Operational Definitions and Estimates of Return to Work Poststroke: A Systematic Review and Meta-Analysis

Duong, Patrick; Sauvé-Schenk, Katrine; Egan, Mary; Meyer, Matthew J.; Morrison, Tricia

doi:10.1016/j.apmr.2018.09.121

Cited by 29 publications

(38 citation statements)

References 69 publications

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“…More than two-thirds of participants returned to work at some point in the year following stroke. This rate is higher than the pooled estimate of 56% reported in a systematic review by Duong et al (33), but it is consistent with Hackett et al (9), who found that 75% of stroke survivors were in full-time paid work at 12 months poststroke in an observational study of 271 Australian stroke participants, mean age 52 years, who were in paid work at stroke onset. Hackett's criterion for paid work was 1 h or more in the preceding month and included casual or temporary work.…”

Section: Discussionsupporting

confidence: 85%

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What is a return to work after stroke? 12-month outcomes in a feasibility trial

Radford

Grant²,

Sinclair³

et al. 2020

J Rehabil Med

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Stroke is the single greatest cause of adult disability in the UK. A quarter of strokes affect people of working age; however, less than half of them return to work. This study described the nature of return to work and the help that people require to go back to work. A total of 46 participants were recruited from one English county. Participants were divided into 2 groups: a group receiving usual care and a group receiving extra rehabilitation. The study assessed their work status, the hours they worked, work accommodations, and what they earned at baseline, 3, 6 and 12 months after stroke. Most people returned to work after a mean of 90 days and stayed with the same employer. However, many people needed changes at work, worked fewer hours and earned less than they did before the stroke. Future research should investigate the implications of work adjustments for stroke survivors and whether the reported reductions in hours, status, roles and responsibilities are viewed as positive or negative. Objective: Stroke is the greatest cause of disability in adults. A quarter of strokes in the UK affect people of working age, yet under half of them return to work after stroke. There has been little investigation into what constitutes "return to work" following stroke. The aim of this study is to describe the work metrics of stroke survivor participants in a feasibility randomized controlled trial of an early stroke-specific vocational rehabilitation intervention. Methods: Retrospective analysis of trial data. Metrics on work status, working hours, workplace accommodations and costs were extracted from trial outcomes gathered by postal questionnaire at 3, 6, and 12 months' post-randomization for 46 stroke participants in a feasibility randomized controlled trial. Participants were randomized to receive vocational rehabilitation (intervention) or usual care (control). Results: Two-thirds (n = 29; 63%) of participants returned to work at some point in the 12 months following stroke. Participants took a mean of 90 days to return to work. Most returned to the same role with an existing employer. Only one-third of participants who were employed full-time at stroke onset were working full-time at 12 months post-stroke. Most participants experienced a reduction in pre-stroke earnings. Workplace accommodations were more common among intervention group participants. More intervention participants than control participants reported satisfaction with work at both 6 and 12 months post-randomization. Conclusion: This study illustrates the heterogeneous nature of return to work and the dramatic impact of stroke on work status, working hours and income. Longitudinal research should explore the socioeconomic legacy of stroke and include clear definitions of work and accurate measures of working hours and income from all sources.

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Section: Discussionsupporting

confidence: 85%

“…These factors should be captured in longitudinal research exploring the socioeconomic legacy and nature of work after stroke. Moreover, adopting consistent follow-up times would promote comparability of studies (33).…”

Section: Discussionmentioning

confidence: 99%

What is a return to work after stroke? 12-month outcomes in a feasibility trial

Radford

Grant²,

Sinclair³

et al. 2020

J Rehabil Med

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“…Up to the third stage of medical rehabilitation, no more than 60% of patients survived after they had suffered a CVA. Despite the high importance of this problem, complex, continuous, and multidisciplinary medical rehabilitation with a return to work is foreseen only in a number of countries (9)(10)(11)).…”

Section: Discussionmentioning

confidence: 99%

Organisational and Economic Activities for Provision of Medical Rehabilitation Services on an Outpatient Basis to Patients That Have Suffered an Acute Cerebrovascular Accident

Badrutdinova

Манерова

2019

Serbian Journal of Experimental and Clinical Research

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The aim of this study was to develop legal, organizational and economic activities for providing medical rehabilitation on an outpatient basis to patients that have suffered an acute cerebrovascular accident (CVA). The study included patients who had suffered a CVA and were undergoing medical rehabilitation on an outpatient basis (400 individuals participated in a retrospective study and 400 individuals took part in a sociological survey) and medical rehabilitation specialists providing care on an outpatient basis to patients who had suffered a CVA (n = 50). All included patients received medical rehabilitation in accordance with the Guidelines of the Ministry of Health of the Russian Federation (No: 70). It should be noted that patients who suffered a CVA occupy a central place in the system of medical rehabilitation performed on an outpatient basis. Medical rehabilitation is important for their medical and social characteristics, motivation, environment, adherence to treatment and a healthy lifestyle. In accordance with the above mentioned, the following activities should be planned and implemented: a) work with doctors, b) work with patients; c) work with patients’ relatives; d) organizational aspects, and e) economic aspects. When organizing medical rehabilitation on an outpatient basis, it should be considered as a system of interaction between all participants in the rehabilitation process, in the center of which the patient is located. The main organizational activity for conducting medical rehabilitation in an outpatient setting is the implementation of a comprehensive interaction of all participants in the rehabilitation process.

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“…Post-discharge employment was defined as the "actual or expected vocational status upon discharge from the rehabilitation facility" (CIHI, 2018b). Return to work was defined as the "resumption of any paid work full-time or part-time, inclusive of self-employment, in a regular or modified capacity" (Duong et al, 2019). Stroke survivors were considered to be intending to return to work if they were coded as being in "paid employment" prior to stroke, and their actual or expected vocational status upon discharge was coded as "paid employment.…”

Section: Data Collectionmentioning

confidence: 99%

“…However, stroke-related impairments can adversely affect the ability to work, which can result in decreased psychosocial well-being (Daniel et al, 2009;Morris, 2011;Wolfenden & Grace, 2015). Furthermore, loss of work can lead to personal financial hardship and difficulties in maintaining housing, affording transportation, and accessing other services necessary for participating in valued occupations (Sauvé-Schenk et al, 2019). A recent Canadian cohort study found that employment rates at 3 years post-stroke were 19.8% less among people who had experienced stroke, and earnings were 31.2% less than those of people of similar age and gender (Garland et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Intention to Return to Work after Stroke Following Rehabilitation in Ontario

Duong¹,

Egan²,

Meyer³

et al. 2020

Can J Occup Ther

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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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Operational Definitions and Estimates of Return to Work Poststroke: A Systematic Review and Meta-Analysis

Cited by 29 publications

References 69 publications

What is a return to work after stroke? 12-month outcomes in a feasibility trial

What is a return to work after stroke? 12-month outcomes in a feasibility trial

Organisational and Economic Activities for Provision of Medical Rehabilitation Services on an Outpatient Basis to Patients That Have Suffered an Acute Cerebrovascular Accident

Intention to Return to Work after Stroke Following Rehabilitation in Ontario

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