Feasibility of the community-based Stay at Work Intervention (SAWI) for stroke survivors

Article type: Research Article

Authors: Turner, Alyna^{a; b; 1; *} | De Wet, Theunis Jacobus^{c; 1} | McMurray, Jade^a | Wrobel, Anna^a | Smith, Heather^d | Clissold, Ben^d | Mohebbi, Mohammadreza^e | Kneebone, Ian^c

Affiliations: [a] Institute for Innovation in Physical and Mental Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia | [b] School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia | [c] Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia | [d] Acute Neurosciences Unit, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia | [e] Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia

Correspondence: [*] Address for correspondence: Alyna Turner, PhD, Institute for Innovation in Physical and Mental Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, HERB Building Level 3, P.O. Box 281, Geelong 3220, VIC, Australia. E-mail: [email protected].

Note: [1] Joint first authors.

Abstract: BACKGROUND:Rates of stroke in people of working age are increasing. Returning to work (RTW) after stroke is a key rehabilitation aspiration for younger stroke survivors. A pilot community-based Stay at Work Initiative (SAWI) was developed and delivered from March 2017 to December 2019. SAWI used a co-ordination based approach, covering rehabilitation and vocational recovery to support RTW in younger stroke survivors. OBJECTIVE:The aim of the study was to conduct a feasibility evaluation of SAWI. METHODS:A mixed methods approach was taken considering quantitative and qualitative data. Quantitative data included employment, mood, anxiety and fatigue outcomes at time of engagement with the service and at 6-months post-stroke. Qualitative data was collected on a sub-sample of SAWI clients who volunteered to participate in a semi-structured interview. RESULTS:Overall, there were 93 referrals to SAWI, with 42 clients completing an initial service meeting. Average working hours pre-stroke were high (mean 46.9, SD 22.0, range 5–100 hours/week). By 6 months post stroke, 71% (n = 29 of 41) of SAWI clients were working. For those with 6-month questionnaire information (n = 19), there was a significant reduction in cognitive fatigue, overall fatigue levels, and perceived impact of stroke on employment (medium effect sizes of r = 0.36, 0.34 and 0.40 respectively). No significant difference was seen on measures of mood or anxiety from pre- to post-intervention. Qualitative interviews with six SAWI participants highlighted the importance of personalised support that addresses individual needs during the RTW journey. CONCLUSIONS:A significant number of eligible participants referred to SAWI can engage with the service. RTW is able to be assessed as are potential predictor variables. Seventy one percent of participants had RTW at 6 months post-stroke. Mood, self-efficacy, adjustment, and fatigue likely impact RTW. Qualitative interviews identified that SAWI’s personalised support, tailored to individual need, was valued.

Keywords: Stroke, work, rehabilitation, feasibility studies, return to work

DOI: 10.3233/JVR-221206

Journal: Journal of Vocational Rehabilitation, vol. 57, no. 2, pp. 151-164, 2022