registered COVID-19 diagnosis. The median duration of sick leave was 35 days, and 347 (2.9%) individuals continued their sick leave during the entire follow-up period. Furthermore, 1 year later, the cumulative incidence of sick leave was slightly higher in males (3.5%) compared to females (2.7%). Older age, being single with no children, diagnosed with the virus, medium income level, history of sick leave, and need for inpatient care were significantly associated with a higher duration of sick leave due to COVID-19, both in the total population and when stratified by sex. These results indicated that three out of 100 (3%) patients were still on sick leave 1 year after their COVID-19 diagnosis. Aspects regarding the importance of sick leave duration differed between males and females and comprised sociodemographic characteristics and need for inpatient care. The results indicated the complexity of sick leave due to COVID-19.
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Affiliation(s)
- Tamar Abzhandadze
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Emma Westerlind
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Emergency Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Annie Palstam
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanna C Persson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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Coutts E, Cooper K. Return to work for adults following stroke: a scoping review of interventions, factors, barriers, and facilitators. JBI Evid Synth 2023; 21:1794-1837. [PMID: 37255032 DOI: 10.11124/jbies-22-00174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This scoping review aimed to map the literature on interventions, factors, barriers, and facilitators for return to work for adults post-stroke with or without communication disorders. INTRODUCTION Difficulties in returning to work can significantly impact individuals following a stroke (eg, their sense of purpose and self-esteem), not only financially, but also as they adjust to the change in their situation. Such difficulties may arise from communication disorders as well as physical impairments. Previous reviews on return to work post-stroke have focused on specific aspects, such as interventions, or barriers and facilitators, but have not provided a comprehensive map of the field. Further, no systematic or scoping reviews to date have focused on literature addressing return to work for people with communication disorders post-stroke. INCLUSION CRITERIA This review considered literature that reported on interventions, barriers, and facilitators for return to work for adults (aged 16 years or older) following an ischemic or hemorrhagic stroke. Records focusing on transient ischemic attacks or acquired brain injury were excluded, as were those in which a comorbidity or disability (eg, learning disability, dementia, respiratory disorder) had a significant impact on the individual's ability to work. METHODS This review followed the JBI scoping review methodology. Primary research of any type, systematic and non-systematic reviews, and gray literature from developed countries written in English from 2010 to the present day were identified from 7 databases, 2 gray literature repositories, JBI Evidence Synthesis , and an internet search. Records were screened for relevance to the review topic by 2 independent reviewers, and data relevant to the review questions were extracted. Findings were presented as narrative supported by tables. RESULTS Of the 106 sources included, 61 addressed demographic-based, socioeconomic-based, impairment-based, or recovery-based factors related to return to work. One of these 61 sources, a narrative review, focused on communication disorders. Thirty-eight sources explored barriers and facilitators for return to work from different stakeholders' perspectives; 3 of these 38 sources, including 2 qualitative studies and 1 narrative review, focused on post-stroke communication disorders. Eleven sources focused on interventions, including 7 studies (reported across 9 sources) that developed or tested return-to-work interventions. Of these primary studies, 1 randomized controlled trial and 1 retrospective cohort study were identified. The remaining intervention studies were case studies or case series. None of these intervention studies addressed communication disorders. CONCLUSIONS While there has been extensive research on factors, barriers, and facilitators for return to work post-stroke, there is a lack of research on interventions supporting return to work. There is also a significant gap in the evidence base on returning to work with a post-stroke communication disorder, highlighting the need for further research in this important area.
