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Bright L, Wei TZ, Lau SCL, Baum CM. An Exploratory Study of Young Stroke Survivors' Lived Experiences: A Multi-Methods Study Using Developmental Theory. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:405-413. [PMID: 37649450 DOI: 10.1177/15394492231196783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Young adults make up 10% of strokes that occur in the United States each year. Little research has shown the developmental and occupational disruption as a result of stroke for this population. The objective of this study was to describe young stroke survivors' perceived disruptions using developmental theory. A multiple methods study was conducted with community-dwelling stroke survivors between the ages of 18 and 40 using Patient-Reported Outcomes Measurement Information System (PROMIS) measures and qualitative interviews. Five themes were reported from the qualitative data: stroke and health, work and school, romantic relationships, parenting, and other social relationships. PROMIS measure results were not significantly different from the normed population despite challenges revealed during qualitative interviews. Qualitative data showed variations in post-stroke deficits and occupational performance that could not be meaningfully captured by the PROMIS measures alone. Occupational therapy practitioners should use developmental theory to guide their understanding of occupational disruptions in young stroke survivors.
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Affiliation(s)
- Lindsay Bright
- Washington University School of Medicine, St. Louis, MO, USA
| | | | - Stephen C L Lau
- Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Washington University School of Medicine, St. Louis, MO, USA
- Washington University in St. Louis, MO, USA
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2
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Starik T, Huber M, Zeilig G, Wolff J, Ratzon NZ. Employment barriers questionnaire: Development and determination of its reliability and validity. Work 2024:WOR230736. [PMID: 38820058 DOI: 10.3233/wor-230736] [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: 06/02/2024] Open
Abstract
BACKGROUND The high unemployment rate among people with disabilities (PWDs) can be attributed to barriers found in the work environment and demands of the job itself. Given the lack of comprehensive tools to identify these barriers, we developed the Employment Barriers Questionnaire (EBQ). OBJECTIVE The objective of this study was to develop and examine the EBQ's reliability and validity for detecting employment barriers and possible modifications to overcome them. METHODS Two stages were conducted: stage I was a cross-sectional design. Stage II included a cross-sectional and prospective design. Thirty-nine people with physical disabilities (mean age 47.21±10.78 years) were recruited, 51% of which were employed during data collection. During stage I, we developed a first version of the EBQ (EBQ.I) and evaluated its internal reliability. The EBQ.I was filled twice, one week apart to assess test-re-test reliability. Predictive validity was tested using a regression model to predict the employment status of stage II based on EBQ.I's results from stage I. In stage II, we generated a second version (EBQ.II) and tested its internal-reliability and known-groups validity, by comparing the EBQ.II's results between employed and unemployed subjects. RESULTS The results showed that the EBQ.II has a high internal-reliability (α= 0.79-0.97) and a medium-large known-groups validity (-3.95≤Z≤-2.26, p < 0.05). Additionally, the EBQ.I has a high test re-test reliability (ICC = 0.85-0.94, p < 0.001) and predictive validity (β= 0.861, p = 0.033). CONCLUSION This study has illustrated that the EBQ.II is a unique, reliable and valid tool for identifying employment barriers and modifications to address them, expected to improve vocational rehabilitation efforts.
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Affiliation(s)
- Tal Starik
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Occupational Therapy, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Maya Huber
- Department of Occupational Therapy, Stanley Steyer, School of Health Professions, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Zeilig
- Division of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Julie Wolff
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Navah Z Ratzon
- Department of Occupational Therapy, Stanley Steyer, School of Health Professions, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hagendijk ME, Zipfel N, Melles M, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Hoving JL, van der Burg-Vermeulen SJ. Towards person-centred work-focused healthcare for people with cardiovascular disease: a qualitative exploration of patients' experiences and needs. Disabil Rehabil 2024:1-13. [PMID: 38676465 DOI: 10.1080/09638288.2024.2344653] [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: 07/29/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. METHODS Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. RESULTS 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. CONCLUSIONS The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marijke Melles
- Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Liu Z, Li J, Liu F, Guan N, Li Y, Zhang Y, Hou L, Jiang Q. Exploring the status and associated factors of the readiness for return-to-work in young and middle-aged stroke patients. Sci Rep 2024; 14:2841. [PMID: 38310121 PMCID: PMC10838315 DOI: 10.1038/s41598-024-53262-2] [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: 11/25/2022] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
Stroke increasingly affects individuals of working age. An accurate assessment of Readiness for Return-to-Work (RRTW) can help determine the optimal timing for RRTW and facilitate an early reintegration into society. This study investigates the current state of RRTW and the influencing factors among young and middle-aged stroke patients in China. A sample of young and middle-aged stroke patients hospitalized in a tertiary hospital in Henan Province between December 2021 and May 2022 were included in this study. A general information questionnaire and the Readiness for RRTW scale, the Social Support Rate Scale, the Stroke Self-Efficacy Scale, and the Fatigue Severity Scale were administered to the patients. Of the 203 patients successfully surveyed, 60 (29.6%) were in the pre-contemplation stage, 35 (17.2%) in the contemplation stage, 81 (39.9%) in the prepared for action-self-evaluative stage, and 27 (13.3%) in the prepared for action- behavior stage. Logistic regression analysis identified education level, monthly income, time to start rehabilitation therapy, social support, stroke self-efficacy, and fatigue severity as key factors affecting RRTW scale readiness in young and middle-aged stroke patients. The readiness of young and middle-aged stroke patients to Return-to-Work needs to be increased further. Healthcare professionals should consider the influencing factors of RRTW and design targeted intervention programs to facilitate a successful Return-to-Work and normal life.
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Affiliation(s)
- Ziwei Liu
- Nursing Department, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou, 450099, He Nan, China
| | - Jiaxin Li
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Fangli Liu
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Ningxiao Guan
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Ye Li
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Yu Zhang
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Linlin Hou
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Qiuhuan Jiang
- Nursing Department, Henan Provincial People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 45003, He Nan, China.
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O'Loghlen J, Geraghty T, Kendall M, Nielsen M, Jones R, McLennan V, Watter K, Ownsworth T. Perceived vocational support needs and return-to-work outcomes in the first 12-months post-discharge in individuals with acquired brain injury and spinal cord injury: A retrospective cohort study. Work 2024; 77:275-293. [PMID: 37638466 DOI: 10.3233/wor-230090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Return-to-work (RTW) is often viewed as an important outcome following acquired brain injury (ABI) and spinal cord injury (SCI), although not all individuals have vocational goals and many experience barriers to RTW. OBJECTIVE This study investigated the relationship between RTW and psychosocial functioning at 12-months post-discharge after ABI and SCI and examined patterns of RTW according to perceived need for and receipt of vocational support. METHODS A file audit was conducted for 69 participants with ABI (n = 44) and SCI (n = 25). Data on employment status and perceived vocational support at 3- and 12-months post-discharge, home and community participation, psychological distress, and health-related quality of life were extracted. RESULTS Individuals in paid employment at 12-months post-discharge (22%, n = 15) reported significantly better psychosocial functioning at this timepoint compared to those not employed (78%; n = 54). For those not employed, three subgroups were identified: 1) Did not perceive the need for or receive vocational support (50%; n = 27); 2) Perceived vocational support needs were unmet (19%; n = 10); and 3) Perceived and received vocational support (31%; n = 17). Psychological distress was highest for those who perceived and received vocational support but were not employed. CONCLUSION RTW was associated with better psychosocial functioning after acquired neurological injury. The findings highlight the need for clinicians to explore and revisit individuals' perceived need for and preferences for vocational support and monitor the psychological well-being of those with RTW goals that are not yet successful.
