Exploring stroke survivors’ experiences and the process of returning to work

Abstract

Background: Returning to work after stroke is recognised as an important component of recovery, extending beyond physical rehabilitation to include psychosocial and cognitive dimensions that influence individuals’ ability to resume employment (Wolfenden & Grace, 2009). Stroke-related impairments, including physical and cognitive difficulties, can limit individuals’ ability to sustain employment, requiring ongoing adaptation and affecting participation in both work and daily life (Palstam et al., 2018). Work is also closely linked to identity, with returning to employment associated with regaining roles, purpose, and a sense of belonging (Wassenius et al., 2023). Aims: This study aimed to explore how stroke survivors experience and navigate the process of returning to work following rehabilitation. It also aimed to identify the factors influencing this transition, including environmental and contextual conditions, personal motivations, and the strategies and adaptations used to sustain work participation. Method: A qualitative research design was employed. Participants were recruited through purposive sampling based on predefined inclusion criteria of being at least 18 years of age, have experienced a stroke and have returned to work. Data were collected through semi-structured interviews with six individuals, allowing for in-depth exploration of participants’ perspectives. The data were analysed using thematic analysis following the framework developed by Braun and Clarke (2006). Findings: Four main themes were identified: ‘Changes in Occupational Identity’, ‘Return to Work Transitions After Stroke’, ‘Navigating the Return to Work Process’ and ‘Acceptance and Adaptation to Limitations and Changed Circumstances’. Participants described a disruption in valued roles and a reduced sense of independence following stroke. Returning to work was often associated with regaining purpose and a sense of normality, however, this process was not straightforward. Ongoing physical and cognitive difficulties influenced work performance, requiring individuals to adapt tasks and routines. Environmental factors, including workplace support, transport challenges, and access to professional input, were found to significantly affect the return to work experience. Discussion: The findings demonstrate that returning to work following stroke is a dynamic and ongoing process shaped by individual and environmental factors. Disruptions in occupational roles and performance highlight the importance of targeted, client-centred occupational therapy interventions. The study emphasises the need for structured return to work support, including workplace adaptations, employer involvement, and continued follow-up beyond discharge, to promote more sustainable outcomes.