Predictors of return to work after stroke: a prospective, observational cohort study with 6 months follow-up

Nascimento, Lucas Rodrigues; Scianni, Aline Alvim; Ada, Louise; Fantauzzi, Marcela O; Hirochi, Tânia Lúcia; Teixeira-Salmela, Luci Fuscaldi

doi:10.1080/09638288.2019.1631396

Cited by 16 publications

(18 citation statements)

References 20 publications

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“…Both were found to decrease after RTW in a statistically significant manner, dropping by 64% (job involvement) and 59% (job satisfaction). The unique study with a Latin American sample [ 30 ] showed that 44% of the participants returned to paid work during the first six months, while among those with severe consequences from the disease, only 32% returned to work later. Detrimental consequences on financial security and the number of paid hours were also reported.…”

Section: Resultsmentioning

confidence: 99%

“…In light of the above, return to work after the sick leave has gradually attracted an increasing amount of attention in the international literature [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. There is currently great interest in understanding the work environment resources which facilitate or hinder the success of these professional transitions since they represent potentially challenging periods in workers’ careers.…”

Section: Introductionmentioning

confidence: 99%

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Well-Being at Work after Return to Work (RTW): A Systematic Review

Figueredo

García-Ael

Gragnano

et al. 2020

IJERPH

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Background: Employees’ well-being at work after the return to work (RTW) is considered a key aspect of rehabilitation and maintenance of workability. This systematic review aimed at identifying the common psychosocial factors that predict the subjective and psychological well-being in RTW processes after having a long-standing health problem or disability. Objective: To evaluate the subjective and psychological well-being at work of employees with chronic or long-standing health problems or those returning to work after any cause of disability. Data source: Systematic review of articles published in English or Spanish using PsycINFO, PsycARTICLES, MEDLINE, Psychology, and Behavioral Sciences Collection, and Pubpsych. An additional study was identified by contacting expert academics in the field. The search equations used included terms such as Return to Work, Long-Standing Health Problems or Disability, Work Health Balance, and job satisfaction or subjective well-being. Eligibility criteria for the studies: Studies that included a measure of employees’ well-being at work following return to work were selected for the review. Evaluation of the studies and synthesis methods: The studies were selected using predefined fields which included quality criteria. Results: Of the 264 articles returned by the initial search, a total of 20 were finally selected. Results were organized around the three different theoretical approaches for understanding RTW and its antecedents and consequences: (a) RTW and autonomy at work have a positive effect on psychological well-being; (b) job demand is linked to less job satisfaction, whereas a higher level on the work–health balance is associated with job satisfaction and work engagement; (c) internal and external support is linked to job satisfaction in the case of a disease. Limitations: The evidence provided by the results is restricted by the limited availability of studies focusing on well-being at work following return to work. Moreover, the studies identified are of different kinds, thereby preventing comparisons. Conclusions and implications of the main findings: Employees’ subjective well-being after return to work has received very little attention to date. Given its importance in the current configuration of the labor market, it should be the object of more research.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Well-Being at Work after Return to Work (RTW): A Systematic Review

Figueredo

García-Ael

Gragnano

et al. 2020

IJERPH

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“…Furthermore, while the majority of TBIs sustained in the United States are less severe concussive injuries, these milder events often lead to long-lasting functional impairments (Dean & Sterr, 2013). Likewise, 50-60% of patients experience lasting motor problems poststroke even with rehabilitation, and a comparable percentage require assistance with day-to-day tasks (Nascimento, 2021;Schaechter, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, while the majority of TBIs sustained in the United States are less severe concussive injuries, these milder events often lead to long‐lasting functional impairments (Dean & Sterr, 2013). Likewise, 50–60% of patients experience lasting motor problems poststroke even with rehabilitation, and a comparable percentage require assistance with day‐to‐day tasks (Nascimento, 2021; Schaechter, 2004). In addition to stroke‐related motor impairments, abnormal cognition, including attention and short‐term memory deficits, often persists poststroke and can progress for years after the initial injury (Hochstenbach et al., 2003; Jourdan et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Secondary thalamic neuroinflammation after focal cortical stroke and traumatic injury mirrors corticothalamic functional connectivity

