Factors predictive of return to work after stroke in patients with mild−moderate disability in India

Abstract

Background Successful return to work after stroke may improve economic circumstances, quality of life and overall life satisfaction, but not all stroke survivors are able to return to work. Aim Our aim was to determine what proportion of previously employed patients return to work after an acute stroke resulting in mild to moderate disability and to examine factors associated with a successful return to work. Methods Patients 18–60 years of age who were previously employed and who had a first‐ever stroke 3 months to 2 years previously resulting in mild to moderate disability (modified Rankin score ≤3) were recruited. Socio‐demographic and clinical information was collected and anxiety, depression and social support were assessed using previously validated instruments. Multivariate logistic regression was used to assess factors associated with a successful return to work. Results Of 141 patients (mean age ± SD 48 ± 8.8 years), 74 (52.5%) returned to work after stroke. Multivariate analysis demonstrated that a lower modified Rankin scale at 3 months [odds ratio (OR) 3.70, 95% confidence interval (CI) 1.77–7.76], younger age (OR 2.24, 95% CI 1.07–4.67) and a professional or business job (OR 3.02, 95% CI 1.44–6.34) were significantly associated with successful return to work and revealed that anxiety, depression and social support score did not affect patients' decision to return to work (P = 0.17, 0.61 and 0.27, respectively). Conclusions Amongst patients with mild to moderate disability after stroke, almost half do not return to work, and this is determined by functional disability and type of job rather than psychosocial factors such as anxiety and depression.

What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings

“…24,49,65,66,75–86 Some single remaining studies on activities such as eating, exercise or leisure 30,31,87–90 did not fit this format. In all the types of valued activities social support was identified as a facilitator to reengagement.…”

Return to work after specialized rehabilitation—An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries

“…Bonner et al. (2016) reported that 52.5% returned to work after 3 months to 2 years post stroke in a relatively young group (<60 years old), with mild to moderate stroke (mRS ≤ 3) in India. In comparison, 17% in the urban area and 11% in the rural area return to work in China at 1 year post discharge.…”

“…Stroke may impose disabilities with severe consequences for the individual, not only in the physical and psychological sense but also with regard to the patient's social situation, work, and family relations. Return to work (RTW) has been shown to improve their overall life satisfaction as well as economic circumstances (Bonner et al., 2016; Treger, Shames, Giaquinto, & Ring, 2007; Vestling, Tufvesson, & Iwarsson, 2003). Factors influencing the RTW after stroke have been related to the financial and intrinsic aspects of the work and focused less on its social aspects (Vestling et al., 2003).…”

5-Jahres-Follow-Up der multizentrischen Evaluationsstudie zur medizinisch-beruflichen Rehabilitation (MEmbeR)

“…Mit ihrer Hilfe kann der Schweregrad des neurologischen Defizits nach einem Schlaganfall erfasst werden, wobei ein Wert von "0" kein neurologisches Defizit und ein Wert von "5" eine schwere Behinderung (Patient ist bettlägerig, inkontinent und beaufsichtigungspflichtig) beschreibt [23]. Ein niedriger Wert in der Rankin-Skala ist dabei mit einer erfolgreichen Reintegration auf dem Arbeitsmarkt assoziiert [24]. Demnach könnte ein niedriger GdB sowie damit vergleichbare analoge internationale Faktoren wie ein niedriger Rankin-Skala Wert [24] und keine motorischen-und kognitiven Einschränkungen [19] mögliche Prognosefaktoren für eine berufliche Reintegration darstellen.…”