title: Return to Work 2-5 Years After Stroke: A Cross Sectional Study in a Hospital-Based Population.
abstract: Purpose To describe factors associated with RTW in patients 2-5 years after stroke. Methods Cross sectional study, including patients 2-5 years after hospitalization for a first-ever stroke, who were <65 years and had been gainfully employed before stroke. Patients completed a set of questionnaires on working status and educational level, physical functioning (Frenchay Activities Index, FAI), mental functioning (Hospital Anxiety and Depression Scale, HADS), Coping Orientations to Problems Experienced, (COPE easy) and quality of life (Short-Form(SF)-36 and EQ(Euroqol)-5D). Caregivers completed the Caregiver Strain Index (CSI). Baseline stroke characteristics were gathered retrospectively. Baseline characteristics and current health status were compared between patients who did and did not RTW by means of logistic regression analysis with odds ratios (OR) and 95 % confidence intervals (CI), adjusted for age and gender. Results Forty-six patients were included, mean age of 47.7 years (SD 9.7), mean time since stroke of 36 months (SD 11.4); 18 (39 %) had RTW. After adjusting for age and gender a shorter length of hospitalization was associated with RTW (OR 0.87; CI 0.77-0.99). Of the current health status, a lower HADS depression score (0.76; 0.63-0.92), a less avoidant coping style (1.99; 0.80-5.00), better scores on the FAI (1.13; 1.03-1.25), the mental component summary score of the SF36 (1.07; 1.01-1.13), the EQ5D (349; 3.33-36687) and the CSI (0.68; 0.50-0.92) were associated with the chance of RTW. Conclusions A minority of working patients RTW after stroke; a shorter duration of the initial hospitalization was associated with a favorable work outcome. The significant association between work status and activities, mental aspects and quality of life underlines the need to develop effective interventions supporting RTW.
authors.affiliation: Sophia Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, The Netherlands. h.arwert@sophiarevalidatie.nl.|MC Haaglanden, The Hague, The Netherlands. h.arwert@sophiarevalidatie.nl.
authors.forename: H J
authors.identifier: 0000-0002-0594-6474
authors.initials: HJ
authors.lastname: Arwert
authors.affiliation: Sophia Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Schults
authors.affiliation: Sophia Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, The Netherlands.
authors.forename: J J L
authors.initials: JJL
authors.lastname: Meesters
authors.affiliation: Department of Medical Statistics, Leiden University Hospital, Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Wolterbeek
authors.affiliation: MC Haaglanden, The Hague, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Boiten
authors.affiliation: Sophia Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, The Netherlands.|Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Hospital, Leiden, The Netherlands.|Rijnlands Rehabilitation Center, Leiden, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Vliet Vlieland
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000150:complications; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D062707:Return to Work / Q000523:psychology* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Disability evaluation; Outcome assessment; Return to work; Social participation; Socioeconomic factors; Stroke