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Affiliation(s)
- Emma Coutts
- Speech and Language Therapy, NHS Grampian, Fraserburgh UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
- The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Robert Gordon University, Aberdeen, UK
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Ogunlana MO, Oyewole OO, Fafolahan A, Govender P. Exploring community reintegration among Nigerian stroke survivors. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2023; 79:1857. [PMID: 37415852 PMCID: PMC10319923 DOI: 10.4102/sajp.v79i1.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/02/2023] [Indexed: 07/08/2023] Open
Abstract
Background Community reintegration is one of the ultimate goals of stroke rehabilitation. The increasing burden of stroke morbidity by other non-communicable diseases in Nigeria indicated the need for our study. Objectives The authors explored the factors contributing to successful community reintegration among Nigerian stroke survivors. Method We conducted an explorative qualitative study design to achieve this aim using in-depth semi-structured interviews with 12-purposively sampled stroke survivors. Results Three overarching themes emerged: restriction of participation experienced by stroke survivors, activity limitation as pointers to the quality-of-life experience of stroke survivors and enablers or barriers to community reintegration for stroke survivors. Among the core, sub-themes included incapability of returning to work, difficulty performing domestic activities, social isolation or separation, recreation and leisure time. Enablers of community reintegration included creating a positive mindset, encouragement and social support, while barriers included mobility and speech or language challenges. Conclusion Stroke survivors have challenges in returning to work and experience varying levels of activity limitation, which affects their quality of life with identifiable enablers or barriers to community reintegration. Clinical implications Stroke survivors with severe functional deficits should be monitored closely and given further rehabilitative assistance to aid functional recovery, thereby facilitating community reintegration.
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Affiliation(s)
- Michael O Ogunlana
- Department of Physiotherapy, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria
- Department of Occupational Therapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Olufemi O Oyewole
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Abiola Fafolahan
- Department of Physiotherapy, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria
| | - Pragashnie Govender
- Department of Occupational Therapy, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Wassenius C, Claesson L, Blomstrand C, Jood K, Carlsson G. The centrality of work in everyday life after stroke: A qualitative study of long-term stroke survivors. Scand J Occup Ther 2023; 30:539-549. [PMID: 36726231 DOI: 10.1080/11038128.2023.2170914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Work is an occupation of great concern for younger stroke survivors. Given the high rate of people not working after stroke, there is a need to explore work after stroke from a long-term perspective, including not just an initial return to work, but also the ability to retain employment and how this may affect everyday life after stroke. Therefore, the objective of this study was to explore experiences relating to work and to work incapacity among long-term stroke survivors. METHOD This study used thematic analysis on data gathered through individual semi-structured interviews with long-term stroke survivors. RESULTS The analysis resulted in four themes that together comprised the main theme 'The centrality of work in everyday life', containing descriptions of how everyday life was affected by aspects of work both for those who did work and those who did not return to work after stroke. CONCLUSION AND SIGNIFICANCE The results highlight the importance of addressing return to work not just as an isolated outcome but as part of everyday life after stroke. The results indicate a need for a more flexible approach to supporting return to work that continues past the initial return.
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Affiliation(s)
- Charlotte Wassenius
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Region Västra Götaland, Department of Research, Education and Innovation, Södra Älvsborg Hospital, Borås, Sweden
| | - Lisbeth Claesson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christian Blomstrand
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Stroke Centre West. The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Neurology, The Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnel Carlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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SAAR K, TOLVANEN A, POUTIAINEN E, ARO T. Returning to Work after Stroke: Associations with Cognitive Performance, Motivation, Perceived Working Ability and Barriers. J Rehabil Med 2023; 55:jrm00365. [PMID: 36622215 PMCID: PMC9847477 DOI: 10.2340/jrm.v55.2576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 11/18/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To investigate post-stroke return-to-work and its associations with cognitive performance, motivation, perceived working ability, and self-perceived barriers to returning to work. DESIGN Prospective cohort study of a clinical sample. SUBJECTS AND METHODS Participants were 77 stroke patients younger than age 69 years. Assessment included a cognitive screening method for stroke patients (CoMet), a questionnaire regarding work-related matters, and a question regarding motivation to return to work. A predictive model of return-to-work was built, and how participants managed in their working life was examined. RESULTS Cognitive performance was significantly connected with returning to work. Three of the 5 individuals who dropped out of working life had cognitive dysfunction. Cognitive performance predicted 80% of those who had not returned and 37% of those who had returned by 6 months after the initial assessment. Self-perceived working ability and barriers predicted 64% of those who had not returned and 78% of those who had returned at the 12-month follow-up. CONCLUSION Cognitive performance seems to be a crucial predictor of return-to-work post-stroke, but individuals' own evaluations of their working capabilities are also important.
