Skip to main content
Top
Published in: Journal of Occupational Rehabilitation 3/2013

Open Access 01-09-2013

Returning to Work After Stroke: Perspectives of Employer Stakeholders, a Qualitative Study

Authors: Carol Coole, Kathryn Radford, Mary Grant, Jane Terry

Published in: Journal of Occupational Rehabilitation | Issue 3/2013

Login to get access

Abstract

Purpose More than 40 % of working age adults with stroke fail to return to work. The work context is a key factor in return to work, but little is known about the experiences of employers in supporting employees with stroke. The aim of this study was to explore return to work after stroke from the employer perspective, to identify key features associated with success and to seek participants’ views regarding the role of healthcare in return to work. Methods Data was gathered through 18 semi-structured interviews with employer stakeholders and included small business owners, line managers, human resources and occupational health staff. Data was analysed thematically. Results The main themes identified were: the impact of stroke on the employer, characteristics of the employee, communication, knowledge and information, experience of other stakeholders, integrating healthcare in return to work. Conclusion Employers face complex emotional and practical issues when helping an employee return to work after stroke, for which many lack knowledge and experience. The range and quality of support networks that they access is variable and advice and support from clinicians is welcomed. Further research is necessary to investigate how such support could be funded and integrated within existing service provision.
Literature
1.
go back to reference Daniel K, Wolfe CD, Busch MA, McKevitt C. What are the social consequences of stroke for working-aged adults? A Systematic Review. Stroke. 2009;40(6):e431–40.PubMedCrossRef Daniel K, Wolfe CD, Busch MA, McKevitt C. What are the social consequences of stroke for working-aged adults? A Systematic Review. Stroke. 2009;40(6):e431–40.PubMedCrossRef
2.
3.
go back to reference Treger I, Shames J, Giaquinto S, Ring H. Return to work in stroke patients. Disabil Rehabil. 2007;29(17):1397–403.PubMedCrossRef Treger I, Shames J, Giaquinto S, Ring H. Return to work in stroke patients. Disabil Rehabil. 2007;29(17):1397–403.PubMedCrossRef
4.
go back to reference Saeki S, Toyonaga T. Determinants of early return to work after first stroke in Japan. J Rehabil Med. 2010;42:254–8.PubMedCrossRef Saeki S, Toyonaga T. Determinants of early return to work after first stroke in Japan. J Rehabil Med. 2010;42:254–8.PubMedCrossRef
5.
go back to reference Lindstrom B, Roding J, Sundelin G. Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke: a national survey. J Rehabil Med. 2009;41:714–8.PubMedCrossRef Lindstrom B, Roding J, Sundelin G. Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke: a national survey. J Rehabil Med. 2009;41:714–8.PubMedCrossRef
6.
go back to reference Vestling M, Tufvesson B, Iwarsson S. Indicators for return to work after stroke and the importance of work for subjective well-being and life satisfaction. J Rehabil Med. 2003;35:127–31.PubMedCrossRef Vestling M, Tufvesson B, Iwarsson S. Indicators for return to work after stroke and the importance of work for subjective well-being and life satisfaction. J Rehabil Med. 2003;35:127–31.PubMedCrossRef
7.
go back to reference Waddell G, Burton AK, Kendall N. Vocational rehabilitation: what works for whom and when? London: TSO; 2008. Waddell G, Burton AK, Kendall N. Vocational rehabilitation: what works for whom and when? London: TSO; 2008.
8.
go back to reference Frank AO, Thurgood J. Vocational rehabilitation in the UK: opportunities for health-care professionals. Int J Therapy Rehabil. 2006;13(3):126–34. Frank AO, Thurgood J. Vocational rehabilitation in the UK: opportunities for health-care professionals. Int J Therapy Rehabil. 2006;13(3):126–34.
9.
go back to reference Playford ED, Radford K, Burton C, Gibson A, Jellie B, Sweetland J, Watkins C. Mapping Vocational Rehabilitation Services for people with Long term neurological conditions: Summary report. Department of Health. March 2011. Available from: http://www.ltnc.org.uk Accessed 9 July 2012. Playford ED, Radford K, Burton C, Gibson A, Jellie B, Sweetland J, Watkins C. Mapping Vocational Rehabilitation Services for people with Long term neurological conditions: Summary report. Department of Health. March 2011. Available from: http://​www.​ltnc.​org.​uk Accessed 9 July 2012.
10.