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Affiliation(s)
- Jessica O'Loghlen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Timothy Geraghty
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Mandy Nielsen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Rachel Jones
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Vanette McLennan
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kerrin Watter
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Tamara Ownsworth
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Gragnano A, Corbière M, Picco E, Negrini A, Savioli G, Conti M, Corsiglia L, Miglioretti M. Adaptation and validation of the cardiovascular version of the Return-to-Work Obstacles and Self-Efficacy Scale (ROSES-CVD) to the Italian context. Disabil Rehabil 2023; 45:3573-3581. [PMID: 36124555 DOI: 10.1080/09638288.2022.2123962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Effective cardiac rehabilitation interventions must provide adequate support to overcome psychosocial return-to-work (RTW) barriers. No validated instrument is available for this aim for cardiovascular patients. The Return-to-work Obstacles and Self-Efficacy Scale (ROSES) measures RTW obstacles workers perceive and the self-efficacy for overcoming them through 46 items and ten dimensions. This study aimed to adapt and validate ROSES for cardiovascular disease (CVD) in the Italian context. METHODS This prospective study involved 183 CVD working patients at baseline and 121 six months later. ROSES-CVD internal consistency, construct, and predictive validity was evaluated with Cronbach's α, Confirmatory factor analyses (CFA), and ANCOVAs. RESULTS CFAs adequately replicated the original ROSES model (CFI = .92-.96; TLI = .91-.94; RMSEA = .042-.057; SRMR = .046-.071) with α close or higher than .70 for all dimensions. Four ROSES-CVD dimensions significantly predicted the number of days to RTW controlling for age, gender, educational level, and surgery type. Workers who perceived salient RTW obstacles and low self-efficacy in any of these dimensions in mean returned to work from 38 to 53 days later. CONCLUSIONS The study supported the validity and reliability of ROSES-CVD. This tool can be used in rehabilitation to detect CVD patients at risk of a longer RTW process and define appropriate cardiac rehabilitation intervention.IMPLICATIONS FOR REHABILITATIONVocational rehabilitation interventions should provide tailor-made support to overcome RTW barriers based on individual risk assessmentThe Italian translation of ROSES-CVD is a valid and reliable tool to measure psychosocial barriers to RTW among CVD working patientsThe use of ROSES-CVD would allow detection of CVD patients at risk of longer RTW processAdministering ROSES-CVD can help focus traditional vocational intervention on individually relevant obstacles to RTW.
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Affiliation(s)
- Andrea Gragnano
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marc Corbière
- Department of Education, Career counselling, Université du Québec à Montréal, Montreal, Canada
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, Canada
| | - Eleonora Picco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Alessia Negrini
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), Montreal, Canada
| | - Gaia Savioli
- Cardiovascular Institute of Camogli (ISCC), Camogli, Italy
| | - Massimo Conti
- Cardiovascular Institute of Camogli (ISCC), Camogli, Italy
| | - Luca Corsiglia
- Cardiovascular Institute of Camogli (ISCC), Camogli, Italy
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Hagendijk ME, Zipfel N, Oomen FJ, Hoving JL, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Melles M, van der Burg-Vermeulen SJ. Work-focused healthcare from the perspective of employees living with cardiovascular disease: a patient experience journey mapping study. BMC Public Health 2023; 23:1765. [PMID: 37697261 PMCID: PMC10494386 DOI: 10.1186/s12889-023-16486-x] [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: 11/14/2022] [Accepted: 08/09/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND People living with cardiovascular diseases (CVD) often experience work participation problems. Good work-focused healthcare, defined as the received advice, treatment, and guidance focusing on work participation, can support the patient and work place. However, experiences with work-focused healthcare are generally not always positive which is a barrier for work participation. Therefore, the objective of this study is to gain insight into the work-focused healthcare journey from the perspective of patients with work participation problems due to CVD, to understand their experiences and needs, and to derive opportunities for improving work-focused healthcare service at a system level. METHODS Semi-structured interviews, preceded by preparatory assignments, were conducted with 17 patients who experience(d) work participation problems due to CVD. The patient experience journey map (PEJM) approach was used to visualize the patients' work-focused healthcare journey, including experiences and needs over time and place, from which opportunities to improve work-focused healthcare from the patient's perspective were derived. RESULTS An aggregated PEJM consisting of six phases was composed and graphically mapped. The first phase, working, represents a period in which CVD health problems and subsequent functional limitations occur. The next two phases, short- and long-term sick leave, represent a period of full sick leave. The last three phases, start-, partial-, and full vocational reintegration, focus on the process of return to work that takes place ranging from a few months up to several years after sick-listing. For each phase the touchpoints, timespan, stakeholders, activities, experiences and needs from the perspective of the patients were identified. Finally, for better work-focused healthcare nine opportunities for improvement were derived from the PEJM, e.g. emphasize the need for work adjustment prior to the medical intervention, provide more personalized advice on handling work limitations, and putting more compelling pressure on the employer to create suitable work positions for their employees. DISCUSSION/CONCLUSION This paper contributes insights to provide a more patient-centered work-focused healthcare trajectory for patients employed in paid jobs when living with CVD. The PEJM provides an understanding of the patients' perspectives throughout their work-focused healthcare journey and highlights opportunities for improvement towards a better suited and seamless patient journey, Although this research was conducted within the Dutch healthcare system, it can be assumed that the findings on integrated work-focused healthcare are largly transferable to other healthcare systems.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Floor J Oomen
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Marijke Melles
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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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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Matérne M, Simpson G, Jarl G, Appelros P, Arvidsson-Lindvall M. Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2119676. [PMID: 36062839 PMCID: PMC9467624 DOI: 10.1080/17482631.2022.2119676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. MATERIAL AND METHOD Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. RESULTS The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. CONCLUSION Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Grahame Simpson
- John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Munsell EGS, Kudla A, Su H, Wong J, Crown D, Capraro P, Trierweiler R, Park M, Heinemann AW. Employers’ Perceptions of Challenges and Strategies in Hiring, Retaining, and Promoting Employees With Physical Disabilities. REHABILITATION COUNSELING BULLETIN 2022. [DOI: 10.1177/00343552221130304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Disability is a common component of human diversity, yet people with disabilities (PWD) are underrepresented in the workplace despite known benefits to PWD and companies alike. There is an urgent need to promote inclusion of PWD in the workplace. The purpose of this study was to explore employer-perceived challenges and strategies for employing, retaining, and promoting people with physical disabilities (PWPD) and to describe the policies, supports, and job accommodations they provide to PWPD. We administered a cross-sectional, online survey to employers in the Midwestern United States ( n = 53). Employers had an average of 8.5 years of experience in their job roles and represented diverse industries and company sizes. Employers provide a range of job accommodations; however, many reported lacking comprehensive disability policies such as training managers on how to support PWPD, providing employee resource groups for PWPD, and having a specific job accommodation fund. Major challenges reported by employers were related to lacking competencies in supporting employees with physical disabilities. However, employers endorsed the utility of strategies to address these challenges, including providing education and training and increasing buy-in from leadership. Study findings inform employers on ways to best support PWPD and improve diversity, equity, and inclusion in the workplace.
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Affiliation(s)
| | | | - Han Su
- Northwestern University, Chicago, IL, USA
| | - Jasin Wong
- National Tsing Hua University, Hsinchu City
| | | | | | | | | | - Allen W. Heinemann
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
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Teo SH, Fong KN, Chen Z, Chung RC. Predictors of long-term return-to-work at five-year follow-up for mild-to-moderate subacute stroke patients enrolled in an early supported discharge program. Work 2022; 73:1001-1010. [DOI: 10.3233/wor-210914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Facilitating return-to-work (RTW) for working-age stroke survivors is a key component of stroke rehabilitation, however, research investigating the long-term outcomes of working-age stroke survivors is lacking. OBJECTIVE: To investigate the factors that influence long-term RTW for patients enrolled on a community-based early supported discharge (ESD) rehabilitation program in Singapore about five years post stroke. METHODS: Sixty-nine patients, aged between 18 and 60 years and were employed at the time of their hospitalization, were enrolled into the ESD program between 2012 and 2014. A prospective cohort design was adopted to examine the relationships between the factors— demographic, functional, personal, psychosocial factors and work related— and RTW at five-year follow-up. Details of RTW were collected through questionnaires via telephone follow-up. RESULTS: Sixty percent of the participants (n = 49) were selected for Cox and logistic regression analyses of RTW at five-year follow-up. The results indicated that having social problems is a negative predictor of RTW (OR 0.02; 95% CI 0.00–0.22) while being the breadwinner is a positive predictor of RTW (OR 13.79; 95% CI 2.46–77.52). The same factors were also significant in the time to RTW event at five-year follow-up, with a hazard ratio of 0.09 and 4.07, respectively. CONCLUSIONS: Early identification of the characteristics of stroke patients enrolled into an ESD program who have the potential to RTW would make interventions more targeted, increasing the likelihood of RTW.
