Returning to Work after Stroke: Associations with Cognitive Performance, Motivation, Perceived Working Ability and Barriers

Abstract

Objective: To investigate post-stroke return-to-work and its associations with cognitive performance, motivation, perceived working ability, and self-perceived barriers to returning to work.Design: Prospective cohort study of a clinical sample.Subjects and methods: Participants were 77 stroke patients younger than age 69 years. Assessment included a cognitive screening method for stroke patients (CoMet), a questionnaire regarding work-related matters, and a question regarding motivation to return to work. A predictive model of return-to-work was built, and how participants managed in their working life was examined.Results: Cognitive performance was significantly connected with returning to work. Three of the 5 individuals who dropped out of working life had cognitive dysfunction. Cognitive performance predicted 80% of those who had not returned and 37% of those who had returned by 6 months after the initial assessment. Self-perceived working ability and barriers predicted 64% of those who had not returned and 78% of those who had returned at the 12-month follow-up.Conclusion: Cognitive performance seems to be a crucial predictor of return-to-work post-stroke, but individuals’ own evaluations of their working capabilities are also important. LAY ABSTRACTReturning to work after stroke is important for stroke patients’ participation in society. This study investigated return-to-work among stroke patients and its association with cognitive skills, motivation, and patients’ self-perceived abilities and barriers concerning returning to work. Cognitive skills were connected to returning to work and predicted returning for a 6-month period. Patients’ self-perceived abilities and barriers predicted returning to work by 12 months after stroke. These findings indicate that cognitive skills have an important role in returning to working life after stroke, but patients’ own evaluations of their capabilities are also important. This study may provide information for better rehabilitation planning after stroke and help rehabilitation professionals to consider the patients’ views of their capabilities.