Alaszewski Andy, Alaszewski Helen, Potter Jonathan, Penhale Bridget
CHSS, University of Kent, Canterbury, UK.
Disabil Rehabil. 2007 Dec 30;29(24):1858-69. doi: 10.1080/09638280601143356. Epub 2007 Feb 22.
This paper examines respondents' relationship with work following a stroke and explores their experiences including the perceived barriers to and facilitators of a return to employment.
Our qualitative study explored the experiences and recovery of 43 individuals under 60 years who had survived a stroke. Participants, who had experienced a first stroke less than three months before and who could engage in in-depth interviews, were recruited through three stroke services in South East England. Each participant was invited to take part in four interviews over an 18-month period and to complete a diary for one week each month during this period.
At the time of their stroke a minority of our sample (12, 28% of the original sample) were not actively involved in the labour market and did not return to the work during the period that they were involved in the study. Of the 31 participants working at the time of the stroke, 13 had not returned to work during the period that they were involved in the study, six returned to work after three months and nine returned in under three months and in some cases virtually immediately after their stroke. The participants in our study all valued work and felt that working, especially in paid employment, was more desirable than not working. The participants who were not working at the time of their stroke or who had not returned to work during the period of the study also endorsed these views. However they felt that there were a variety of barriers and practical problems that prevented them working and in some cases had adjusted to a life without paid employment. Participants' relationship with work was influenced by barriers and facilitators. The positive valuations of work were modified by the specific context of stroke, for some participants work was a cause of stress and therefore potentially risky, for others it was a way of demonstrating recovery from stroke. The value and meaning varied between participants and this variation was related to past experience and biography. Participants who wanted to work indicated that their ability to work was influenced by the nature and extent of their residual disabilities. A small group of participants had such severe residual disabilities that managing everyday life was a challenge and that working was not a realistic prospect unless their situation changed radically. The remaining participants all reported residual disabilities. The extent to which these disabilities formed a barrier to work depended on an additional range of factors that acted as either barriers or facilitator to return to work. A flexible working environment and supportive social networks were cited as facilitators of return to paid employment.
Participants in our study viewed return to work as an important indicator of recovery following a stroke. Individuals who had not returned to work felt that paid employment was desirable but they could not overcome the barriers. Individuals who returned to work recognized the barriers but had found ways of managing them.
本文研究中风患者病后与工作的关系，探讨他们的经历，包括重返工作岗位所面临的感知障碍和促进因素。
我们的定性研究探讨了43名60岁以下中风幸存者的经历和康复情况。通过英格兰东南部的三个中风服务机构招募了参与者，他们均在不到三个月前首次中风，且能够参与深入访谈。每位参与者被邀请在18个月内参加四次访谈，并在此期间每月完成一周的日记记录。
在中风发生时，我们样本中的少数人（12人，占原始样本的28%）未积极参与劳动力市场，且在参与研究期间未重返工作岗位。在中风发生时仍在工作的31名参与者中，13人在参与研究期间未重返工作岗位，6人在三个月后重返工作岗位，9人在不到三个月内甚至在中风后几乎立即重返工作岗位。我们研究中的参与者都重视工作，并且认为工作，尤其是有偿工作，比不工作更可取。在中风发生时未工作或在研究期间未重返工作岗位的参与者也认同这些观点。然而，他们认为存在各种障碍和实际问题阻碍他们工作，并且在某些情况下已经适应了没有有偿工作的生活。参与者与工作的关系受到障碍和促进因素的影响。对工作的积极评价因中风的具体情况而有所改变，对一些参与者来说，工作是压力的来源，因此可能有风险，而对另一些人来说，工作是中风康复的一种证明方式。参与者之间的价值和意义各不相同，这种差异与过去的经历和个人经历有关。想要工作的参与者表示，他们的工作能力受到残余残疾的性质和程度的影响。一小部分参与者有严重的残余残疾，管理日常生活都是一项挑战，除非情况发生根本改变，否则工作是不现实的前景。其余参与者均报告有残余残疾。这些残疾对工作构成障碍的程度取决于一系列额外的因素，这些因素既可能成为重返工作岗位的障碍，也可能成为促进因素。灵活的工作环境和支持性的社会网络被认为是重返有偿工作的促进因素。
我们研究中的参与者将重返工作视为中风后康复的重要指标。未重返工作岗位的个体认为有偿工作是可取的，但他们无法克服障碍。重返工作岗位的个体认识到障碍，但找到了应对方法。