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Affiliation(s)
- Sock Hong Teo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
- National University Hospital, Singapore, Singapore
| | - Kenneth N.K. Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | | | - Raymond C.K. Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
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Zhang Y, Mou Y, Zhang Y, Wang J, Kong F. Psychological experience and social reintegration needs of young stroke patients: a systematic review and meta-aggregation of qualitative studies. J Community Health Nurs 2022; 39:150-169. [PMID: 35653793 DOI: 10.1080/07370016.2022.2077074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The visible physical dysfunction and invisible psychological effects after stroke prevent young patients from returning to their pre-stroke roles and social activities. PURPOSE/AIM To comprehensively analyze the psychological experience and social reintegration needs of young stroke patients, which may be beneficial for improving quality of life and social reintegration after stroke. METHODS We conducted a comprehensive literature search of 10 databases. The screening and quality assessment of the included articles were performed by the Qualitative Assessment and Review Instrument (QARI). Meta-aggregation was conducted to synthesize the findings of the included studies. We summarized the certainty of confidence using the Confidence in Evidence from Reviews of Qualitative Research (CERQual) approach. RESULTS A total of 5506 studies were screened, of which 12 were included. Data synthesis suggested two new themes: (a) the self-growth process from denial of stroke to accepting stroke (high CERQual confidence), and (b) desire to regain pre-stroke normality, but having difficulty in the social reintegration process (high CERQual confidence). CONCLUSION Stroke, as a traumatic event, disrupts the life structure of young patients, and their needs of reintegration are not adequately considered. Interventions based on the principle of individuation should focus on this issue to restore continuity in life after stroke.
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Affiliation(s)
- Yongli Zhang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China.,College of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yating Mou
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China.,College of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yunqian Zhang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
| | - Jingmei Wang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
| | - Fanyi Kong
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
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13
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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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Small SP, de Boer C, Swab M. Barriers to and facilitators of labor market engagement for individuals with chronic physical illnesses in their experiences with work disability policy: a qualitative systematic review. JBI Evid Synth 2021; 20:348-536. [PMID: 34669686 DOI: 10.11124/jbies-20-00482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review was to identify and synthesize the best available evidence to address two questions. From the perspectives of individuals with chronic physical illnesses: i) what are barriers in work disability policies with respect to labor market engagement? and ii) what are facilitators in work disability policies with respect to labor market engagement? INTRODUCTION Chronic physical illnesses have a high and increasing prevalence worldwide and are associated with significant disability in the working-age population. Individuals with chronic illnesses and disability have low employment and high unemployment rates, and low wages. Work disability policies have important role in reducing negative labor market impacts, but inadequate policies may also pose barriers to work engagement. INCLUSION CRITERIA This review included studies of individuals who were of working age, had one or more chronic physical illness, and had experience relevant to disability policy and work engagement. The phenomena of interest were perceived barriers and perceived facilitators in work disability policies with respect to labor market engagement. The context was any study setting globally. Studies considered for this review had qualitative data from a variety of methodologies. METHODS This review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. A literature search involved academic databases (ie, CINAHL Plus, MEDLINE, PsycINFO, AgeLine, SocINDEX, Social Work Abstracts, Sociological Abstracts, Social Services Abstracts) for published studies; gray literature sources (ie, ProQuest Dissertations and Theses, MedNar, Google Scholar, OpenGrey, OAIster, Google, and relevant websites) for unpublished studies; and reference lists of retrieved records. No language, date, or country limiters were applied to the searches. Retrieved records from the database and gray literature searches were screened, with potentially relevant records then examined in full against the inclusion criteria. Eligible studies were critically appraised for methodological quality and those included in this review were subjected to data extraction of descriptive details and the study findings that were relevant to the review questions. Study findings were synthesized and were assigned confidence scores. RESULTS Forty-four studies of various qualitative designs and varied methodological quality (from low to high) were included in this review. The study samples represented a number of different chronic physical illnesses. There were 301 credible and unequivocal study findings, which were aggregated into 20 categories and 5 synthesized findings. Persons with chronic physical illnesses perceived barriers and facilitators relevant to the adequacy of disability policies in meeting their needs for returning to work after leave due to illness and for sustaining ongoing work engagement. They also perceived barriers and facilitators relevant to stakeholders' communication, help, and support respecting workers' efforts toward work engagement. CONCLUSION Although confidence in the synthesized findings is low due to limitations in the methods and research findings across primary studies, the evidence suggests that both the adequacy and implementation of work disability policies need to be improved to meet the needs of workers with chronic physical illnesses, for their labor market engagement. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42016033476.
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Affiliation(s)
- Sandra P Small
- Faculty of Nursing, Memorial University, St. John's, NL, Canada Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada School of Social Work, Memorial University, St. John's, NL, Canada Health Sciences Library, Memorial University, St. John's, NL, Canada
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15
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Green TL, McGovern H, Hinkle JL. Understanding Return to Work After Stroke Internationally: A Scoping Review. J Neurosci Nurs 2021; 53:194-200. [PMID: 34270512 DOI: 10.1097/jnn.0000000000000603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT BACKGROUND: Internationally, the changing landscape of diagnosis, treatment, and follow-up post stroke is resulting in a concomitant rise in the number of survivors still in the workforce. Return to work (RTW) is a common goal for adults after stroke; however, poststroke disabilities may limit occupational opportunities. This scoping review was undertaken to gain an understanding of the concept of RTW, how it is defined in the literature, types of research conducted on RTW after stroke, and characteristics of patients who do and do not RTW. We also wanted to gain an understanding of the interventions that were successful for RTW, their efficacy, and which healthcare professionals conducted such interventions. METHODS: Two authors reviewed articles using a customized data extraction tool. Adhering to current scoping review guidelines, data were collated and described using narrative and tables. RESULTS: A total of 48 studies were included in this scoping review: 34 quantitative, 11 qualitative, and 3 mixed method studies. The studies were conducted between the years 1998 and 2018, with more than half undertaken within the past decade and primarily in economically developed countries. DISCUSSION: Few interventions specifically targeted RTW as a primary outcome; most interventions were conducted by rehabilitation professionals with RTW measured by self-report. The nursing contribution was noticeably absent in the literature. CONCLUSIONS: Return to work has not been consistently operationalized in the literature. Although nurses are in a unique position to assist stroke survivors in their goal of RTW, how to do so remains elusive.
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Elderly Patients after Stroke Increase Skeletal Muscle Mass by Exercise Therapy in Rehabilitation Wards. J Stroke Cerebrovasc Dis 2021; 30:105958. [PMID: 34303088 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Loss of skeletal muscle is a critical health issue that frequently occurs due to aging and various pathologies. No studies have reported increases in appendicular skeletal muscle mass among elderly patients after stroke. Our hypothesis was that even older individuals after stroke could increase skeletal muscle mass by rehabilitation. OBJECTIVES This study aimed to evaluate changes to skeletal muscle mass in elderly patients after stroke rehabilitation and to assess factors associated with skeletal muscle mass increases. MATERIALS AND METHODS Participants in this case-control study were 159 patients ≥ 80 years old in rehabilitation wards after stroke. Body mass index (BMI), appendicular skeletal muscle index (SMI), Functional Independence Measure (FIM), interval from onset to transfer, presence of hemiplegia, National Institutes of Health Stroke Scale (NIHSS), length of hospital stay for rehabilitation, period of exercise therapy per day, and protein intake were examined. Multivariate logistic regression analysis was performed to identify association between these values and SMI increases. RESULTS SMI at discharge was significantly increased (5.30 kg/m2) compared to baseline (5.20kg/m2; p = 0.002). Multiple logistic regression analysis showed that length of hospital stay and protein intake were significantly associated with SMI increases, with odds ratios of 1.013 (95% confidence interval, 1.005-1.022) and 3.746 (95% confidence interval, 1.077-13.028), respectively. CONCLUSIONS The SMI of patients ≥ 80 years old increased significantly with rehabilitation after stroke. In addition, length of hospital stay and protein intake were independently associated with increases in SMI.
