Brannigan Colm, Galvin Rose, Walsh Mary E, Loughnane Cliona, Morrissey Emma-Jane, Macey Chris, Delargy Mark, Horgan N Frances
a School of Physiotherapy, Royal College of Surgeons in Ireland , Dublin , Republic of Ireland.
b Department of Clinical Therapies, Faculty of Education and Health Sciences, Health Research Institute , University of Limerick , Limerick , Republic of Ireland.
Disabil Rehabil. 2017 Feb;39(3):211-222. doi: 10.3109/09638288.2016.1141242. Epub 2016 Apr 21.
To enhance the employment outcomes of individuals who experience a stroke, it is essential to understand the factors that determine successful return to work. The aim of this systematic review was to examine barriers to and facilitators of return to work after stroke from the perspective of people with stroke through the process of a qualitative meta-synthesis.
A systematic literature search was conducted. Studies that employed qualitative methods to explore the experiences of individuals with stroke around return to work after stroke were included. The methodological quality of the studies was assessed by two independent reviewers. Overarching themes, concepts and interpretations were extracted from each individual study, compared and meta-synthesized.
Fifteen studies were included and the overall methodological quality of the studies was good. Four broad themes emerged as factors associated with return to work after stroke. These included (i) the nature of the effects of stroke, (ii) the preparatory environment, (iii) personal coping strategies and internal challenges and (iv) the meaning of work.
Return to work after stroke is a complex process which can be facilitated or impeded by organizational, social or personal factors, as well as accessibility to appropriate services. Implications for Rehabilitation Following a period of dedicated inpatient rehabilitation, there is a need to integrate community-support services to optimize return to work among stroke survivors. A dedicated community stroke support liaison officer may help to facilitate the transition between the hospital and the community and workplace environment. Education provided by healthcare professionals is necessary in the community and the workplace to ensure that family, friends and employers are aware of the impairments, activity limitations and participation restrictions of the stroke survivor.
为提高中风患者的就业成果，了解决定成功重返工作岗位的因素至关重要。本系统评价的目的是通过定性元综合过程，从中风患者的角度审视中风后重返工作岗位的障碍和促进因素。
进行了系统的文献检索。纳入采用定性方法探索中风患者中风后重返工作经历的研究。由两名独立评审员评估研究的方法学质量。从每项单独研究中提取总体主题、概念和解释，进行比较和元综合。
纳入15项研究，研究的总体方法学质量良好。出现了四个与中风后重返工作相关的广泛主题。这些主题包括：（i）中风影响的性质；（ii）准备环境；（iii）个人应对策略和内部挑战；（iv）工作的意义。
中风后重返工作是一个复杂的过程，可能受到组织、社会或个人因素以及获得适当服务的机会的促进或阻碍。康复启示 在经过一段时间的专门住院康复后，需要整合社区支持服务，以优化中风幸存者的重返工作。一名专门的社区中风支持联络官可能有助于促进医院与社区及工作场所环境之间的过渡。医疗保健专业人员在社区和工作场所提供教育是必要的，以确保家人、朋友和雇主了解中风幸存者的损伤、活动限制和参与限制。
