Date Presented 04/06/19
Work supports individual health and well-being, and loss of work often leads to lower life satisfaction. Psychosocial factors can impact an individual’s ability to work. The purpose of this scoping review is 1) to identify the psychosocial deficits that impact a stroke survivor’s ability to return to work (RTW) or maintain employment; and 2) to identify the evidence-based interventions that support stroke survivors to RTW or maintain employment.
Primary Author and Speaker: Deborah Haynes
Contributing Authors: Koob Moua, Michelle Doering, Alex Wong
PURPOSE: Work supports individual health and well-being, and loss of work often leads to lower life satisfaction (Maaijwee et al., 2014). Specifically, return to work (RTW) is perceived as an indicator of well-being (Hartke, Trierweiler, & Bode, 2011), while failure to RTW is associated with negative physical and psychological health outcomes, as well as socioeconomic risks (Harris, 2014). There are a multitude of factors which can affect an individual’s ability to work including psychosocial factors. Unfortunately, there is a gap in the research for specific psychosocial factors that impact stroke survivors at work. However, psychosocial well-being is defined for stroke survivors in 4 areas: 1) mood (joy, pleasure, well-being) with absence of sadness/emptiness, 2) participation and engagement in meaningful activities, 3) good social relations and a feeling of love in those relations, and 4) self-concept (self-valuing, self-acceptance, usefulness, and believing in your abilities) (Kirkevold, Bronken, Martinsen, & Kvigne, 2012; Kirkevold, Martinsen, Bronken, & Kvigne, 2014). The purpose of this scoping review is 1) to identify the psychosocial deficits that impact stroke survivor’s ability to return to work (RTW) and/or maintain paid employment; and 2) to identify the evidence-based interventions that support stroke survivors to RTW and/or maintain their employment.
DESIGN: A scoping review study design was used with studies as data sources.
METHOD: Following Arksey and O’Malley (2005)’s methodological framework for conducting scoping studies, we searched articles published without date restrictions through PubMed and CINAHL databases using Medical Subject Headings (MeSH) terms related to “stroke,” “work outcome” and “rehabilitation.” Two independent reviewers performed selection of articles and characterization.
RESULTS: An initial literature search obtained 194 articles. Two reviewers screened initial 23% of articles with 93% inter-rater reliability. Of 194 articles identified, 17 articles meeting the selection criteria were included for the subsequent review. Fifteen (88%) articles identified psychosocial deficits that impact stroke survivors in RTW and/or maintaining employment. Four (24%) articles identified interventions to address post-stroke deficits in RTW and/or maintaining employment. Psychosocial deficits included: depression (33%), lack of social support (27%), and lack of acceptance of disability (27%). Work interventions included: The Brain Integration Program, individualized workplace intervention, metacognitive contextual intervention, and an awareness intervention.
CONCLUSION: Many psychosocial deficits have been found to impact RTW and/or maintain employment. However, there is limited research related to interventions to address RTW and/or maintain employment for stroke survivors. Nevertheless, all interventions identified in this review supporting the amelioration of psychosocial deficits as part of their interventions with associated positive employment outcomes. Additional research is needed to develop and test interventions for successful RTW and/or maintaining employment post-stroke.
IMPACT STATEMENT: This scoping review will help increase occupational therapist's awareness of the psychosocial deficits and interventions impacting work for stroke survivors.
References
Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32.
Maaijwee, N.A., Rutten-Jacobs, L.C., Arntz, R.M., Schaapsmeerders, P., Schoonderwaldt, H.C., van Dijk, E.J., & de Leeuw, F.E. (2014). Long-term increased risk of unemployment after young stroke A long-term follow-up study. Neurology, 83(13), 1132-1138.
Hartke, R.J., Trierweiler, R., & Bode, R. (2011). Critical factors related to return to work after stroke: A qualitative study. Topics in Stroke Rehabilitation, 18(4), 341-351.
Kirkevold, M., Bronken, B. A., Martinsen, R., & Kvigne, K. (2012). Promoting psychosocial well-being following a stroke: Developing a theoretically and empirically sound complex intervention. International Journal of Nursing Studies, 49(4), 386-397.
