Return to work after stroke: The KOSCO Study

Chang, Won Hyuk; Sohn, Min Kyun; Lee, Jongmin; Kim, Deog Young; Lee, Sam-Gyu; Shin, Yong‐Il; Oh, Gyung-Jae; Lee, Yang-Soo; Joo, Min Cheol; Han, Eun Young; Kim, Jeong Hyun; Kim, Yun-Hee

doi:10.2340/16501977-2053

Cited by 45 publications

(42 citation statements)

References 15 publications

(18 reference statements)

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“…The association between high scores and RTW could mean that people who RTW experience a higher health-related quality of life, but also that less problems in the domains that EQ-5D measure could facilitate RTW. Previous research supports a higher health-related quality of life in the RTW group [9, 41], which emphasizes the importance of optimizing the system of support people RTW.…”

Section: Discussionmentioning

confidence: 88%

“…A relatively modest number of possible predictors for RTW were used, resulting in the risk of important predictors and confounders being neglected. For instance, the type of occupation, educational level and comorbidity have shown to be significant factors in previous research [41–43] but have not been considered here. Furthermore, the relatively large CI could indicate that there is relatively small number of participants in each subgroup, which results in an uncertainty regarding the exact OR/HR.…”

Section: Discussionmentioning

confidence: 99%

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

2017

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ObjectivesStroke is one of the most common and resource intensive diseases for society. Stroke in the working age population is increasing in different parts of the world. An incomplete return to work (RTW) after sick leave post stroke entails negative consequences for the affected person and an economical burden for society. The aim of this study was to explore the RTW rate and factors associated with RTW in a six-year follow up post stroke.MethodsData from 174 persons 63 years or younger, with first ever stroke in 2009–2010 in Gothenburg were analyzed. Baseline characteristics were collected through medical records and the Swedish Health Insurance Office provided information on sick leave up to 6 years post stroke. Time-to-event was presented and cox regression as well as logistic regression were used to analyze risk factors for no-RTW.ResultsThe RTW rate was 74.7%, at the end of follow up. Participants continued to RTW until just over 3 years post stroke. Dependency at discharge (in the modified Rankin Scale) and sick leave prior to the stroke were significant risk factors for no-RTW after 1 year with odds ratio 4.595 and 3.585, respectively. The same factors were significant in time-to-event within six years post stroke with hazard ratio 2.651 and 1.929, respectively.ConclusionsRTW after a stroke is incomplete, however RTW is possible over a longer period of time than previously thought. More severe disability at discharge from hospital and sick leave prior to the stroke were shown to be risk factors for no-RTW. This knowledge can contribute to more individualized vocational rehabilitation.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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

2017

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“…However, most cross-sectional or cohort studies did not confirm a relationship between the presence of spouses, family or friends and reengagement in valued activities. 33,34,38,39,45,46,64–66 Sometimes, their presence was even found to worsen reengagement. 67 For a detailed description of the similarities and inconsistencies between findings and related levels of evidence, see Supplementary Table IV, last column; ‘synthesis’.…”

Section: Resultsmentioning

confidence: 99%

“…24,49,65,66,75–86 Some single remaining studies on activities such as eating, exercise or leisure 30,31,87–90 did not fit this format. In all the types of valued activities social support was identified as a facilitator to reengagement.…”

Section: Resultsmentioning

confidence: 99%

What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings

et al. 2016

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Objective:Identify the environmental factors that influence stroke-survivors’ reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types.Data sources:PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments.Review methods:An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence.Results:The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others’ negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others’ attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively.Conclusion:A diversity of environmental factors was related to stroke-survivors’ reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.

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“…The KOSCO study from Korea reported that 60% returned to work at 6 months in a population of stroke victims with minor disabilities (Chang et al., 2016). Bonner et al.…”

Section: Discussionmentioning

confidence: 99%

Return to work after specialized rehabilitation—An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries

et al. 2018

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IntroductionStroke may impose disabilities with severe consequences for the individual, with physical, psychological, social, and work‐related consequences. The objective with the current study was to investigate to what extent persons with stroke were able to return to work, to maintain their financial situation, and to describe the follow‐up services and participation in social networks and recreational activities.MethodsThe design was a prospective, descriptive study of specialized stroke rehabilitation in nine rehabilitation centers in seven countries. Semistructured interviews, which focused on the return to work, the financial situation, follow‐up services, the maintenance of recreational activities, and networks, were performed 6 and 12 months post discharge from rehabilitation.ResultsThe working rate before the onset of stroke ranged from 27% to 86%. At 12 months post stroke, the return to work varied from 11% to 43%. Consequently, many reported a reduced financial situation from 10% to 70% at 6 months and from 10% to 80% at 12 months. Access to postrehabilitation follow‐up services varied in the different countries from 24% to 100% at 6 months and from 21% to 100% at 12 months. Physical therapy was the most common follow‐up services reported. Persons with stroke were less active in recreational activities and experienced reduced social networks. Associations between results from the semistructured interviews and related themes in LiSat‐11 were small to moderate. The study shows that education, age, and disability are predictors for return to work. Differences between countries were observed in the extent of unemployment.ConclusionsIn this international multicentre study, return to work after severe stroke and specialized/comprehensive rehabilitation was possible, depending on the extent of the disability, age, and education. Altered financial situation, reduced social networks, and reduced satisfaction with life were common psychosocial situations for these patients.

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Return to work after stroke: The KOSCO Study

Cited by 45 publications

References 15 publications

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

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

What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings

Return to work after specialized rehabilitation—An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries

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