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Yousef HA, Khalil HW, Nazzal MS, El-Salem KI, Hawamdeh ZM, Almeida P. Prevalence and predictors of return to work among stroke survivors in Jordan. Work 2021; 67:817-827. [PMID: 33337400 DOI: 10.3233/wor-203334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Returning to work (RTW) is an essential goal for many stroke survivors. Currently, the prevalence of RTW post stroke in developing countries such as Jordan is unknown. Additionally, more research is required to identify factors that contribute to RTW post stroke. OBJECTIVES This study aims to (1) determine the prevalence of RTW among stroke survivors in Jordan, and (2) determine the predictors of RTW from a holistic perspective using the Occupational Therapy Practice Framework (OTPF) 3rd edition. METHODS Recruitment was carried out from different Jordanian hospitals and rehabilitation centers. A complete battery of outcome measures was used to reflect OTPF domains. These included outcome measures of occupations, client factors, performance skills, and context and environment. Logistic regression was used to determine factors that predicted RTW. RESULTS 69 participants were enrolled; 45 Males, 24 females; mean age±SD, 52.2±11.07 years. Only 29% succeeded in RTW during the first year after stroke onset. The highest percentage of RTW was among craft workers (40% ), and those who were self-employed (60% ). Of those who resumed work, 35% returned to their previous work, while 65% needed to make work modifications, or change positions or jobs. Factors that predicted higher rates of RTW were walking speed (Odds ratio (OR)=0.004, 95% confidence interval (CI)=0.00-0.55, P < 0.02), as well as absence of environmental restrictions (OR = 21.16, 95% CI = 1.91-233.5, P < 0.013). CONCLUSIONS The alarming low prevalence of RTW among stroke survivors in Jordan emphasizes the essential need to develop vocational rehabilitation programs. Clinicians should pay attention to enhancing walking abilities and reducing environmental restrictions post stroke, in order to improve the occurrence of RTW.
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Affiliation(s)
- Huda A Yousef
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan W Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad S Nazzal
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid I El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad M Hawamdeh
- Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Patrícia Almeida
- Department of Physiotherapy, Alcoitao School of Health Sciences, Alcoitao, Portugal
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18
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Olaoye OA, Soeker SM, Anthea R. Predictors of return to work among stroke survivors in south-west Nigeria. Hong Kong J Occup Ther 2021; 34:13-22. [PMID: 34408555 PMCID: PMC8366211 DOI: 10.1177/1569186120926614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/20/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Stroke is acknowledged globally and among Nigerian rehabilitation researchers as a public health problem that leaves half of its survivors with significant neurological deficits and inability to re-establish pre-existing roles. Consequent to the dearth of country specific data on return to work and its determinants for stroke survivors in Nigeria, this study investigated the predictors of return to work among stroke survivors in south-west Nigeria. METHOD Two hundred and ten stroke survivors from five tertiary health facilities in Osun state, Nigeria responded to a validated three-section questionnaire assessing return to work rates and its determinants after stroke in this study. Collected data were analysed using descriptive statistics and inferential statistic of chi-square, t-test and multiple logistic regression. RESULT The mean age of the respondents was 52.90 ± 7.92 years. Over 60% of the respondents returned to work with about half of them in full time employment (32.9%). Majority of the respondents noted that travel to and from work (43.8%) and access at work (43.3%) had an impact on their ability to work. The symptoms of stroke (odds ratio (OR) = 0.87), the environment (OR = 0.83), body function impairments (OR = 0.86) as well as activity and participation problems (OR = 0.80) were the significant predictors of return to work. Hemiplegia or paresis of the non-dominant side of the body was associated with a higher chance of return to work (OR = 7.64). CONCLUSION Body function impairments, activity and participation problems were independent predictors of return to work after stroke. Similarly, side of hemiplegia plays a prominent role in resumption of the worker role of stroke survivors in south-west Nigeria.
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Affiliation(s)
- Olumide Ayoola Olaoye
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
- Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ife, Nigeria
| | - Shaheed Moghammad Soeker
- Department of Occupational Therapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Rhoda Anthea
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Brakenridge CL, Leow CKL, Kendall M, Turner B, Valiant D, Quinn R, Johnston V. Exploring the lived return-to-work experience of individuals with acquired brain injury: use of vocational services and environmental, personal and injury-related influences. Disabil Rehabil 2021; 44:4332-4342. [PMID: 33794118 DOI: 10.1080/09638288.2021.1903101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore work outcomes, vocational services, barriers and facilitators for returning to work in individuals with acquired brain injury (ABI) in Queensland, Australia and to identify areas for improvement. DESIGN AND METHODS Ten semi-structured interviews were conducted with individuals with ABI (stroke, traumatic brain injury, tumour). Interviews were analysed using a realist thematic analysis approach. RESULTS Participants either returned to the same work, different work, did not maintain work or did not have any work since their injury. Use of vocational services depended on participants' needs and insurance. Facilitators for return to work (RTW) were a supportive workplace and family, vocational rehabilitation that met the individual's needs, insurance coverage and self-motivation. Workplaces that were not understanding of brain injury, employment service providers who were unable to find work for participants, and physical and cognitive deficits were barriers to RTW. Workplaces, employment service providers and individuals require more information about the deficits associated with brain injury. CONCLUSIONS The use and effectiveness of vocational services were variable across participants and depended on insurance coverage and needs. Barriers and facilitators for RTW were affected by both the environment and the individual. Implications for vocational rehabilitation were identified.Implications for RehabilitationA supportive workplace and family, and access to appropriate vocational rehabilitation are important environmental facilitators for RTW in individuals with ABI.Workplaces with a poor understanding of ABI and employment service providers unable to find work for individuals with ABI are environmental barriers to RTW.Workplaces, employment service providers and individuals with ABI require more information about the physical and cognitive deficits associated with ABI.Employment service providers need more training to develop comprehensive strategies to help individuals with ABI find new employment.
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Affiliation(s)
| | - Charmaine Kai Ling Leow
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Melissa Kendall
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Ben Turner
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Donna Valiant
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Ray Quinn
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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Physicians' Perspectives on Person-Related Factors Associated With Work Participation and Methods Used to Obtain Information About These Factors. J Occup Environ Med 2020; 61:499-504. [PMID: 31167222 DOI: 10.1097/jom.0000000000001596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Person-related factors influencing work participation of employees with health problems are important. However, the best method to obtain information about them, according to occupational physicians (OPs) and insurance physicians (IPs), is unknown. METHODS Questionnaires in which OPs and IPs rated the importance of and described methods to obtain information about 10 person-related factors: expectations regarding recovery or return to work, optimism/pessimism, self-efficacy, motivation, feelings of control, perceived health, coping strategies, fear-avoidance beliefs, perceived work-relatedness, and catastrophizing. RESULTS OPs and IPs perceived all person-related factors, except for optimism/pessimism and perceived health as important for work participation. Information about the factors could best be obtained with use of a topic list during consultations. CONCLUSIONS OPs and IPs should take person-related factors into account during consultations and it is best to use a topic list when discussing them.
