Need for structured healthcare organization and support for return to work after stroke in Sweden: Experiences of stroke survivors

Abstract

To be able to return to work after stroke is important for health and well-being and participation in society. In this qualitative study, 20 stroke survivors were interviewed in focus groups about their experiences of healthcare-related facilitators and barriers. Perceived facilitating factors were a tailored rehabilitation content and a structured stepwise return-to-work process. A lack of sufficient early healthcare information, rehabilitation planning and coordination were perceived as barriers. An early rehabilitation plan, a contact person, and improved communication between rehabilitation actors were requested, as well as help with work transport, home care, children and psychosocial support for families. These aspects should be considered in order to improve the return-to-work process after stroke. Objective: To explore stroke survivors' experiences of healthcare-related facilitators and barriers concerning return to work after stroke. Design: A qualitative study. Setting: Outpatient stroke rehabilitation unit at a University Hospital in southern Sweden. Participants: A convenience sample of 20 persons admitted to Skåne University Hospital for acute stroke care (median age 52 years), in employment of at least 10 h per week at stroke onset and been referred to stroke rehabilitation within 180 days. Methods: The interviews were performed by focus groups, and the data were analysed by content analysis. Results: Facilitating factors were a tailored rehabilitation content with relevant treatments, adequate timing and a structured stepwise return-to-work process. A lack of sufficient early healthcare information, rehabilitation planning and coordination were perceived as barriers. An early rehabilitation plan, a contact person, and improved communication between rehabilitation actors were requested, as well as help with work transport, home care, children and psychosocial support for families. Conclusion: Tailored rehabilitation content and a structured stepwise return-to-work process facilitated return to work. Insufficient structure within the healthcare system and lack of support in daily life were perceived barriers to return to work, and need to be improved. These aspects should be considered in the return-to-work process after stroke.

Exploring Stroke Patients’ Needs after Discharge from Rehabilitation Centres: Meta-Ethnography

“…The sample size of included studies ranged from six participants [ 25 ] to one hundred twenty-five participants [ 13 ]. Among these studies, thirteen articles [ 10 , 11 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ] recruited stroke participants only. Mixed participants of stroke survivors and carers were recruited in nine studies [ 14 , 25 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

“…After stroke, detailed information on prevention of stroke recurrence was desired [ 32 , 36 , 37 , 46 ].…”

Patient Pathways During Acute in-Hospital Stroke Treatment: A Qualitative Multi-Method Study

“…For example, most patient requests for information are likely to emerge at the SU where patients tend to regain (full) consciousness, but SU staff do not have direct patient interactions in the two previous phases. To this purpose, acute care may look at integrated care initiatives from the area of chronic care, in which the use of such strategies to support communication needs – for example, the use of care coordinators operating across institutions, shared medical records or designated family contact persons – may already be more common [ 56 57 58 59 60 61 ]. Similar questions may also be asked regarding communication across different hospitals and other institutions such as long-term care facilities.…”

Work conditions, support, and changing personal priorities are perceived important for return to work and for stay at work after stroke – a qualitative study

“…The qualitative data include facilitators and barriers for RTW and stay at work, and cover both work and healthcare related factors, as well as personal factors [26]. In this study, only qualitative data exploring work-related and personal factors in relation to RTW and stay at work after stroke are presented.…”