go back to reference Tyerman A, Meehan MJ, editors. Vocational assessment and rehabilitation after acquired brain injury: inter-agency guidelines. London: British Society of Rehabilitation Medicine/Royal College of Physicians; 2004. Tyerman A, Meehan MJ, editors. Vocational assessment and rehabilitation after acquired brain injury: inter-agency guidelines. London: British Society of Rehabilitation Medicine/Royal College of Physicians; 2004.
11.
go back to reference National Clinical Guidelines for Stroke. 3rd ed. Intercollegiate stroke working party. London: Royal College of Physicians of London; 2008. National Clinical Guidelines for Stroke. 3rd ed. Intercollegiate stroke working party. London: Royal College of Physicians of London; 2008.
12.
go back to reference Department of Health. National stroke strategy. London: UK; 2007. Department of Health. National stroke strategy. London: UK; 2007.
14.
go back to reference Department of Health. The NHS outcomes framework 2011/12, London; 2010. Department of Health. The NHS outcomes framework 2011/12, London; 2010.
15.
go back to reference Deshpande P, Turner-Stokes L. Survey of vocational rehabilitation services available to people with acquired brain injury in the UK. In: Tyerman A, Meehan MJ, editors. Vocational assessment and rehabilitation after acquired brain injury: Inter-agency guidelines. 2004. Deshpande P, Turner-Stokes L. Survey of vocational rehabilitation services available to people with acquired brain injury in the UK. In: Tyerman A, Meehan MJ, editors. Vocational assessment and rehabilitation after acquired brain injury: Inter-agency guidelines. 2004.
17.
go back to reference Radford KA, Grant MI, Terry J, Marr L, Brain N. Developing stroke specific vocational rehabilitation: mapping current service provision. Int J Stroke. 2011;6(Suppl 2):49. Radford KA, Grant MI, Terry J, Marr L, Brain N. Developing stroke specific vocational rehabilitation: mapping current service provision. Int J Stroke. 2011;6(Suppl 2):49.
18.
go back to reference Black C, Frost D. Health at work: an independent review of sickness absence. London: TSO; 2011. Black C, Frost D. Health at work: an independent review of sickness absence. London: TSO; 2011.
19.
go back to reference Department for Work and Pensions. Building capacity for work, A UK framework for vocational rehabilitation, London UK; 2004. Department for Work and Pensions. Building capacity for work, A UK framework for vocational rehabilitation, London UK; 2004.
20.
go back to reference Glozier N, Hackett ML, Parag V, Anderson CS. The influence of psychiatric morbidity on return to paid work after stroke in younger adults: the Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003. Stroke. 2008;39:1526–32.PubMedCrossRef Glozier N, Hackett ML, Parag V, Anderson CS. The influence of psychiatric morbidity on return to paid work after stroke in younger adults: the Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003. Stroke. 2008;39:1526–32.PubMedCrossRef
21.
go back to reference Lock S, Jordan L, Bryan K, Maxim J. Work after stroke: focusing on barriers and enablers. Disabil Soc. 2005;20(1):33–47.CrossRef Lock S, Jordan L, Bryan K, Maxim J. Work after stroke: focusing on barriers and enablers. Disabil Soc. 2005;20(1):33–47.CrossRef
22.
go back to reference Alaszewski A, Alaszewski H, Potter J, Penhale B. Working after a stroke: survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disabil Rehabil. 2007;29(24):1858–69.PubMedCrossRef Alaszewski A, Alaszewski H, Potter J, Penhale B. Working after a stroke: survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disabil Rehabil. 2007;29(24):1858–69.PubMedCrossRef
23.
go back to reference Holmgren K, Ivanoff SD. Supervisors’ views on employer responsibility in the return to work process. A focus group study. J Occup Rehabil. 2007;17:93–106.PubMedCrossRef Holmgren K, Ivanoff SD. Supervisors’ views on employer responsibility in the return to work process. A focus group study. J Occup Rehabil. 2007;17:93–106.PubMedCrossRef
24.
go back to reference Munir F, Yarker J, Hicks B, Donaldson-Fielder E. Returning employees back to work: developing a measure for supervisors to support return to work. J Occup Rehab. 2012;22:196–208.CrossRef Munir F, Yarker J, Hicks B, Donaldson-Fielder E. Returning employees back to work: developing a measure for supervisors to support return to work. J Occup Rehab. 2012;22:196–208.CrossRef
25.
go back to reference Culler KH, Wang Y-C, Byers K, Trierweiler R. Barriers and facilitators of return to work for individuals with strokes: perspectives of the stroke survivor, vocational specialist, and employer. Top Stroke Rehabil. 2011;18(4):325–40.PubMedCrossRef Culler KH, Wang Y-C, Byers K, Trierweiler R. Barriers and facilitators of return to work for individuals with strokes: perspectives of the stroke survivor, vocational specialist, and employer. Top Stroke Rehabil. 2011;18(4):325–40.PubMedCrossRef