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Radford KA, Craven K, McLellan V, Sach TH, Brindle R, Holloway I, Hartley S, Bowen A, O'Connor R, Stevens J, Philips J, Walker M, Holmes J, McKevitt C, Murray J, Watkins C, Powers K, Shone A, Farrin A. An individually randomised controlled multi-centre pragmatic trial with embedded economic and process evaluations of early vocational rehabilitation compared with usual care for stroke survivors: study protocol for the RETurn to work After stroKE (RETAKE) trial. Trials 2020; 21:1010. [PMID: 33298162 PMCID: PMC7724443 DOI: 10.1186/s13063-020-04883-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Return to work (RTW) is achieved by less than 50% of stroke survivors. The rising incidence of stroke among younger people, the UK economic forecast, and clinical drivers highlight the need for stroke survivors to receive support with RTW. However, evidence for this type of support is lacking. This randomised controlled trial (RCT) will investigate whether Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care (UC) (i.e. usual NHS rehabilitation) is more clinically and cost-effective for supporting post-stroke RTW, than UC alone. METHODS Seven hundred sixty stroke survivors and their carers will be recruited from approximately 20 NHS stroke services. A 5:4 allocation ratio will be employed to randomise participants to receive ESSVR plus UC, or UC alone. The individually tailored ESSVR intervention will commence within 12 weeks of stroke onset and be delivered for up to 12 months as necessary by trained RETAKE occupational therapists in the community, participants' homes or workplaces, and outpatient/inpatient therapy settings, via telephone, email, or SMS text message. Outcome data will be collected via self-report questionnaires administered by post or online at 3, 6, and 12 months follow-up. The primary outcome will be self-reported RTW and job retention at 12 months (minimum 2 h/week). Secondary outcomes will include mood, function, participation, health-related quality of life, confidence, intervention compliance, health and social care resource use, and mortality. An embedded economic evaluation will estimate cost-effectiveness and cost-utility analyses from National Health Service (NHS) and Personal Social Services (PSS) perspectives. An embedded process evaluation will employ a mixed methods approach to explore ESSVR implementation, contextual factors linked to outcome variation, and factors affecting NHS roll-out. DISCUSSION This article describes the protocol for a multi-centre RCT evaluating the clinical- and cost-effectiveness of an early vocational rehabilitation intervention aimed at supporting adults to return to work following a stroke. Evidence favouring the ESSVR intervention would support its roll-out in NHS settings. TRIAL REGISTRATION ISRCTN, ISRCTN12464275 . Registered on 26 February 2018.
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Affiliation(s)
- Kathryn A Radford
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK.
| | - Kristelle Craven
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Vicki McLellan
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Room 2.37, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Richard Brindle
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Ivana Holloway
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Suzanne Hartley
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
| | - Audrey Bowen
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester MAHSC, Manchester, M13 9PL, UK
| | - Rory O'Connor
- Academic Department of Rehabilitation Medicine, Leeds Institute of Molecular Medicine, University of Leeds, Level D, Martin Wing, Leeds General Infirmary, Leeds, LS1 3EX, UK
| | - Judith Stevens
- Patient and Public Involvement Collaborator, Hampshire, UK
| | - Julie Philips
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Marion Walker
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Jain Holmes
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Christopher McKevitt
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, 5th Floor Addison House, Guy's Campus, London, SE1 1UL, UK
| | - John Murray
- Different Strokes, Raphael House, Ilford, London, IG1 1YT, UK
| | - Caroline Watkins
- Lancashire Clinical Trials Unit, School of Health, University of Central Lancashire, Brook Building, Room 217, Preston, PR1 2HE, UK
| | - Katie Powers
- Division of Rehabilitation and Ageing, School of Medicine, Medical School Queen's Medical Centre, B-Floor, Nottingham, NG7 2UH, UK
| | - Angela Shone
- Research and Innovation, Jubilee Conference Centre, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK
| | - Amanda Farrin
- Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Level 11 Worsley Building, Leeds, LS2 9JT, UK
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Figueredo JM, García-Ael C, Gragnano A, Topa G. Well-Being at Work after Return to Work (RTW): A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207490. [PMID: 33076302 PMCID: PMC7602369 DOI: 10.3390/ijerph17207490] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022]
Abstract
Background: Employees’ well-being at work after the return to work (RTW) is considered a key aspect of rehabilitation and maintenance of workability. This systematic review aimed at identifying the common psychosocial factors that predict the subjective and psychological well-being in RTW processes after having a long-standing health problem or disability. Objective: To evaluate the subjective and psychological well-being at work of employees with chronic or long-standing health problems or those returning to work after any cause of disability. Data source: Systematic review of articles published in English or Spanish using PsycINFO, PsycARTICLES, MEDLINE, Psychology, and Behavioral Sciences Collection, and Pubpsych. An additional study was identified by contacting expert academics in the field. The search equations used included terms such as Return to Work, Long-Standing Health Problems or Disability, Work Health Balance, and job satisfaction or subjective well-being. Eligibility criteria for the studies: Studies that included a measure of employees’ well-being at work following return to work were selected for the review. Evaluation of the studies and synthesis methods: The studies were selected using predefined fields which included quality criteria. Results: Of the 264 articles returned by the initial search, a total of 20 were finally selected. Results were organized around the three different theoretical approaches for understanding RTW and its antecedents and consequences: (a) RTW and autonomy at work have a positive effect on psychological well-being; (b) job demand is linked to less job satisfaction, whereas a higher level on the work–health balance is associated with job satisfaction and work engagement; (c) internal and external support is linked to job satisfaction in the case of a disease. Limitations: The evidence provided by the results is restricted by the limited availability of studies focusing on well-being at work following return to work. Moreover, the studies identified are of different kinds, thereby preventing comparisons. Conclusions and implications of the main findings: Employees’ subjective well-being after return to work has received very little attention to date. Given its importance in the current configuration of the labor market, it should be the object of more research.
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Affiliation(s)
- José-María Figueredo
- International School of Doctorate, National Distance Education University (UNED), 28040 Madrid, Spain;
| | - Cristina García-Ael
- Department of Social and Organizational Psychology, National Distance Education University (UNED), 28040 Madrid, Spain;
| | - Andrea Gragnano
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Gabriela Topa
- Department of Social and Organizational Psychology, National Distance Education University (UNED), 28040 Madrid, Spain;
- Correspondence:
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Duong PK, Egan MY, Meyer MJ, Morrison TL. Intention to Return to Work after Stroke Following Rehabilitation in Ontario. Can J Occup Ther 2020; 87:221-226. [DOI: 10.1177/0008417420905706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Returning to work is important for many people following stroke. An estimate of the prevalence of people intending to return to work post-stroke would be helpful in planning services supporting work reintegration. Purpose. This study examined the prevalence of intention to return to work after discharge among stroke rehabilitation inpatients. Methods. We performed secondary analysis of National Rehabilitation Reporting System data for all stroke rehabilitation inpatients across Ontario (2012–2017). Intention to return to work was examined by gender, age, and level of disability. Findings. Among 25,691 stroke rehabilitation inpatients, 4,668 (18.2%) were employed pre-stroke and 2,039 (43.7%) of them intended to return to work. Intention to return to work was somewhat higher among younger and middle-aged stroke survivors and those with mild disability. Implications. Providers and planners should be aware that almost half of previously employed stroke-rehabilitation inpatients may be seeking services to assist with return to work.
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Guzik A, Kwolek A, Drużbicki M, Przysada G. Return to work after stroke and related factors in Poland and abroad: A literature review. Work 2020; 65:447-462. [PMID: 31985482 DOI: 10.3233/wor-203097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The incidence of stroke is growing in various parts of the world and the condition most commonly affects the adult population. OBJECTIVES The purpose of the study is to provide a narrative review of papers published in the last 11 years in English and in Polish and focusing on demographic characteristics of individuals returning to work after stroke, return to work rates, length of time post stroke to return to work as well as health conditions, or personal and environmental factors associated with return to work after stroke. The study also presents the situation regarding return to work after stroke in Poland in comparison to other countries. METHODS The narrative review covers Polish and foreign literature published between 2007 and 2018. The number of records initially identified through English databases search amounted to 4,912. Five records were additionally identified through other sources (Polish databases). Ultimately 26 (21 foreign, 5 Polish) refereed publications were selected to be reviewed in this study, based on their relevance in terms of specific inclusion/exclusion criteria. RESULTS The appraisal of Polish and English-language literature shows that stroke survivors' ability to return to work varies; in our country the rate being 43% and outside of Poland reaching the rate of 74.7%. Average time frames for return to work for stroke survivors include from 3 to 6 months, from 12 to 18 months and up to 3 years post stroke. One of the most frequently reported positive factors in the English-language literature is individually tailored vocational rehabilitation. There is a scarcity of studies related to return to work after stroke in Poland. CONCLUSIONS The findings from studies included in this narrative review may suggest a need to improve the situation in Poland with regard to measures related to return to work after stroke, including vocational rehabilitation which is insufficiently available in Poland.
