1
|
Umemura T, Hachisuka K, Saeki S, Nishizawa S, Yamamoto J. Rate of return to work in patients with stroke under the health and employment support program of Rosai hospitals in Japan. Sci Rep 2023; 13:15795. [PMID: 37737495 PMCID: PMC10516957 DOI: 10.1038/s41598-023-43162-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 09/20/2023] [Indexed: 09/23/2023] Open
Abstract
To facilitate return to work (RTW) in patients with stroke, a health and employment support (HES) program was started at Rosai hospitals in Japan. This study aimed to determine the rate of RTW in patients with stroke under this support program. We collected demographic and clinical data of patients with stroke from the implementation reports of the HES program. The program provided coordinated dual support, such as acute medical treatments, and stroke and vocational rehabilitation on the medical side, and management and support on the workplace side. The primary endpoint was RTW. Successful and unsuccessful RTW were examined using the χ2 test. The RTW rate curves were analyzed using the Kaplan-Meier method. We enrolled 483 patients; 355 (73%) and 128 (27%) patients had successful and unsuccessful RTW, respectively. Stroke types, neurological findings, and activities of daily living were significant factors for RTW. The Kaplan-Meier method revealed that left hemiplegia, right hemiplegia, and neuropsychological deficits, except for combined disability (hemiplegia with neuropsychological deficits), had similar RTW curves with an RTW rate of > 70%.
Collapse
Affiliation(s)
- Takeru Umemura
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
- Department of Neurosurgery, Moji Medical Center, Kyushu Rosai Hospital, Kitakyushu, Japan.
| | - Kenji Hachisuka
- Department of Rehabilitation Medicine, Moji Medical Center, Kyushu Rosai Hospital, Kitakyushu, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shigeru Nishizawa
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Brouns R, Valenzuela Espinoza A, Goudman L, Moens M, Verlooy J. Interventions to promote work participation after ischaemic stroke: A systematic review. Clin Neurol Neurosurg 2019; 185:105458. [DOI: 10.1016/j.clineuro.2019.105458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 11/16/2022]
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Sen A, Bisquera A, Wang Y, McKevitt CJ, Rudd AG, Wolfe CD, Bhalla A. Factors, trends, and long-term outcomes for stroke patients returning to work: The South London Stroke Register. Int J Stroke 2019; 14:696-705. [DOI: 10.1177/1747493019832997] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and purpose There is limited information on factors, trends, and outcomes in return to work at different time-points post-stroke; this study aims to identify these in a multi-ethnic urban population. Methods Patterns of return to work were identified in individuals in paid work prior to first-ever stroke in the population-based South London Stroke Register (SLSR) between 1995 and 2014. Multivariable logistic regression examined associations between patient characteristics and return to work at 1 year (1 y), 5 years (5 y) and 10 years (10 y) post-stroke. Results Among 5609 patients, 940 (17%) were working prior to their stroke, of whom 177 (19%) were working 3 months post-stroke, declining to 172 (18%) at 1 y, 113 (12%) at 5 y, and 27 (3%) at 10 y. Factors associated with return to work within 1 y, after logistic regression, included functional independence (BI ≥ 19; p < 0.01) and shorter length of stay ( p < 0.05). Younger age ( p < 0.01) was associated with return to work at 5 y and 10 y post-stroke. Non-manual occupation ( p < 0.05) was associated with return to work at 10 y post-stroke. Return to work within 1 y increased the likelihood of working at 5 y (OR: 13.68; 95% CI 5.03–37.24) and 10 y (9.07; 2.07–39.8). Of those who were independent at follow-up (BI ≥ 19), 48% were working at 1 y, 42% at 5 y, and 28% at 10 y. Lower rates of anxiety and depression and higher self-rated health were associated with return to work at 1 y ( p < 0.01). Conclusion Although functionally independent stroke survivors are more likely to return to work long-term, a large proportion do not return to work despite functional independence. Return to work post-stroke is associated with improved long-term psychological outcomes and quality of life.
