“I’ve still got a job to go back to”: the importance of early vocational rehabilitation after stroke

Abstract

Purpose

Returning to work is an important goal after stroke, not only as a recovery indicator but also for facilitating independent living and improved social identity. The aim of this study was to explore the lived experiences of vocational rehabilitation and the return to work pathway after stroke.

Method

Qualitative data were collected through semi-structured interviews with purposively selected participants who had participated in a vocational rehabilitation trial. All participants were employed at the time of their stroke and were community-living. Interviews were undertaken by occupational therapists and were transcribed verbatim before data were thematically analysed using a framework approach.

Results

Sixteen participants were interviewed, seven received specialist vocational rehabilitation and nine received usual clinical rehabilitation. Three major themes were identified which highlighted the importance of tailored vocational rehabilitation to address the challenges that arise when returning to the workplace. Stroke survivors perceived the most beneficial components of the specialist vocational rehabilitation intervention to be employer liaison support, fatigue management, and support for cognition and executive processing skills.

Conclusions

Vocational rehabilitation was perceived to provide an opportunity to influence working after stroke, although areas of unmet need were highlighted. Findings provide direction for the development of future stroke-specific vocational rehabilitation programs.

IMPLICATIONS FOR REHABILITATION

• Psychosocial (emotional) and cognitive (memory and planning) changes along with post-stroke fatigue were perceived to be the greatest barriers faced on returning to work and should be key areas for intervention within a vocational rehabilitation program.

• Vocational rehabilitation interventions should be tailored to each participant, incorporating elements perceived to be important to stroke survivors, including workplace liaison, employer communication and psychological support.

• Workplaces may benefit from access to information about the range of physical, cognitive and language deficits associated with stroke, and the potential impact these may have on work skills.

Keywords:

• Stroke
• rehabilitation
• vocational rehabilitation
• return to work
• qualitative research
• occupational therapy

Acknowledgments

We acknowledge the Brain Recovery and Rehabilitation Stakeholder Advisory Group who improved the quality of research and ensured its conduct was more responsive to, and reflective of, the needs and experiences of working age Australians with stroke. We would also like to express our appreciation to the participants and to thank the investigators and participating trial sites.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by a Medical Research Future Fund/Stroke Foundation Initiative Return to Life Return to Work grant. SOK is supported by an Australian Government Research Training Program Scholarship. NAL received support from the Heart Foundation of Australia (Future Leader Fellowship GNT102055).