Deans' stroke musings: The reasons for not returning to work and health-related quality of life among young and middle-aged patients with stroke: A cross-sectional study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, March 9, 2023

The reasons for not returning to work and health-related quality of life among young and middle-aged patients with stroke: A cross-sectional study

Damn this is easy to explain. Your doctors and therapists have completely failed you by not providing 100% recovery protocols. So do the research on why doctors and therapists fail at their only task of 100% recovery. Don't you dare try to blame failure to recover on the patient!

The reasons for not returning to work and health-related quality of life among young and middle-aged patients with stroke: A cross-sectional study

Xi Pan¹^†,

Zhi Wang¹^†,

Lin Yao² and

Lan Xu²^*

¹Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
²Nursing Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Objectives: This study aimed to explore the reasons and influencing factors for non-return to work (non-RTW) within 1 year among young and middle-aged patients with stroke and to assess their health-related quality of life (HRQoL) at 1 year across different reasons.

Methods: The study was conducted as a telephone-based cross-sectional survey. Seven hundred eighty-nine young and middle-aged patients with stroke aged between 18 and 54 years for men and 18 and 49 years for women in the electronic medical system were included. Data collection included demographic characteristics, socioeconomic status, behavioral habits, history of chronic diseases, work status, reasons for non-RTW, and HRQoL.

Results: Of 789 patients, 435 (55.1%) (mean [SD] age, 47.7 [7.8] years) did not return to work within 1 year after stroke. Among the patients who did not RTW, 58.9% were unable to work, 9.7% retired early, 11.03% became full-time homemakers or were unemployed, and 20.5% were reluctant to work. The disordered multiclass logistic regression model showed that the factors influencing the reasons for non-RTW included age, gender, education, income, health insurance, diabetes comorbidity, ability to perform activities of daily living, and mobility of the right upper extremity. Furthermore, patients who were unable to work had significantly lower HRQoL compared to those who had RTW, followed by those who retired early.

Conclusions: More than half did not RTW within 1 year in our study. The results will help inform future research to identify interventions to promote RTW and improve HRQoL for young and middle-aged patients with stroke.

1. Introduction

Recent data show that the incidence of stroke is increasing among young and middle-aged people and is highest in Asians compared to that in other ethnic groups (1, 2). According to reports, nearly 40% of patients with stroke are of working age, an age group whose specific social characteristics dictate a higher willingness to return to work (RTW) after a stroke (3). RTW is the primary goal of the rehabilitation process for most working-age patients (4), and it is closely related to the patient's quality of life, physical and mental health, subjective wellbeing, and life satisfaction (5).

Unfortunately, it can be challenging for stroke sufferers to return to work (6). Several studies have demonstrated that with proper rehabilitation, most young and middle-aged post-stroke survivors can achieve functional independence and high activity levels (1, 7). Nevertheless, the proportion of patients with stroke who do not return to work ranges from 25 to 50% (8–10). Exploring the reasons for non-RTW among young and middle-aged patients with stroke and the associated factors require clinical practice by identifying the types of non-RTW that may occur in different patients and that can be improved through rehabilitation (4, 11, 12). Although previous research has explored the factors impacting non-RTW after stroke, such as gender and advanced age (8–10), most studies have evaluated non-RTW as a whole and cannot differentiate between various non-RTW types and their associated factors. However, some qualitative studies have been conducted to explore the related causes and influencing factors (4, 11), but the researchers' opinions and thoughts may introduce bias in interpreting the results, resulting in a lack of objectivity and the inability to identify relevant influencing factors.

To the best of our knowledge, no specific study has been conducted that quantitatively describes the reason for non-RTW following stroke, and its associated factors are mainly unclear. In addition, it is uncertain whether the reported reasons for non-RTW are related to health-related quality of life (HRQoL). Therefore, the aims of this study were to (1) quantify reasons for non-RTW among young and middle-aged patients with stroke; (2) identify factors predicting different reasons for non-RTW, focusing mainly on sociodemographic and clinical characteristics factors; and (3) investigate the impact of different reasons for non-RTW on HRQoL.