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Affiliation(s)
- Katri SAAR
- South Savo Social and Health Care and Authority, Suojelius Oy, Espoo
| | - Asko TOLVANEN
- Department of Psychology, University of Jyväskylä, Jyväskylä
| | | | - Tuija ARO
- Department of Psychology, University of Jyväskylä, Jyväskylä
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Pan X, Wang Z, Yao L, Xu L. The reasons for not returning to work and health-related quality of life among young and middle-aged patients with stroke: A cross-sectional study. Front Neurol 2023; 14:1078251. [PMID: 36908631 PMCID: PMC9995965 DOI: 10.3389/fneur.2023.1078251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
Objectives This study aimed to explore the reasons and influencing factors for non-return to work (non-RTW) within 1 year among young and middle-aged patients with stroke and to assess their health-related quality of life (HRQoL) at 1 year across different reasons. Methods The study was conducted as a telephone-based cross-sectional survey. Seven hundred eighty-nine young and middle-aged patients with stroke aged between 18 and 54 years for men and 18 and 49 years for women in the electronic medical system were included. Data collection included demographic characteristics, socioeconomic status, behavioral habits, history of chronic diseases, work status, reasons for non-RTW, and HRQoL. Results Of 789 patients, 435 (55.1%) (mean [SD] age, 47.7 [7.8] years) did not return to work within 1 year after stroke. Among the patients who did not RTW, 58.9% were unable to work, 9.7% retired early, 11.03% became full-time homemakers or were unemployed, and 20.5% were reluctant to work. The disordered multiclass logistic regression model showed that the factors influencing the reasons for non-RTW included age, gender, education, income, health insurance, diabetes comorbidity, ability to perform activities of daily living, and mobility of the right upper extremity. Furthermore, patients who were unable to work had significantly lower HRQoL compared to those who had RTW, followed by those who retired early. Conclusions More than half did not RTW within 1 year in our study. The results will help inform future research to identify interventions to promote RTW and improve HRQoL for young and middle-aged patients with stroke.
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Affiliation(s)
- Xi Pan
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhi Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lin Yao
- Nursing Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lan Xu
- Nursing Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Wicht CA, Chavan CF, Annoni JM, Balmer P, Aellen J, Humm AM, Crettaz von Roten F, Spierer L, Medlin F. Predictors for Returning to Paid Work after Transient Ischemic Attack and Minor Ischemic Stroke. J Pers Med 2022; 12:jpm12071109. [PMID: 35887606 PMCID: PMC9325246 DOI: 10.3390/jpm12071109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/30/2022] [Indexed: 12/02/2022] Open
Abstract
This study aims to determine which factors within the first week after a first-ever transient ischemic attack (TIA) or minor ischemic stroke (MIS) are associated with stroke survivors’ ability to return to either partial or full time paid external work (RTpW). In this single-center prospective cohort study, we recruited 88 patients with first-ever TIA or MIS (NIHSS ≤ 5). Bivariate analyses were conducted between patients that did (RTpW) or did not return to paid work (noRTpW) within 7 days after stroke onset and at 3-months follow-up. Then, we conducted multivariate logistic and negative binomial regression analyses assessing (i) which factors are associated with RTpW at 3 months (ii) the likelihood that patients would RTpW at 3 months and (iii) the number of months necessary to RTpW. Overall, 43.2% of the patients did not RTpW at 3 months. At 3-months follow-up, higher anxiety/depression and fatigue-related disabilities were associated with noRTpW. Multivariate analysis showed that higher NIHSS scores at onset and hyperlipidemia (LDL cholesterol > 2.6 mmol/L or statins at stroke onset) were associated with noRTpW at 3 months. Stroke severity and/or newly diagnosed hypercholesterolemia at stroke onset in TIA or MIS patients were associated with not returning to paid work at 3 months.
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Affiliation(s)
- Corentin A. Wicht
- Neurology Unit, Medicine Section, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland; (C.A.W.); (J.-M.A.); (L.S.)
| | - Camille F. Chavan
- Stroke Unit and Unit of Neurology, Department of Internal Medicine, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland; (C.F.C.); (P.B.); (A.M.H.)
