Journal of Rehabilitation Medicine 51-10 | Page 24

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discuss RTW matters with others in the same situation.
Concerning the timing, some wanted an early start to
rehabilitation, while others needed a long period of
rest prior to commencement of RTW.
I wish that there would be a therapy group for people
who are in the same situation… how we can help each
other, what kind of demands can I make at work. I would
be open to that after 4 months, when I have come to terms
with my situation a bit and it would’ve been OK to share it
with others. Conversations would last for a while and later
decline to every fourth or every sixth week[s] (Inf. 17).
I think you need more help mentally after some time than in
the beginning… now the rumination starts (Inf. 5).
Moreover, they wanted support to deal with life as a
whole; for example, psychological help to handle new
priorities in the work situation. The participants also
had comments on at which level of care the interven-
tions should be offered.
…I should’ve received that kind of help [CBT] when I went
home… it shouldn’t have been handled through the primary
healthcare centre (Inf. 8).
Stepwise return to work facilitated the return to
work process
A major facilitating factor for RTW was the ability to
increase the working hours per week stepwise from 10
to 40 h/week. Without this stepwise process, it could
be difficult to return to work.
But it was good that I could increase my working time,
first part-time/half-time and then 75% and that was actually
good… I did that for a few months. I took it easy when I came
home [from work]. I didn’t do anything (Inf. 9).
To return to work early after stroke onset was perceived
as a barrier, with negative effects.
In the beginning, I increased to 100% pretty quickly. And
then my brain just shut down completely. So in reality, I needed
a lot more time [sick leave] than I received (Inf. 4).
You’d need help that someone told you that “Don’t bother
going to work. No matter how good you may be (Inf. 5).
Lack of early information, regular contact and a
rehabilitation plan were barriers to return to work
A need for early information about stroke and its con-
sequences, relevant regulations, early contact with a
stroke rehabilitation unit, regular follow-ups, an early
rehabilitation plan and a contact person were consi-
dered important, and were perceived as barriers if not
provided. The participants requested information from
healthcare professionals, from discharge and subse-
quently; for example, information about recovery as
well as physical and mental fatigue.
…you’ve had very little information about, about what
to expect… I have problems with my right hand… then I’m
www.medicaljournals.se/jrm
very… I get very tired as well. And that’s also – will that go
away?...there’s no one who can really give an answer… I’ve
never gotten any explanation (Inf. 1).
They also wanted information about relevant regu-
lations.
We need a check list. “You’ve experienced a stroke: Think
of this, do this, get in touch with the Social Insurance Agency”.
You can’t take all of that in at once (Inf. 17).
To have brochures to inform employers and relatives
about the disabilities after stroke was another sugges-
tion to facilitate RTW. These could, for example, be a
written text about hidden disabilities.
They [healthcare professionals] could provide some kind
of information to various bosses, that we get tired and what
happens in our brains. For there to be some kind of pamphlet
to give to bosses…”here’s something to read up on so you’ll
have some understanding” (Inf. 12).
Moreover, the participants suggested that a rehabilita-
tion plan at an early stage after stroke onset and early
contact with an outpatient stroke rehabilitation unit
would facilitate RTW.
It would have been good to get a plan earlier. To receive
[a rehabilitation] contact earlier (Inf. 9).
I would’ve liked to have had contact with [the stroke rehab]
immediately (Inf. 17).
To get a professional contact and coaching directly af-
ter discharge and support further on during the process
could also facilitate RTW.
Just to go and talk to someone that “now it’s like this” in
a month you’ll be called to this” and so on. To know what’s
gonna happen (Inf. 11).
You should get some kind of contact person… someone who
calls and checks on you “how is it now, are you experiencing
any problems?” could refer you to, well, here or there (Inf. 3).
I probably would’ve liked coaching support (Inf. 8)
… the absolute best thing would be to have an appointment
with a counsellor immediately after discharge. Because there
you talk about everything like work and help at home (Inf. 5).
The participants perceived a lack of regular follow-
ups from the rehabilitation professional as a barrier to
RTW. Another barrier was that each individual had to
contact the primary care themselves for the follow-ups.
…nobody mentioned anything about follow-ups, having to
call them myself and ask for a follow-up (Inf. 5).
[I would’ve liked] a follow-up from the healthcare “is it
going in the right direction” a confirmation that something
has been helpful and that we’re on the right track (Inf. 12).
However, some participants were content.
Everything has gone by itself automatically, like they [the
hospital] had already planned how it was going to be (Inf. 12)
… instead, I asked myself “is this really necessary? I’m
content. But had it been a more serious situation, I don’t know
what I would’ve said (Inf. 13).