Patient's perceived factors that influence return to work after stroke

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg, 2012Introduction: Stroke continues to be a major public health problem for both the developed and developing world despite the various advances in health care. The economic burden of stroke is ever increasing and in light of this, return to work post-stroke is becoming an important area of research for therapists. Thus the main aims of the study were to establish the rate of return to work of patients following stroke and to establish the patients’ perceived factors which influence their return to work after stroke. Method This was a quantitative cross sectional study. A sample of convenience of ninety seven participants were selected from a list of patients obtained from various rehabilitation units and government clinics within the Gauteng province. A self-designed questionnaire was used. A pilot study was conducted to determine the questionnaire’s reliability and validity, and the validity, inter-rater and intra-rater reliability were all found to be satisfactory. The participants were contacted and interviewed at their homes or a location suitable for them using a self-designed questionnaire. The percentage of patients that returned to work was determined and reasons for returning or not returning to work were summarised using frequencies and percentages. A univariate and then multivariate analysis was performed to establish perceived factors which had an influence on return to work Results The study sample had more males than females with an overall mean age of 51years. They were mostly black and between 18 months and 24 months post-stroke. The most common co-morbidities were fatigue and hypertension. There was a 34% return to work rate, with 3% stopping work after a period of time, leaving 31% of the sample working at the time of interview. The most common reasons for returning to work were financial (77%), enjoyment of work (77%) and personal development (73%). For those who did not return to v work the two most common reasons were upper limb dysfunction (61%) and walking difficulties (53%). The main factors that decreased likelihood of return to work included depression and not paying life insurance or monthly car repayments. Conclusion The return to work rate following stroke in this study group is in line with other countries around the world, although it is still relatively low with less than a third of patients with stroke returning to work. Enjoyment of work was shown to be as important a motivating factor for return to work as finances, and physical fallout was the most demotivating factor. Depression was the most likely factor to decrease return to work