- Neuropsychology Unit, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland
| | - Jean-Marie Annoni
- Neurology Unit, Medicine Section, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland; (C.A.W.); (J.-M.A.); (L.S.)
- Stroke Unit and Unit of Neurology, Department of Internal Medicine, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland; (C.F.C.); (P.B.); (A.M.H.)
| | - Philippe Balmer
- Stroke Unit and Unit of Neurology, Department of Internal Medicine, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland; (C.F.C.); (P.B.); (A.M.H.)
| | - Jérôme Aellen
- Department of Radiology, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland;
| | - Andrea M. Humm
- Stroke Unit and Unit of Neurology, Department of Internal Medicine, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland; (C.F.C.); (P.B.); (A.M.H.)
| | | | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland; (C.A.W.); (J.-M.A.); (L.S.)
| | - Friedrich Medlin
- Stroke Unit and Unit of Neurology, Department of Internal Medicine, Cantonal Hospital, 1752 Villars-sur-Glâne, Switzerland; (C.F.C.); (P.B.); (A.M.H.)
- Correspondence: ; Tel.: +41-26-306-22-37; Fax: +41-26-306-22-31
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Radford KA, McKevitt C, Clarke S, Powers K, Phillips J, Craven K, Watkins C, Farrin A, Holmes J, Cripps R, McLellan V, Sach T, Brindle R, Holloway I, Hartley S, Bowen A, O'Connor RJ, Stevens J, Walker M, Murray J, Shone A, Clarke D. RETurn to work After stroKE (RETAKE) Trial: protocol for a mixed-methods process evaluation using normalisation process theory. BMJ Open 2022; 12:e053111. [PMID: 35292493 PMCID: PMC8928258 DOI: 10.1136/bmjopen-2021-053111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This mixed-method process evaluation underpinned by normalisation process theory aims to measure fidelity to the intervention, understand the social and structural context in which the intervention is delivered and identify barriers and facilitators to intervention implementation. SETTING RETurn to work After stroKE (RETAKE) is a multicentre individual patient randomised controlled trial to determine whether Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care is a clinically and cost-effective therapy to facilitate return to work after stroke, compared with usual care alone. This protocol paper describes the embedded process evaluation. PARTICIPANTS AND OUTCOME MEASURES Intervention training for therapists will be observed and use of remote mentor support reviewed through documentary analysis. Fidelity will be assessed through participant questionnaires and analysis of therapy records, examining frequency, duration and content of ESSVR sessions. To understand the influence of social and structural contexts, the process evaluation will explore therapists' attitudes towards evidence-based practice, competency to deliver the intervention and evaluate potential sources of contamination. Longitudinal case studies incorporating non-participant observations will be conducted with a proportion of intervention and usual care participants. Semistructured interviews with stroke survivors, carers, occupational therapists, mentors, service managers and employers will explore their experiences as RETAKE participants. Analysis of qualitative data will draw on thematic and framework approaches. Quantitative data analysis will include regression models and descriptive statistics. Qualitative and quantitative data will be independently analysed by process evaluation and Clinical Trials Research Unit teams, respectively. Linked data, for example, fidelity and describing usual care will be synthesised by comparing and integrating quantitative descriptive data with the qualitative findings. ETHICS AND DISSEMINATION Approval obtained through the East Midlands-Nottingham 2 Research Ethics Committee (Ref: 18/EM/0019) and the National Health ServiceResearch Authority. Dissemination via journal publications, stroke conferences, social media and meetings with national Stroke clinical leads. TRIAL REGISTRATION NUMBER ISRCTN12464275.