26.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
27.
go back to reference Fylan B, Fylan F, Caveney L. An evaluation of the Statement of Fitness for Work: qualitative work with GPs. Department for Work and Pensions Research Report 780; 2011. Fylan B, Fylan F, Caveney L. An evaluation of the Statement of Fitness for Work: qualitative work with GPs. Department for Work and Pensions Research Report 780; 2011.
28.
29.
go back to reference de Vries G, Koeter MWJ, Nabitz U, Hees HL, Schene AH. Return to work after sick leave due to depression; a conceptual analysis based on perspectives of patients, supervisors and occupational physicians. J Affect Disord. 2011;136(3):1017–26.PubMedCrossRef de Vries G, Koeter MWJ, Nabitz U, Hees HL, Schene AH. Return to work after sick leave due to depression; a conceptual analysis based on perspectives of patients, supervisors and occupational physicians. J Affect Disord. 2011;136(3):1017–26.PubMedCrossRef
30.
go back to reference Lemieux P, Durand M-J, Hong QN. Supervisors’ perception of the factors influencing the return to work of workers with common mental disorders. J Occup Rehabil. 2011;21:293–303.PubMedCrossRef Lemieux P, Durand M-J, Hong QN. Supervisors’ perception of the factors influencing the return to work of workers with common mental disorders. J Occup Rehabil. 2011;21:293–303.PubMedCrossRef
31.
go back to reference Haafkens JA, Kopnina H, Meerman MGM, van Dijk FJH. Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers. BMC Health Serv Res. 2011;11:104.PubMedCrossRef Haafkens JA, Kopnina H, Meerman MGM, van Dijk FJH. Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers. BMC Health Serv Res. 2011;11:104.PubMedCrossRef
32.
go back to reference Cunningham I, James P, Dibben P. Bridging the gap between rhetoric and reality: line managers and the protection of job security for ill workers in the modern workplace. Br J Manage. 2004;15:273–90.CrossRef Cunningham I, James P, Dibben P. Bridging the gap between rhetoric and reality: line managers and the protection of job security for ill workers in the modern workplace. Br J Manage. 2004;15:273–90.CrossRef
33.
go back to reference Amir Z, Wynn P, Chan F, Strauser D, Whitaker S, Luker K. Return to work after cancer in the UK: attitudes and experiences of line managers. J Occup Rehabil. 2010;20:435–42.PubMedCrossRef Amir Z, Wynn P, Chan F, Strauser D, Whitaker S, Luker K. Return to work after cancer in the UK: attitudes and experiences of line managers. J Occup Rehabil. 2010;20:435–42.PubMedCrossRef
34.
go back to reference Cohen CA, Colantonio A, Vernich L. Positive aspects of caregiving: rounding out the caregiver experience. Int J Geriat Psychiatr. 2002;17(2):184–8.CrossRef Cohen CA, Colantonio A, Vernich L. Positive aspects of caregiving: rounding out the caregiver experience. Int J Geriat Psychiatr. 2002;17(2):184–8.CrossRef
35.
go back to reference Park CH, Shin DW, Choi JY, Kang J, Baek YJ, Mo HN, Lee MS, Park SJ, Park SM, Park S. Determinants of the burden and positivity of family caregivers of terminally ill cancer patients in Korea. Psychooncology. 2012;21(3):282–90.PubMedCrossRef Park CH, Shin DW, Choi JY, Kang J, Baek YJ, Mo HN, Lee MS, Park SJ, Park SM, Park S. Determinants of the burden and positivity of family caregivers of terminally ill cancer patients in Korea. Psychooncology. 2012;21(3):282–90.PubMedCrossRef
36.
go back to reference Department for Work and Pensions, Department of Health, Health & Safety Executive. Health work and well-being strategy, London UK; 2008. Department for Work and Pensions, Department of Health, Health & Safety Executive. Health work and well-being strategy, London UK; 2008.
37.
go back to reference Carbonneau H, Caron C, Desrosiers J. Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia. 2010;9(3):327–353.CrossRef Carbonneau H, Caron C, Desrosiers J. Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia. 2010;9(3):327–353.CrossRef
38.
go back to reference Improving Work & Health, Changing Lives. The government’s response to Dame Carol Black’s review of the health of Britain’s working age population. London: TSO; 2008. Improving Work & Health, Changing Lives. The government’s response to Dame Carol Black’s review of the health of Britain’s working age population. London: TSO; 2008.
39.