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Affiliation(s)
- Agnieszka Guzik
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Andrzej Kwolek
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Mariusz Drużbicki
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Grzegorz Przysada
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland
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Kim SH, Shin YI, Kim SC, Ko SH, Kim DY, Lee J, Sohn MK, Lee SG, Oh GJ, Lee YS, Joo MC, Han EY, Han J, Chang WH, Min JH, Kim YH. Factors Associated to Returning Home in the First Year after Stroke. BRAIN & NEUROREHABILITATION 2019; 13:e1. [PMID: 36744270 PMCID: PMC9879522 DOI: 10.12786/bn.2020.13.e1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/02/2019] [Accepted: 09/12/2019] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to investigate factors affecting the return home one year after a stroke. The subjects of this study consisted of patients who participated in a large-scale multi-objective cohort study of initial stage stroke patients who were admitted to 9 representative hospitals in Korea. We analyzed the distribution of the subjects who had experienced stroke a year earlier by distinguishing the group who returned home and the other group that was hospitalized in rehabilitation hospitals. Based on this distribution, we evaluated the demographic, environmental, clinical, and psychological factors that can affect the return home. Overall, there were 464 subjects in the 'Return home' group and 99 subjects in the 'Rehabilitation hospitalization' group. job status, inconvenient housing structures, residential types, diagnosis, Functional Ambulation Categories, modified Rankin Scale, Korea-Modified Barthel Index, Function Independence Measure, Fugl-Meyer Assessment, Korean version of Mini-Mental State Examination, Korean version of Frenchay Aphasia Screening Test, Psychosocial Well-being Index-Short Form, Geriatric Depression Scale-Short Form, EuroQol-five Dimensional showed a significant difference between the 2 groups one year after the stroke. The factors affecting the return home one year after a stroke include functional status, activities of daily living, cognition, depression, stress, quality of life, job status. It is expected that factors affecting the rehabilitation of patients with stroke can be considered as basic data for establishing rehabilitation goals and treatment plans.
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Affiliation(s)
- Seung Han Kim
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Chan Kim
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sung Hwa Ko
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Deog Young Kim
- Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Sam-Gyu Lee
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University, School of Medicine, Jeju, Korea
| | - Junhee Han
- Department of Statistics, Hallym University, Chuncheon, Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hong Min
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Han J, Lee HI, Shin YI, Son JH, Kim SY, Kim DY, Sohn MK, Lee J, Lee SG, Oh GJ, Lee YS, Joo MC, Han EY, Chang WH, Kim YH. Factors influencing return to work after stroke: the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) Study. BMJ Open 2019; 9:e028673. [PMID: 31300502 PMCID: PMC6629413 DOI: 10.1136/bmjopen-2018-028673] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To investigate the rate of return to work and identify key factors associated with return to work between 3 months and 2 years after stroke. DESIGN Prospective cohort study. SETTING The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) in Korea. PARTICIPANTS A total of 193 persons with first-ever stroke who reported working status at 3 months after stroke. OUTCOME MEASURES Data on baseline characteristics were collected from medical records. Functional assessments were performed using the National Institutes of Health Stroke Scale, the modified Rankin Scale, the Fugl-Meyer Assessment, the Functional Ambulatory Category, the Korean Mini-Mental State Examination, the Korean version of the Frenchay Aphasia Screening Test, the American Speech-Language-Hearing Association National Outcomes Measurement System, the Korean-Modified Barthel Index, the Geriatric Depression Scale-Short Form and the EuroQol-5 dimensions. An enumeration survey included the Reintegration to Normal Living Index, the Psychosocial Well-being Index-Short Form (, the Family Support Index and the Caregivers Burden Index. RESULTS Overall, 145 (75.1%) patients who had a stroke in the "Continuously-Employed" group and 48 (24.9%) in the "Employed-Unemployed" group returned to work between 3 months and 2 years after stroke. Multivariate logistic analysis demonstrated that in patients who had a stroke, characteristics such as age, PWI-SF Score, and caregiver characteristics, including age, sex (female) and living arrangements, were significantly associated with return to work between 3 months and 2 years after stroke. CONCLUSION Age and PWI-SF Score of patients who had a stroke, as well as the age, sex and living arrangements of caregivers, are key factors influencing the return to work after stroke. TRIAL REGISTRATION NUMBER NCT03402451.
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Affiliation(s)
- Junhee Han
- Department of Statistics and Institute of Statistics, Hallym University, Chuncheon, The Republic of Korea
| | - Hae In Lee
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, The Republic of Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, The Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, The Republic of Korea
| | - Ju Hyun Son
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, The Republic of Korea
| | - Soo-Yeon Kim
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, The Republic of Korea
| | - Deog Young Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, The Republic of Korea
| | - Min Kyun Sohn
- School of Medicine, Department of Rehabilitation Medicine, Chungnam National University, Daejeon, The Republic of Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, The Republic of Korea
| | - Sam-Gyu Lee
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, The Republic of Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, School of Medicine, Wonkwang University, Iksan, The Republic of Korea
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu, The Republic of Korea
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, School of Medicine, Wonkwang University, Iksan, The Republic of Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, School of Medicine, Jeju National University, Jeju, The Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
- Department of Health Sciences and Technology,Department of Medical Device Management & Research, Department of DigitalHealth, SAIHST, Sungkyunkwan University, Seoul, The Republic of Korea
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Long-term participation 7-8 years after stroke: Experiences of people in working-age. PLoS One 2019; 14:e0213447. [PMID: 30865696 PMCID: PMC6415844 DOI: 10.1371/journal.pone.0213447] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 02/21/2019] [Indexed: 01/14/2023] Open
Abstract
Objective To enhance the understanding of long-term participation in working-aged people 7–8 years after stroke. Methods This study had a qualitative design, using a thematic analysis methodology. Eleven individuals took part in an in depth interview 7–8 years after a first time stroke. They had received care at the Sahlgrenska University Hospital in Gothenburg, and were recruited as a heterogenic sample with respect to age, gender, stroke severity and subtype. Results From the participants’ experiences four themes emerged: “Returning to work after stroke”; “Working life 7–8 years after stroke”; “Social life 7–8 years after stroke”; and “A state of reorientation in life”. Quotes about experienced participation in everyday life were summarized and presented as “Participation after stroke narratives”. Participants chose to emphasize on work- and social life when describing situations of successful participation. Being included in the wider community and having a sense of purpose, when interacting with others, were factors that these narratives had in common. Participants had gradually become accustomed to a somewhat altered life situation. Some consequences after stroke were still considered frustrating in social or work situations. However, the importance of these issues had reduced and were no longer problematized. Conclusions Participants felt content with their everyday life in general, which was a principal and positive result of this study. Reaching a stage of acceptance seemed to be a complex and continuous struggle, and an individual approach in long-term rehabilitation would be valuable to support this personal process. More knowledge about what factors that facilitate participation in people of working-age many years after stroke is needed, so that more people can reach a state of positive identity and participation.
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28
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Returning to Work After Mild Stroke. Arch Phys Med Rehabil 2019; 100:379-383. [DOI: 10.1016/j.apmr.2018.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022]
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Shipley J, Luker J, Thijs V, Bernhardt J. How can stroke care be improved for younger service users? A qualitative study on the unmet needs of younger adults in inpatient and outpatient stroke care in Australia. Disabil Rehabil 2019; 42:1697-1704. [DOI: 10.1080/09638288.2018.1534278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jessica Shipley
- Royal Melbourne Hospital, Melbourne, Australia
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Julie Luker
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Neurology Department, Austin Health, Melbourne, Australia
| | - Julie Bernhardt
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Interdisciplinary Approaches to Facilitate Return to Driving and Return to Work in Mild Stroke: A Position Paper. Arch Phys Med Rehabil 2018. [DOI: 10.1016/j.apmr.2018.01.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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de Wit M, Wind H, Hulshof CTJ, Frings-Dresen MHW. Person-related factors associated with work participation in employees with health problems: a systematic review. Int Arch Occup Environ Health 2018; 91:497-512. [PMID: 29700608 PMCID: PMC6002456 DOI: 10.1007/s00420-018-1308-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems? METHODS A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies. RESULTS In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation. CONCLUSIONS The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.
