Predictors of long-term return-to-work at five-year follow-up for mild-to-moderate subacute stroke patients enrolled in an early supported discharge program

Article type: Research Article

Authors: Teo, Sock Hong^{a; b} | Fong, Kenneth N.K.^{a; *} | Chen, Zhenzhen^b | Chung, Raymond C.K.^a

Affiliations: [a] Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR | [b] National University Hospital, Singapore, Singapore

Correspondence: [*] Address for correspondence: Kenneth N.K. Fong, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR. E-mail: rsnkfong@polyu.edu.hk.

Abstract: BACKGROUND:Facilitating return-to-work (RTW) for working-age stroke survivors is a key component of stroke rehabilitation, however, research investigating the long-term outcomes of working-age stroke survivors is lacking. OBJECTIVE:To investigate the factors that influence long-term RTW for patients enrolled on a community-based early supported discharge (ESD) rehabilitation program in Singapore about five years post stroke. METHODS:Sixty-nine patients, aged between 18 and 60 years and were employed at the time of their hospitalization, were enrolled into the ESD program between 2012 and 2014. A prospective cohort design was adopted to examine the relationships between the factors— demographic, functional, personal, psychosocial factors and work related— and RTW at five-year follow-up. Details of RTW were collected through questionnaires via telephone follow-up. RESULTS:Sixty percent of the participants (n = 49) were selected for Cox and logistic regression analyses of RTW at five-year follow-up. The results indicated that having social problems is a negative predictor of RTW (OR 0.02; 95% CI 0.00–0.22) while being the breadwinner is a positive predictor of RTW (OR 13.79; 95% CI 2.46–77.52). The same factors were also significant in the time to RTW event at five-year follow-up, with a hazard ratio of 0.09 and 4.07, respectively. CONCLUSIONS:Early identification of the characteristics of stroke patients enrolled into an ESD program who have the potential to RTW would make interventions more targeted, increasing the likelihood of RTW.

Keywords: Return-to-work, rehabilitation, stroke

DOI: 10.3233/WOR-210914

Journal: Work, vol. 73, no. 3, pp. 1001-1010, 2022