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Affiliation(s)
- Kathryn A Radford
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Christopher McKevitt
- Department of Public Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Sara Clarke
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Katie Powers
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Julie Phillips
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Kristelle Craven
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Caroline Watkins
- Faculty of Health and Care, University of Central Lancashire, Preston, Lancashire, UK
| | - Amanda Farrin
- Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Jain Holmes
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Rachel Cripps
- Department of Public Health Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Vicki McLellan
- Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Tracey Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Richard Brindle
- Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Ivana Holloway
- Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Suzanne Hartley
- Clinical Trials Research Unit (CTRU), University of Leeds, Leeds, UK
| | - Audrey Bowen
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Rory J O'Connor
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Judith Stevens
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Marion Walker
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John Murray
- Centre for Rehabilitation and Ageing Research, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Angela Shone
- Research and Innovation, University of Nottingham, Nottingham, UK
| | - David Clarke
- Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Lindgren I, Pessah-Rasmussen H, Gard G, Brogårdh C. Perceived work situation and work ability among persons who are working one year after stroke. J Rehabil Med 2021; 54:jrm00254. [PMID: 34825916 PMCID: PMC8862645 DOI: 10.2340/jrm.v53.918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To explore how persons who have returned to work perceive their work situation and work ability one year after stroke. Design Cross-sectional design. Subjects A total of 88 persons of working age (mean age 52 (standard deviation; SD 8) years, 36% women), with mild to moderate disabilities following stroke, who had returned to work within one year after stroke participated in the study. Methods A survey including a questionnaire regarding psychological and social factors at work (QPS Nordic) and 4 questions from the Work Ability Index (WAI) was posted to the participants. Results According to the QPS Nordic survey, 69–94% of respondents perceived their work duties as well defined, and were content with their work performance. Most participants had good social support at work and at home. Between 51% and 64% of respondents reported that they seldom felt stressed at work, seldom had to work overtime, or that work demands seldom interfered with family life. According to the WAI ≥75% of respondents perceived their work ability as sufficient, and they were rather sure that they would still be working 2 years ahead. Conclusion Persons who have returned to work within one year after stroke appear to be content with their work situation and work ability. Appreciation at work, well-defined and meaningful work duties and support seem to be important for a sustainable work situation.
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Affiliation(s)
- Ingrid Lindgren
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Sweden.
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Lindberg M, Ranner M, Månsson-Lexell E, Jacobsson L, Larsson-Lund M. Work and everyday life in a digitalized time: Experiences of people with subjective cognitive difficulties related to neurological disorders. PLoS One 2021; 16:e0260013. [PMID: 34780560 PMCID: PMC8592488 DOI: 10.1371/journal.pone.0260013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/30/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Digitalization has changed working life and increased cognitive demands on employees in general. Nevertheless, the consequences for employees with cognitive impairments and subjective cognitive difficulties are to a large extent unexplored. The aim of this study was to explore and describe how employees with subjective cognitive difficulties who are performing digital work tasks experience their vocational situation and how this situation influences their everyday life. METHODS A qualitative, descriptive, multiple-case study was designed. Self-reports, assessments and qualitative interviews were used to collect data from the seven participants with neurological disorders. The data were analysed using pattern matching. FINDINGS The analysed data formed four categories conceptualized as "Working to my full potential", "Working, but it is largely up to me", "Working at the expense of everyday life" and "Working without known difficulties", and these categories included one to four subcategories. CONCLUSION Managing subjective cognitive difficulties in vocational situations and everyday life was challenging in a digitalized working life for participants with neurological disorders. To provide equal access to preventive measures and rehabilitation and a sustainable working life, it is important to investigate the influence of subjective cognitive difficulties systematically on work, everyday life and management strategies in people with neurological disorders in digitalized work.
