Self-rated health and return to work after first-time stroke

Abstract

Objective: Self-rated health is an essential aspect of life after stroke, and return to work is considered one of the most important outcomes for younger stroke patients. The aim of this study was to examine whether self-rated health 3 months after stroke, clinical and demographic determinants are independently associated with return to work and subsequent work-stability. Material and methods: A total of 590 patients with firsttime stroke were included from a Danish population-based cohort study. All patients were younger than 60 years and working or unemployed at the time of stroke. Information on self-rated health (Short Form 12; SF-12) was collected from questionnaires 3 months after stroke. Employment status was defined on a weekly basis using national registerdata on transfer payments. Results: Fifty percent were self-supporting or job-seeking 12 months after stroke, and the same proportion was found after 24 months. More than 70% of the patients who returned to work did not receive sickness benefits in the 12 months following return to work. Good self-rated health 3 months after stroke and minor stroke severity were strongly associated with return to work after 12 and 24 months. Conclusion: Self-rated health 3 months after stroke was strongly associated with return to work and work-stability after stroke.

Return to Work after a Stroke in Working Age Persons; A Six-Year Follow Up

“…Even though the system of entering early retirement instead of sick leave after a long-term absence from work might reduce the RTW rate in Sweden, the system of giving wage subsides to employers for hiring persons with a disability could possibly contribute to a higher RTW rate. In the current study, the RTW rate at one year was 48.3%, compared with 75% in an Australian study [13], 50% in a Danish study [16], 62.4% in a Japanese study [29] and 35% in a study conducted in the UK [30]. Three different reviews with varying follow up time, mostly shorter than six years, additionally present substantially lower RTW rate than in the current study [31–33].…”

“…In the current study participants continued to RTW even up to three years post stroke, not shown previously with shorter follow-up time [13, 16]. The finding is important not only for patients but also for governments when creating policies regarding this major health and economic issue.…”

“…Stroke sequele might be difficult to combine with work even in the long term after RTW. In a Danish two year follow up study, about 30% did make the transition from working to sick leave within one year after initial RTW post stroke [16]. A suggestion for further research is to investigate work stability after a stroke in the long-term perspective.…”

“…All the above studies used self-reported RTW as the outcome. A Danish study published in 2016 showed that 50% had left the workforce permanently or were still on sick-leave one year after stroke [16]. Self-rated health was strongly associated with RTW and those who had a mild or moderate stroke were significantly more likely to RTW than those with a severe stroke [16].…”

Work‐related predictors for return to work after stroke

“…6 Predictors for no RTW have been reported to be physical dependency at discharge, higher degree of residual disability, 11 sick leave prior to stroke, 9 unemployment prior to stroke, 12 low socio-economic status, 8 being an immigrant, 12 comorbidities, 12 older age 7 and being female. 6 Predictors for no RTW have been reported to be physical dependency at discharge, higher degree of residual disability, 11 sick leave prior to stroke, 9 unemployment prior to stroke, 12 low socio-economic status, 8 being an immigrant, 12 comorbidities, 12 older age 7 and being female.…”