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Affiliation(s)
- Mariska de Wit
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Haije Wind
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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Schwarz B, Claros-Salinas D, Streibelt M. Meta-Synthesis of Qualitative Research on Facilitators and Barriers of Return to Work After Stroke. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:28-44. [PMID: 28536888 DOI: 10.1007/s10926-017-9713-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose Despite existing rehabilitation services, return to work (RTW) rates among stroke survivors are quite low. An increased number of qualitative studies have been conducted to identify facilitators and barriers to RTW after stroke and to derive recommendations for future interventions. The aim of our study was to carry out a meta-synthesis of those studies and thus strengthen evidence in the field. Methods To identify relevant studies (qualitative studies focusing on RTW after stroke, published in English or German between 2000 and 2015), we conducted a systematic literature search in PubMed, OVID, and Web of Science. After assessing the quality of eligible studies, we synthesized their findings according to meta-ethnographic methodology. Results Fourteen out of 553 studies-three of very high, seven of high, three of medium, and one of low quality-met the inclusion criteria. After the extraction of all first-order concepts and their translation into 64 second-order interpretations, we synthesized the findings by developing a model of RTW factors after stroke. It contains factors related to the person (impairments, coping/adaptation, significance of work/RTW motivation), workplace (job demands/work adaptations, disability management, work climate/social support), and rehabilitation services (availability, accessibility, appropriateness), as well as relevant factors in the interaction of these three stakeholders (work capacity, performance and capability, and initial RTW experiences). Three basic principles-adaptiveness, purposefulness, and cooperativeness-complete the model and led us to its name: the APC model. Conclusions Successful RTW after stroke depends on diverse factors and stakeholders. Rehabilitation strategies have to consider this; otherwise they become RTW barriers themselves.
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Affiliation(s)
- Betje Schwarz
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | | | - Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Hohenzollerndamm 47, 10704, Berlin, Germany.
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Öst Nilsson A, Eriksson G, Johansson U, Hellman T. Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme. Scand J Occup Ther 2016; 24:349-356. [DOI: 10.1080/11038128.2016.1249404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Annika Öst Nilsson
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Gunilla Eriksson
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Ulla Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Therese Hellman
- Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Solna, Sweden
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Jellema S, van Hees S, Zajec J, van der Sande R, Nijhuis-van der Sanden MW, Steultjens EM. What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings. Clin Rehabil 2016; 31:936-947. [PMID: 27681480 PMCID: PMC5482381 DOI: 10.1177/0269215516671013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. DATA SOURCES PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. REVIEW METHODS An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. RESULTS The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. CONCLUSION A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.
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Affiliation(s)
- Sandra Jellema
- 1 Radboud university medical center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands
| | - Suzanne van Hees
- 3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Jana Zajec
- 3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Rob van der Sande
- 2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands.,4 Radboud university medical center, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- 1 Radboud university medical center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands.,3 Radboud university medical center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Esther Mj Steultjens
- 2 HAN University of Applied Sciences, Institute of Health Studies, Nijmegen, The Netherlands
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35
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Brannigan C, Galvin R, Walsh ME, Loughnane C, Morrissey EJ, Macey C, Delargy M, Horgan NF. Barriers and facilitators associated with return to work after stroke: a qualitative meta-synthesis. Disabil Rehabil 2016; 39:211-222. [PMID: 27097520 DOI: 10.3109/09638288.2016.1141242] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To enhance the employment outcomes of individuals who experience a stroke, it is essential to understand the factors that determine successful return to work. The aim of this systematic review was to examine barriers to and facilitators of return to work after stroke from the perspective of people with stroke through the process of a qualitative meta-synthesis. METHODS A systematic literature search was conducted. Studies that employed qualitative methods to explore the experiences of individuals with stroke around return to work after stroke were included. The methodological quality of the studies was assessed by two independent reviewers. Overarching themes, concepts and interpretations were extracted from each individual study, compared and meta-synthesized. RESULTS Fifteen studies were included and the overall methodological quality of the studies was good. Four broad themes emerged as factors associated with return to work after stroke. These included (i) the nature of the effects of stroke, (ii) the preparatory environment, (iii) personal coping strategies and internal challenges and (iv) the meaning of work. CONCLUSION Return to work after stroke is a complex process which can be facilitated or impeded by organizational, social or personal factors, as well as accessibility to appropriate services. Implications for Rehabilitation Following a period of dedicated inpatient rehabilitation, there is a need to integrate community-support services to optimize return to work among stroke survivors. A dedicated community stroke support liaison officer may help to facilitate the transition between the hospital and the community and workplace environment. Education provided by healthcare professionals is necessary in the community and the workplace to ensure that family, friends and employers are aware of the impairments, activity limitations and participation restrictions of the stroke survivor.
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Affiliation(s)
- Colm Brannigan
- a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland
| | - Rose Galvin
- a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland.,b Department of Clinical Therapies, Faculty of Education and Health Sciences, Health Research Institute , University of Limerick , Limerick , Republic of Ireland
| | - Mary E Walsh
- a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland
| | | | | | - Chris Macey
- c Irish Heart Foundation , Dublin , Republic of Ireland
| | - Mark Delargy
- d National Rehabilitation Hospital, Dun Laoghaire, Co. , Dublin , Republic of Ireland
| | - N Frances Horgan
- a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland
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Balasooriya-Smeekens C, Bateman A, Mant J, De Simoni A. Barriers and facilitators to staying in work after stroke: insight from an online forum. BMJ Open 2016; 6:e009974. [PMID: 27053267 PMCID: PMC4823433 DOI: 10.1136/bmjopen-2015-009974] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore barriers and facilitators to staying in work following stroke. DESIGN Qualitative analysis of posts regarding staying in work following stroke using the archives of an online forum for stroke survivors. PARTICIPANTS 60 stroke survivors (29 male, 23 female, 8 not stated; mean age at stroke 44 years) who have returned to work, identified using terms 'return to work' and 'back at work'. SETTING Posts from UK stroke survivors and family members on Talkstroke, the forum of the Stroke Association, between 2004 and 2011. RESULTS Stroke and transient ischaemic attack (TIA) survivors reported residual impairments that for many had impact on work. Most impairments were 'invisible', including fatigue, problems with concentration, memory and personality changes. Participants described positive (eg, back at work being better than expected) and negative work experiences, including being at risk of losing the job because of stroke-related impairments. Barriers to successfully staying in work included lack of understanding of stroke--in particular invisible impairments--of survivors, employers and general practitioners (GPs), and lack of support in terms of formal adjustments, and 'feeling supported'. Stroke survivors described how they developed their own coping strategies, and how workplace and employer helped them to stay in work. CONCLUSIONS Despite having been able to return to work after a stroke, people may still experience difficulties in staying in work and risking losing their job. There is a need to improve awareness, in particular of invisible stroke-related impairments, among stroke survivors, work personnel and clinicians. This might be achieved through improved assessments of residual impairments in the workplace and in general practice. Future studies should investigate the effect of unrecognised fatigue and invisible impairments on staying in work following stroke, and explore the potential role for primary care in supporting stroke survivors who have returned to employment.