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Affiliation(s)
- Monika Lindberg
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Ranner
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Eva Månsson-Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
| | - Lars Jacobsson
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Larsson-Lund
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
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Karcz K, Trezzini B, Escorpizo R, Schwegler U, Finger M. Factors associated with sustaining work after an acquired brain injury: a scoping review. Disabil Rehabil 2021; 44:6510-6530. [PMID: 34590966 DOI: 10.1080/09638288.2021.1960439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Maintaining work in the long term represents a major challenge for people with acquired brain injury (ABI) as evidenced by a high rate of premature labour market dropouts. The present study aimed to compile factors associated with working in the long term after sustaining an ABI. MATERIALS AND METHODS We carried out a scoping review synthesizing quantitative and qualitative research conducted between 2000 and 2021. Databases searched comprised PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Ten quantitative and nine qualitative studies were included, all but one from high-resource countries. Quantitative research predominantly comprised longitudinal follow-ups on individuals' work status several years post ABI onset, showing an effect of injury-related and sociodemographic factors. Qualitative studies mostly dealt with work maintenance and revealed a key role of cognitive difficulties, psychological personal factors (e.g., adequate coping strategies) and environmental factors (e.g., flexible work schedules, supportive colleagues). CONCLUSIONS The factors identified in our review should receive particular attention in vocational integration and job retention programs to support work participation of people with ABI in the long term. There is a need for measures that regularly monitor and promote a good match between individuals and their work environment.Implications for RehabilitationPeople with acquired brain injury (ABI) often have long-lasting and invisible injury-related difficulties that hamper their labour market participation.Factors identified as positively associated with working in the long term, such as coping strategies and self-awareness, should be strengthened.Future interventions should educate affected persons, employers and health care professionals about long-lasting injury-related difficulties and promote a supportive work environment for people with ABI.Prolonged availability of vocational services could be beneficial for supporting work maintenance of people with ABI.
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Affiliation(s)
- Katarzyna Karcz
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Bruno Trezzini
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Reuben Escorpizo
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Rehabilitation and Movement Science, The University of Vermont, USA
| | - Urban Schwegler
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Monika Finger
- Work and Integration Group, Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Butt JH, Kragholm K, Kruuse C, Christensen H, Iversen HK, Johnsen SP, Rørth R, Vinding NE, Yafasova A, Christiansen CB, Gislason GH, Torp-Pedersen C, Køber L, Fosbøl EL. Workforce Attachment after Ischemic Stroke - The Importance of Time to Thrombolytic Therapy. J Stroke Cerebrovasc Dis 2021; 30:106031. [PMID: 34450481 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/23/2021] [Accepted: 08/01/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES The ability to remain in employment addresses an important consequence of stroke beyond the usual clinical parameters. However, data on the association between time to intravenous thrombolysis and workforce attachment in patients with acute ischemic stroke are sparse. MATERIALS AND METHODS In this nationwide cohort study, stroke patients of working age (18-60 years) treated with thrombolysis (2011-2016) who were part of the workforce prior to admission and alive at discharge were identified using the Danish Stroke Registry. The association between time to thrombolysis and workforce attachment one year later was examined with multivariable logistic regression. RESULTS The study population comprised 1,329 patients (median age 51 years [25th-75th percentile 45-56], 67.3% men). The median National Institutes of Health Stroke Scale score at presentation was 4 (25th-75th percentile 2-8), and the median time from symptom-onset to initiation of thrombolysis was 140min (25th-75th percentile 104-196min). The proportion of patients who were part of the workforce at one-year follow-up was 64.6%, 64.3%, 64.9%, and 60.0% in patients receiving thrombolysis within 90min, between 91-180min, between 181-270min, and after 270min, respectively. In adjusted analysis, time to thrombolysis between 91-180min, 181-270min, and >270min was not significantly associated with workforce attachment compared with thrombolysis received ≤90min of symptom-onset (ORs 0.89 [95%CI 0.60-1.31], 0.93 [0.66-1.31], and 0.80 [0.43-1.52], respectively). CONCLUSIONS In patients of working age admitted with stroke and treated with thrombolysis, two out of three were part of the workforce one year after discharge. There was no graded relationship between time to thrombolysis and the likelihood of workforce attachment.
