Return to Work Among Stroke Survivors

Ashley, Kristin D; Lee, Loretta T.; Heaton, Karen

doi:10.1177/2165079918812483

Cited by 41 publications

(50 citation statements)

References 23 publications

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“…Better self-perceived general health, and less pain, and depression post-stroke in the RTW group compared with the no-RTW group are expected, and RTW has been associated with better well-being, quality of life, and less depression in previous research 12,15 . One explanation could be that the people who RTW after stroke usually have milder symptoms from stroke 19 . This is also seen in the present study where the RTW group had lower stroke severity than the no-RTW group.…”

Section: Discussionmentioning

confidence: 99%

Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

Westerlind

Persson

Palstam

et al. 2020

Sci Rep

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Stroke is one of the most common diseases and has several potential consequences, such as psychological problems and pain. Return to work (RTW) after stroke in working-age individuals is incomplete. The present study aimed to investigate differences in self-perceived general health, pain, and depression between 1 and 5 years post-stroke related to RTW status. The study was nationwide, registry-based and the study population (n = 398) consisted of working-age people who had a stroke in 2011 and participated in 1-year and 5-year follow-up questionnaire surveys. Shift analyses with the Wilcoxon signed rank test and logistic regression were used. RTW within the first year post-stroke was associated with better self-perceived general health, less pain, and less depression both at 1 and 5 years post-stroke, compared with the no-RTW group. However, the RTW group had significant deterioration in general health and pain between 1 and 5 years, while the no-RTW group had no significant change. RTW was a significant predictor of lower odds of improvement in general health and pain between 1 and 5 years. This emphasizes the need for continued follow-up and support to ensure a balance between work and health for RTW individuals after stroke. Globally, stroke is the second largest cause of death and the second most common cause of disability 1. Although the total incidence of stroke is decreasing in most parts of the world, the number of disability adjusted life years is increasing 1 , as is the incidence of stroke in the working age population (20-64 years old) 2. Consequences of stroke, in addition to physical and cognitive impairment, include depression 3 and pain 4. The prevalence varies, but it has been estimated that approximately 1 of 3 suffers from depression 3 and up to half of the people have pain post-stroke 4. Ten years post-stroke, pain and psychological problems are two of the symptoms still experienced by a substantial proportion of people with stroke 5. Hypothetical recovery trajectories after stroke show a fast recovery during the first weeks and plateaus after approximately 6 months. After the initial 6 months the patterns are heterogeneous, with some people declining and some continuing to improve 6. In line with this, improvements in activities of daily living the first year poststroke has been reported, but between 1 and 3 years post-stroke there seems to be a small decline 7. Participants in another study reported less self-efficacy, less optimism and less proactive coping 2 years post-stroke compared with 2 months post-stroke 8. A decline in several self-reported functional aspects such as strength, activities of daily living, and mobility between 1 and 6 years post-stroke has also been reported 9. Absence from work due to sickness could have an effect on the individual's life situation as a whole. In addition to its impact on the financial situation, being on long-term sick leave is detrimental to psychological well-being and sleep 10 , and is even a risk factor for developing stroke 11. Working seems to...

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Section: Discussionmentioning

confidence: 99%

Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

Westerlind

Persson

Palstam

et al. 2020

Sci Rep

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show abstract

“…Previous studies have shown that many stroke survivors experience long-lasting reductions in their ability to work and earn income (11,29,30). One of the most consistent predictors of stroke survivors return to work is stroke severity (31,32). Stroke survivors with higher SES are more likely to return to work after the stroke event (29,30).…”

Section: Discussionmentioning

confidence: 99%

Employment transitions for spouses of stroke survivors: Evidence from Swedish national registries

Persson

Hensing

2020

Preprint

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Background: The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses’ employment transition probabilities. Thus, the aim of this study was to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses. The aim was also to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect. Method: Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1,818 spouses of first ever stroke survivors during 2010 and 2011, and 7,399 matched controls that were employed or unemployed during five years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset.Results: Employed spouses prior stroke onset reduced their employment by -1.3 percentage points (95% CI: -2.4, -0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset. Conclusion: The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.

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“…Previous studies have shown that many stroke survivors experience long-lasting reductions in their ability to work and earn income [12,30,31]. One of the most consistent predictors of stroke survivors return to work is stroke severity [32,33]. Stroke survivors with higher SES are more likely to return to work after the stroke event [30,31].…”

Section: Discussionmentioning

confidence: 99%

Employment transitions for spouses of stroke survivors: evidence from Swedish national registries

2020

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Background The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses’ employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect. Method Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1818 spouses of first ever stroke survivors during 2010 and 2011, and 7399 matched controls that were employed or unemployed during 5 years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset. Results Employed spouses prior stroke onset reduced their employment by − 1.3 percentage points (95% CI, − 2.4, − 0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset. Conclusion The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.

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Return to Work Among Stroke Survivors

Cited by 41 publications

References 23 publications

Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

Employment transitions for spouses of stroke survivors: Evidence from Swedish national registries

Employment transitions for spouses of stroke survivors: evidence from Swedish national registries

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