go back to reference Gard G, Larsson A. How can cooperation between rehabilitation professionals in rehabilitation planning be improved? A qualitative study from the employer’s perspective. Work. 2006;26(2):191–6.PubMed Gard G, Larsson A. How can cooperation between rehabilitation professionals in rehabilitation planning be improved? A qualitative study from the employer’s perspective. Work. 2006;26(2):191–6.PubMed
40.
go back to reference Sawney P, Challenor J. Poor communication between health professionals is a barrier to rehabilitation. Occup Med. 2003;53:246–8.CrossRef Sawney P, Challenor J. Poor communication between health professionals is a barrier to rehabilitation. Occup Med. 2003;53:246–8.CrossRef
41.
go back to reference Doucet T, Muller F, Verdun-Esquer C, Debelleix X, Brochard P. Returning to work after a stroke: a retrospective study at the physical and rehabilitation medicine centre “La Tour de Gassies”. Ann Phys Rehabil Med. 2012;55(12):112–27.PubMedCrossRef Doucet T, Muller F, Verdun-Esquer C, Debelleix X, Brochard P. Returning to work after a stroke: a retrospective study at the physical and rehabilitation medicine centre “La Tour de Gassies”. Ann Phys Rehabil Med. 2012;55(12):112–27.PubMedCrossRef
42.
go back to reference Hussey L, Turner S, Thorley K, McNamee R, Agius R. Comparison of work-related ill health reporting by occupational physicians and general practitioners. Occup Med. 2010;60:294–300.CrossRef Hussey L, Turner S, Thorley K, McNamee R, Agius R. Comparison of work-related ill health reporting by occupational physicians and general practitioners. Occup Med. 2010;60:294–300.CrossRef
43.
go back to reference Sinclair A, Martin R, Tyers C. Occupational Health advice lines: final evaluation. Research Report 793. Department for Work and Pensions; 2012. Sinclair A, Martin R, Tyers C. Occupational Health advice lines: final evaluation. Research Report 793. Department for Work and Pensions; 2012.
44.
go back to reference Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035.PubMedCrossRef Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035.PubMedCrossRef
45.
go back to reference Will MC. Let us pause and reflect: but not too long. Except Child. 1984;51(1):11–6.PubMed Will MC. Let us pause and reflect: but not too long. Except Child. 1984;51(1):11–6.PubMed
46.
go back to reference Bond GR, Drake RE, Becker DR. An update on randomized controlled trials of evidence-based supported employment. Psych Rehab J. 2008;31(4):280–90.CrossRef Bond GR, Drake RE, Becker DR. An update on randomized controlled trials of evidence-based supported employment. Psych Rehab J. 2008;31(4):280–90.CrossRef
47.
go back to reference Wehman P, Kregel J, Keyser-Marcus L, Sherron-Targett P, Campbell L, West M, Cifu DX. Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency. Arch Phys Med Rehabil. 2003;84(2):192–6.PubMedCrossRef Wehman P, Kregel J, Keyser-Marcus L, Sherron-Targett P, Campbell L, West M, Cifu DX. Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency. Arch Phys Med Rehabil. 2003;84(2):192–6.PubMedCrossRef
48.
go back to reference Fadyl JK, McPherson KM. Approaches to vocational rehabilitation after traumatic brain injury: a review of the evidence. J Head Trauma Rehabil. 2009;24(3):195–212.PubMedCrossRef Fadyl JK, McPherson KM. Approaches to vocational rehabilitation after traumatic brain injury: a review of the evidence. J Head Trauma Rehabil. 2009;24(3):195–212.PubMedCrossRef
49.
go back to reference Hart T, Dijkers M, Fraser R, Cicerone K, Bogner JA, Whyte J, Malec J, Waldron B. Vocational services for traumatic brain injury: treatment definition and diversity within model systems of care. J Head Trauma Rehabil. 2006;21(6):467–82.PubMedCrossRef Hart T, Dijkers M, Fraser R, Cicerone K, Bogner JA, Whyte J, Malec J, Waldron B. Vocational services for traumatic brain injury: treatment definition and diversity within model systems of care. J Head Trauma Rehabil. 2006;21(6):467–82.PubMedCrossRef
50.
go back to reference Soklaridis S, Ammendolia C, Cassidy D. Looking upstream to understand low back pain and return to work: psychosocial factors as the product of system issues. Soc Sci Med. 2010;71(9):1557–66.PubMedCrossRef Soklaridis S, Ammendolia C, Cassidy D. Looking upstream to understand low back pain and return to work: psychosocial factors as the product of system issues. Soc Sci Med. 2010;71(9):1557–66.PubMedCrossRef
Metadata
Title
Returning to Work After Stroke: Perspectives of Employer Stakeholders, a Qualitative Study
Authors
Carol Coole
Kathryn Radford
Mary Grant
Jane Terry
Publication date
01-09-2013
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 3/2013
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-012-9401-1

Other articles of this Issue 3/2013

Journal of Occupational Rehabilitation 3/2013 Go to the issue