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Affiliation(s)
- Jawad H Butt
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.
| | | | - Christina Kruuse
- Department of Neurology, Herlev-Gentofte University Hospital, Denmark
| | - Hanne Christensen
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Denmark
| | - Helle K Iversen
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Denmark
| | - Rasmus Rørth
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Naja Emborg Vinding
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Adelina Yafasova
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | | | - Gunnar H Gislason
- Department of Cardiology, Herlev-Gentofte University Hospital, Denmark
| | | | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Emil L Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
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Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year. Sci Rep 2020; 10:13251. [PMID: 32764611 PMCID: PMC7413535 DOI: 10.1038/s41598-020-70228-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/24/2020] [Indexed: 11/23/2022] Open
Abstract
Stroke is one of the most common diseases and has several potential consequences, such as psychological problems and pain. Return to work (RTW) after stroke in working-age individuals is incomplete. The present study aimed to investigate differences in self-perceived general health, pain, and depression between 1 and 5 years post-stroke related to RTW status. The study was nationwide, registry-based and the study population (n = 398) consisted of working-age people who had a stroke in 2011 and participated in 1-year and 5-year follow-up questionnaire surveys. Shift analyses with the Wilcoxon signed rank test and logistic regression were used. RTW within the first year post-stroke was associated with better self-perceived general health, less pain, and less depression both at 1 and 5 years post-stroke, compared with the no-RTW group. However, the RTW group had significant deterioration in general health and pain between 1 and 5 years, while the no-RTW group had no significant change. RTW was a significant predictor of lower odds of improvement in general health and pain between 1 and 5 years. This emphasizes the need for continued follow-up and support to ensure a balance between work and health for RTW individuals after stroke.
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15
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Rydén I, Carstam L, Gulati S, Smits A, Sunnerhagen KS, Hellström P, Henriksson R, Bartek J, Salvesen Ø, Jakola AS. Return to work following diagnosis of low-grade glioma: A nationwide matched cohort study. Neurology 2020; 95:e856-e866. [PMID: 32540938 PMCID: PMC7605502 DOI: 10.1212/wnl.0000000000009982] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/27/2020] [Indexed: 01/11/2023] Open
Abstract
Objective Return-to-work (RTW) following diagnosis of infiltrative low-grade gliomas is unknown. Methods Swedish patients with histopathologic verified WHO grade II diffuse glioma diagnosed between 2005 and 2015 were included. Data were acquired from several Swedish registries. A total of 381 patients aged 18–60 were eligible. A matched control population (n = 1,900) was acquired. Individual data on sick leave, compensations, comorbidity, and treatments assigned were assessed. Predictors were explored using multivariable logistic regression. Results One year before surgery/index date, 88% of cases were working, compared to 91% of controls. The proportion of controls working remained constant, while patients had a rapid increase in sick leave approximately 6 months prior to surgery. After 1 and 2 years, respectively, 52% and 63% of the patients were working. Predictors for no RTW after 1 year were previous sick leave (odds ratio [OR] 0.92, 95% confidence interval [CI] 0.88–0.96, p < 0.001), older age (OR 0.96, 95% CI 0.94–0.99, p = 0.005), and lower functional level (OR 0.64 95% CI, 0.45–0.91 p = 0.01). Patients receiving adjuvant treatment were less likely to RTW within the first year. At 2 years, biopsy (as opposed to resection), female sex, and comorbidity were also unfavorable, while age and adjuvant treatment were no longer significant. Conclusions Approximately half of patients RTW within the first year. Lower functional status, previous sick leave, older age, and adjuvant treatment were risk factors for no RTW at 1 year after surgery. Female sex, comorbidity, and biopsy only were also unfavorable for RTW at 2 years.
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Affiliation(s)
- Isabelle Rydén
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Louise Carstam
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Sasha Gulati
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Anja Smits
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Katharina S Sunnerhagen
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Per Hellström
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Roger Henriksson
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Jiri Bartek
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Øyvind Salvesen
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark
| | - Asgeir Store Jakola
- From the Section of Clinical Neuroscience, Institute of Neuroscience and Physiology (I.R., L.C., A.S., K.S.S., P.H., A.S.J.), University of Gothenburg, Sahlgrenska Academy; Departments of Neurology (I.R., A.S., P.H.) and Neurosurgery (L.C., A.S.J.), Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurosurgery (S.G., A.S.J.), St. Olavs University Hospital HF; Institute of Neuroscience (S.G.) and Department of Public Health and Nursing (Ø.S.), Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience (A.S.), Uppsala University; Department of Radiation Sciences & Oncology (R.H.), University of Umeå; Department of Neurosurgery (J.B.), Karolinska University Hospital; Departments of Neuroscience and Medicine (J.B.), Karolinska Institutet, Stockholm, Sweden; and Department of Neurosurgery (J.B.), Copenhagen University Hospital Rigshospitalet, Denmark.