Collapse
Affiliation(s)
- Arup Sen
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Alessandra Bisquera
- School of Population Health & Environmental Sciences, King’s College London, London, UK
| | - Yanzhong Wang
- School of Population Health & Environmental Sciences, King’s College London, London, UK
- National Institute for Health Research Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Christopher J McKevitt
- School of Population Health & Environmental Sciences, King’s College London, London, UK
- National Institute for Health Research Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Anthony G Rudd
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- School of Population Health & Environmental Sciences, King’s College London, London, UK
- National Institute for Health Research Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Charles D Wolfe
- School of Population Health & Environmental Sciences, King’s College London, London, UK
- National Institute for Health Research Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust and King’s College London, London, UK
| | - Ajay Bhalla
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- School of Population Health & Environmental Sciences, King’s College London, London, UK
| |
Collapse
|
6
|
Abstract
Despite improvements in the treatment of stroke, many individuals still face cognitive, emotional, and physical impairments. Stroke is a leading cause of serious long-term disability and subsequent failure to return to work (RTW). The purpose of this literature review was to synthesize and discuss the literature relevant to factors affecting RTW for stroke survivors, summarize the identified gaps, and discuss steps occupational health nurses can take to facilitate RTW among stroke survivors. A literature search was conducted using the keywords: “stroke,” “cerebrovascular disease,” “return to work,” and “employment.” After excluding articles based on inclusion/exclusion criteria, 19 quantitative research articles were reviewed. Consistent themes found in the literature affecting RTW following stroke included physical, social, and cognitive factors. One of the most consistent predictors of RTW found was stroke severity. Individuals who experienced a mild to moderate stroke, those of Caucasian ethnicity, and higher socioeconomic levels were more likely to RTW. Findings suggest the importance of future studies to examine factors among African American stroke survivors that predict RTW and the role of occupational health nurses.
Collapse
|
7
|
Saeki S, Hachisuka A, Itoh H, Kato N, Ochi M, Matsushima Y. Overview of the returning to work after stroke. ACTA ACUST UNITED AC 2019. [DOI: 10.3995/jstroke.10668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Satoru Saeki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| | - Akiko Hachisuka
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| | - Hideaki Itoh
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| | - Noriaki Kato
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| | - Mitsuhiro Ochi
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| | - Yasuyuki Matsushima
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health
| |
Collapse
|
8
|
Langhammer B, Sunnerhagen KS, Sällström S, Becker F, Stanghelle JK. Return to work after specialized rehabilitation-An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries: The Sunnaas International Network stroke study. Brain Behav 2018; 8:e01055. [PMID: 30022609 PMCID: PMC6085896 DOI: 10.1002/brb3.1055] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Stroke may impose disabilities with severe consequences for the individual, with physical, psychological, social, and work-related consequences. The objective with the current study was to investigate to what extent persons with stroke were able to return to work, to maintain their financial situation, and to describe the follow-up services and participation in social networks and recreational activities. METHODS The design was a prospective, descriptive study of specialized stroke rehabilitation in nine rehabilitation centers in seven countries. Semistructured interviews, which focused on the return to work, the financial situation, follow-up services, the maintenance of recreational activities, and networks, were performed 6 and 12 months post discharge from rehabilitation. RESULTS The working rate before the onset of stroke ranged from 27% to 86%. At 12 months post stroke, the return to work varied from 11% to 43%. Consequently, many reported a reduced financial situation from 10% to 70% at 6 months and from 10% to 80% at 12 months. Access to postrehabilitation follow-up services varied in the different countries from 24% to 100% at 6 months and from 21% to 100% at 12 months. Physical therapy was the most common follow-up services reported. Persons with stroke were less active in recreational activities and experienced reduced social networks. Associations between results from the semistructured interviews and related themes in LiSat-11 were small to moderate. The study shows that education, age, and disability are predictors for return to work. Differences between countries were observed in the extent of unemployment. CONCLUSIONS In this international multicentre study, return to work after severe stroke and specialized/comprehensive rehabilitation was possible, depending on the extent of the disability, age, and education. Altered financial situation, reduced social networks, and reduced satisfaction with life were common psychosocial situations for these patients.
Collapse
Affiliation(s)
- Birgitta Langhammer
- Faculty of Health SciencesSunnaas Rehabilitation HospitalOslo Metropolitan UniversityOsloNorway
- Sunnaas Rehabilitation HospitalNesoddtangenNorway
| | | | | | - Frank Becker
- Sunnaas Rehabilitation HospitalNesoddtangenNorway
- Faculty of MedicineUniversity of OsloNesoddtangenNorway
| | - Johan K. Stanghelle
- Sunnaas Rehabilitation HospitalNesoddtangenNorway
- Faculty of MedicineUniversity of OsloNesoddtangenNorway
| |
Collapse
|