Necula

Cho

et al. 2021

J of Comparative Neurology

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While cortical injuries, such as traumatic brain injury (TBI) and neocortical stroke, acutely disrupt the neocortex, most of their consequent disabilities reflect secondary injuries that develop over time. Thalamic neuroinflammation has been proposed to be a biomarker of cortical injury and of the long‐term cognitive and neurological deficits that follow. However, the extent to which thalamic neuroinflammation depends on the type of cortical injury or its location remains unknown. Using two mouse models of focal neocortical injury that do not directly damage subcortical structures—controlled cortical impact and photothrombotic ischemic stroke—we found that chronic neuroinflammation in the thalamic region mirrors the functional connections with the injured cortex, and that sensory corticothalamic regions may be more likely to sustain long‐term damage than nonsensory circuits. Currently, heterogeneous clinical outcomes complicate treatment. Understanding how thalamic inflammation depends on the injury site can aid in predicting features of subsequent deficits and lead to more effective, customized therapies.

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“…27 Furthermore, although standardized data collection within the registry with a focus on acute treatment parameters allowed us to analyze an extensive set of patient, stroke and treatment characteristics, it did not allow us to obtain in depth information about patient education and socioeconomic situation or job and enterprise characteristics, which have been identified to also play a role in RTW in stroke patients and might mediate the observed effect. 8,22,23 Therefore, our findings are limited, especially with regard to conclusions about adjustment of job characteristics, reduction in weekly working hours or job change after MT. Also, we did not have data available about employment status beyond the follow-up of 3 months, which could shed light on robustness of predictors over time or differentiate between relevance for early versus long-term vocational rehabilitation.…”

Section: Discussionmentioning

confidence: 86%

Sex Disparities in Re-Employment in Stroke Patients With Large Vessel Occlusion Undergoing Mechanical Thrombectomy

Hahn

Gröschel

Hayani

et al. 2022

Stroke

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BACKGROUND: Strokes in the working-age population represent a relevant share of ischemic strokes and re-employment is a major factor for well-being in these patients. Income differences by sex have been suspected a barrier for women in returning to paid work following ischemic stroke. We aim to identify predictors of (not) returning to paid work in patients with large vessel occlusion treated with mechanical thrombectomy (MT) to identify potential areas of targeted vocational rehabilitation. METHODS: From 6635 patients enrolled in the German Stroke Registry Endovascular Treatment between 2015 and 2019, data of 606 patients of the working population who survived large vessel occlusion at least 90 days past MT were compared based on employment status at day 90 follow-up. Univariate analysis, multiple logistic regression and analyses of area under the curve were performed to identify predictors of re-employment. RESULTS: We report 35.6% of patients being re-employed 3 months following MT (median age 54.0 years; 36.1% of men, 34.5% of women [ P =0.722]). We identified independent negative predictors against re-employment being female sex (odds ratio [OR], 0.427 [95% CI, 0.229–0.794]; P =0.007), higher National Institutes of Health Stroke Scale (NIHSS) score 24 hours after MT (OR, 0.775 [95% CI, 0.705–0.852]; P <0.001), large vessel occlusion due to large-artery atherosclerosis (OR, 0.558 [95% CI, 0.312–0.997]; P =0.049) and longer hospital stay (OR, 0.930 [95% CI, 0.868–0.998]; P =0.043). Positive predictors favoring re-employment were excellent functional outcome (modified Rankin Scale score of 0–1) at 90 day follow-up (OR, 11.335 [95% CI, 4.864–26.415]; P <0.001) and combined treatment with intravenous thrombolysis (OR, 1.904 [95% CI, 1.046–3.466]; P =0.035). Multiple regression modeling increased predictive power of re-employment status significantly over prediction by best single functional outcome parameter (National Institutes of Health Stroke Scale 24 hours after MT ≤5; R 2 : 0.582 versus 0.432; area under the receiver operating characteristic curve: 0.887 versus 0.835, P <0.001). CONCLUSIONS: There is more to re-employment after MT than functional outcome alone. In particular, attention should be paid to possible systemic barriers deterring women from resuming paid work. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03356392.

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Predictors of return to work after stroke: a prospective, observational cohort study with 6 months follow-up

Cited by 16 publications

References 20 publications

Well-Being at Work after Return to Work (RTW): A Systematic Review

Well-Being at Work after Return to Work (RTW): A Systematic Review

Secondary thalamic neuroinflammation after focal cortical stroke and traumatic injury mirrors corticothalamic functional connectivity

Sex Disparities in Re-Employment in Stroke Patients With Large Vessel Occlusion Undergoing Mechanical Thrombectomy

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