Understanding Return to Work After Stroke Internationally: A Scoping Review

ABSTRACT BACKGROUND: Internationally, the changing landscape of diagnosis, treatment, and follow-up post stroke is resulting in a concomitant rise in the number of survivors still in the workforce. Return to work (RTW) is a common goal for adults after stroke; however, poststroke disabilities may limit occupational opportunities. This scoping review was undertaken to gain an understanding of the concept of RTW, how it is defined in the literature, types of research conducted on RTW after stroke, and characteristics of patients who do and do not RTW. We also wanted to gain an understanding of the interventions that were successful for RTW, their efficacy, and which healthcare professionals conducted such interventions. METHODS: Two authors reviewed articles using a customized data extraction tool. Adhering to current scoping review guidelines, data were collated and described using narrative and tables. RESULTS: A total of 48 studies were included in this scoping review: 34 quantitative, 11 qualitative, and 3 mixed method studies. The studies were conducted between the years 1998 and 2018, with more than half undertaken within the past decade and primarily in economically developed countries. DISCUSSION: Few interventions specifically targeted RTW as a primary outcome; most interventions were conducted by rehabilitation professionals with RTW measured by self-report. The nursing contribution was noticeably absent in the literature. CONCLUSIONS: Return to work has not been consistently operationalized in the literature. Although nurses are in a unique position to assist stroke survivors in their goal of RTW, how to do so remains elusive.