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Affiliation(s)
| | - Andrew Bateman
- The Oliver Zangwill Centre, The Princess of Wales Hospital, Ely, Cambridgeshire, UK
| | - Jonathan Mant
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anna De Simoni
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Frostad Liaset I, Lorås H. Perceived factors in return to work after acquired brain injury: A qualitative meta-synthesis. Scand J Occup Ther 2016; 23:446-57. [DOI: 10.3109/11038128.2016.1152294] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
PURPOSE To describe the development and results of a detailed survey on return to work (RTW) after stroke completed by survivors at various stages of recovery. METHOD This study used a multi-method qualitative and quantitative research strategy to design and implement a 39-item survey for stroke survivors. Individual interviews, focus groups, and working committees were used to conceptualize the issues and translate them into a survey format. Surveys were distributed in regular and electronic mail. Groups of rehabilitation professionals, employers, and stroke survivors were assembled to review findings and obtain feedback to aide in interpretation. RESULTS Overall 715 surveys were completed. The respondents were on average 54 years of age, mostly white, well-educated, urban dwelling, and in skilled occupations. Results are described in seven areas: financial, stroke impairments, organizational, work and psychological issues, interpersonal support, and therapy. Several salient findings are described including the role of fatigue, under utilization of vocational rehabilitation (VR) services, and motivational factors related to finances, self-esteem, work, and workplace relationships. CONCLUSION Although earning an income is a strong motivation to RTW, salary decreases in importance when compared with other psychological benefits. Fatigue was rated as the second highest impairment barrier to RTW and persisted as a relevant impediment over time. Attitudes of co-workers and flexibility in work schedule were viewed as most helpful to the RTW process, whereas work stress was viewed as the greatest impediment to return. Only 24% of the sample received VR counseling with more respondents receiving counseling if they returned 6 months or longer after their stroke. Other trends and clinical and research implications are discussed.
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de Jong M, de Boer AGEM, Tamminga SJ, Frings-Dresen MHW. Quality of working life issues of employees with a chronic physical disease: a systematic review. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:182-96. [PMID: 24832893 DOI: 10.1007/s10926-014-9517-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. METHODS A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. RESULTS From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. CONCLUSION This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes.
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Affiliation(s)
- Merel de Jong
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands,
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Roth EJ, Lovell L. Employment After Stroke: Report of a State of the Science Symposium. Top Stroke Rehabil 2015; 21 Suppl 1:S75-86. [DOI: 10.1310/tsr21s1-s75] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Background and aims: Previous research has focused primarily on incidence rates and barriers/facilitators influencing return to work, without considering the formal paths accessed by people with stroke. The aim of this study was to identify the paths used by Australian people to return to work following stroke, including changes to work-related habits and routines, and job satisfaction.Methods: This descriptive, retrospective study recruited people through newsletters and online forums for people with stroke. The quantitative data were summarised descriptively and the Wilcoxon signed-rank test was used to compare pre- and post-stroke job satisfaction rates.Results: Participants (n= 21) were aged 48 years on average, female (67%) and university trained (71%). Ten (48%) participants did not access formal return-to-work services, yet participants commonly reported changes to work-related habits and routines. Participants were significantly less satisfied with their post-stroke job suitability (physically, cognitively and financially), stability and importance (p< .05).Conclusion: Participants in this small-scale study did not routinely access formal support services to return to work, while experiencing changes to work-related habits and satisfaction. Further research is required to document the return-to-work paths, including the experience from the perspective of the person with stroke.
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Sarre S, Redlich C, Tinker A, Sadler E, Bhalla A, McKevitt C. A systematic review of qualitative studies on adjusting after stroke: lessons for the study of resilience. Disabil Rehabil 2013; 36:716-26. [PMID: 23883420 DOI: 10.3109/09638288.2013.814724] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To synthesize qualitative studies on adjusting after stroke, from stroke survivors' and carers' perspectives, and to outline their potential contribution to an understanding of resilience. METHODS A systematic review of qualitative studies in peer reviewed journals from 1990 to 2011 was undertaken. Findings from selected studies were summarized and synthesized and then considered alongside studies of resilience. RESULTS Forty studies were identified as suitable. These suggested that the impact of stroke was felt on many dimensions of experience, and that the boundaries between these were permeable. Nor was stroke as an adverse "event" temporally bounded. Adjustment was often marked by setbacks and new challenges over time. Participants identified personal characteristics as key, but also employed practical and mental strategies in their efforts to adjust. Relationships and structural factors also influenced adjustment after stroke. CONCLUSIONS The impacts of stroke and the processes of adjusting to it unfold over time. This presents a new challenge for resilience research. Processes of adjustment, like resilience, draw on personal, inter-personal and structural resources. But the reviewed studies point to the importance of an emic perspective on adversity, social support, and what constitutes a "good" outcome when researching resilience, and to a greater focus on embodiment. Implications for Rehabilitation Stroke is a sudden onset condition which for around a third of people has long-term consequences. Stroke can cause a variety of physical and cognitive impairments, some of which may not be obvious to an outsider. As well as physical functioning, stroke can have a profound effect on survivors' sense of self and on their relationships. Stroke survivors' accounts suggest that relationships (including relationships with health care professionals) and structural factors (such as access to health services, employment possibilities and welfare systems) mediate efforts to adjust after stroke. While there is considerable overlap between notions of adjustment and resilience, the experiences of stroke survivors suggest further issues that need to be addressed in order to gain a more comprehensive understanding of resilience.
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Affiliation(s)
- Sophie Sarre
- Department of Primary Care & Public Health Sciences, King's College London , London , UK
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Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Laperrière E. Obstacles to and facilitators of return to work after work-disabling back pain: the workers' perspective. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:280-9. [PMID: 23124686 DOI: 10.1007/s10926-012-9399-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Back pain entails considerable costs, particularly because many injured workers are absent from work for long periods. Factors that influence return to work among workers with back pain are still, however, not well understood. This qualitative study aimed at documenting affected workers' perspective on the: 1--difficulties caused by back pain, and 2--most important obstacles to and facilitators of return to work. METHODS Two focus groups composed of workers having suffered from work-disabling back pain were held: a group of participants who had returned to work (n = 9) and a group of participants who had not returned or had recently returned to work (n = 10). The verbatim accounts of the discussions were transcribed and a content analysis was carried out that included a ranking of items. RESULTS Difficulties caused by back pain were related to: (1) personal, (2) family, (3) social, (4) occupational, and (5) financial factors, and (6) health services. Obstacles to and facilitators of return to work were of 4 different types: (1) occupational factors, (2) factors associated with the utilization of health services, (3) clinical, and (4) personal factors. Persistent pain, lack of access to information or support groups, and lack of collaboration and understanding from employer were the most important obstacles identified, whereas knowledge of one's limits and physical training were perceived to be the most important facilitators of return to work, ahead of work-related factors. Differences between groups' perceptions were attributed mainly to control beliefs. CONCLUSIONS Personal, clinical, occupational and health services factors are perceived by workers with back pain to play a crucial role in determining whether they return to work or not.
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Affiliation(s)
- Clermont E Dionne
- URESP, Centre de recherche FRQS du Centre hospitalier universitaire (CHU) de Québec, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Quebec City, QC, G1S 4L8, Canada.
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Gallacher K, Morrison D, Jani B, Macdonald S, May CR, Montori VM, Erwin PJ, Batty GD, Eton DT, Langhorne P, Mair FS. Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research. PLoS Med 2013; 10:e1001473. [PMID: 23824703 PMCID: PMC3692487 DOI: 10.1371/journal.pmed.1001473] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 05/09/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed 'treatment burden' and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective. METHODS AND FINDINGS The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce. CONCLUSIONS Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems.
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Affiliation(s)
- Katie Gallacher
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Deborah Morrison
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Bhautesh Jani
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Sara Macdonald
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Carl R. May
- Faculty of Health Sciences, University of Southampton, United Kingdom
| | - Victor M. Montori
- Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, United States of America
| | - Patricia J. Erwin
- Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, United States of America
| | - G. David Batty
- Department of Epidemiology and Public Health, University College London, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom
| | - David T. Eton
- Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, United States of America
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
| | - Frances S. Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, United Kingdom
- * E-mail:
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Trygged S. Return to work and wellbeing after stroke—a success story? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.8.431] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Sven Trygged
- Stockholm University, Department of Social Work, Stockholm, Sweden
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