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Westerlind E, Persson HC, Eriksson M, Norrving B, Sunnerhagen KS. Return to work after stroke: A Swedish nationwide registry-based study. Acta Neurol Scand 2020; 141:56-64. [PMID: 31659744 PMCID: PMC6916554 DOI: 10.1111/ane.13180] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A substantial proportion of individuals with stroke are of working age. After stroke, it is important to return to work (RTW), both for the individual's satisfaction with life and economically for society. The current comprehensive, long-term study aimed at investigating in what time period the RTW continues after stroke and what factors could predict RTW. MATERIALS AND METHODS All individuals registered in the registry Riksstroke with stroke in Sweden at ages 18-58 years during 2011 were eligible for participation. RTW was based on sickness absence data from the Social Insurance Agency covering 1 year prestroke to 5 years post-stroke. Time to RTW was analyzed with Kaplan-Meier curves. Potential predictors of RTW were analyzed with Cox regression and logistic regression. RESULTS For RTW analyses, 1695 participants were included. Almost 50% RTW within 3 months, 70% within 1 year, and 80% within 2 years post-stroke. However, the RTW continued for several years, with a total of 85% RTW. Predictors of favorable time to RTW were male sex, ischemic stroke, and long university education compared with primary school education. Predictors of unfavorable times to RTW were higher stroke severity, defined by the level of consciousness, and older ages. Participants with self-expectations of RTW 1 year post-stroke had higher odds of RTW within 5 years. CONCLUSIONS The RTW continues for a longer time after stroke than previously known. Both self-expectations and demographical, socioeconomic, stroke-related factors were important predictors of RTW. This knowledge could assist healthcare professionals to individualize the rehabilitation post-stroke.
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Affiliation(s)
- Emma Westerlind
- Department of Clinical NeuroscienceInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Hanna C. Persson
- Department of Clinical NeuroscienceInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | | | - Bo Norrving
- Department of Clinical SciencesSection of NeurologyLund UniversitySkåne University HospitalLundSweden
| | - Katharina S. Sunnerhagen
- Department of Clinical NeuroscienceInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Palstam A, Westerlind E, Persson HC, Sunnerhagen KS. Work-related predictors for return to work after stroke. Acta Neurol Scand 2019; 139:382-388. [PMID: 30657175 PMCID: PMC6617971 DOI: 10.1111/ane.13067] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/19/2018] [Accepted: 01/12/2019] [Indexed: 11/30/2022]
Abstract
Objectives Disability due to stroke imposes a large burden on individuals, and on society, in terms of impaired work ability and sick leave. The reported return to work (RTW) rate after stroke varies globally and is influenced by a range of different aspects. The aim of this study was to investigate the influence of work‐related factors on time to RTW after stroke, and possible differences between the sexes. Materials & Methods Data from 204 persons with first‐time stroke in the years 2009‐2010 in Gothenburg, Sweden, who were of working age and had worked prior to their stroke, were analysed. Disease‐related characteristics were retrieved from medical records, and work‐related‐ and socio‐economic data were collected up to 6 years post‐stroke from Statistics Sweden and the Swedish Social Insurance Agency. Cox regression was used to analyse predictors for time to RTW. Results We identified qualified occupation and large organizational size as work‐related predictors for shorter time to RTW after stroke. Being male predicted a faster and higher frequency of RTW. Qualified occupation predicted shorter time to RTW in men but not in women. For women, the only predictor for RTW was physical dependency at discharge. Conclusion Type of work and organizational size are work‐related factors of importance for RTW after stroke. Work‐related factors were important for RTW in men, but not in women. Reasons for differences between men and women in work‐related factors that influence RTW need to be further investigated to better understand how to support women in the RTW process.
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Affiliation(s)
- Annie Palstam
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Emma Westerlind
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Hanna C. Persson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Katharina S. Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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