Journal of Rehabilitation Medicine 51-10 | Page 27

Healthcare-related factors in RTW after stroke
practical help with housework and children, to be able
to return to work in accordance with the recommen-
dations in the interdisciplinary practice model (23).
Family members and relatives may also need to be
informed about disabilities following stroke, such as
cognitive limitations and fatigue, in order to understand
the consequences of stroke in daily life more fully and
thereby be more supportive in the RTW process.
Methodological discussion
A strength of the study was that the 20 informants vo-
lunteered to participate in the focus groups because of
their interest in sharing their experiences, which they
described freely during the interviews. Therefore, the
data became rich. The study had clear inclusion criteria
and obtained variety regarding age, sex, socio-cultural
background, disability and type of work. The intervie-
wers were familiar with performing both focus group
interviews and qualitative content analysis.
Credibility refers to the researchers’ ability to cap-
ture the reality (30). All the researchers had earlier
experience of working with qualitative methods and
had a long-term understanding of stroke rehabilitation.
The researchers worked close to the text in the analytic
process and description of the results, which ensured
confirmability according to Öhman (30). Triangula-
tion was performed by the researchers. Dependability
refers to the relationships between informants and
researchers in terms of being interrelated and having
had professional interaction with each other (30). The
researchers had no earlier relation to the informants.
All researchers had a pre-understanding of stroke,
which may have influenced both the way the questions
were formulated, and the analytic process. However,
the results were grounded in the data and the analysis
was performed close to the text. Concerning transfera-
bility, the knowledge obtained from this study may be
transferable to similar contexts in other populations.
Persons not fluent in Swedish or with severe cognitive
and/or language deficits were excluded due to the study
design. However, exclusion of these persons is a study
limitation. Another limitation is that all participants
had RTW or were work training and we thus lacked
information from those who did not RTW.
Conclusion
A tailored rehabilitation content and a structured
stepwise RTW process facilitated RTW. Insufficient
structure within the healthcare system and lack of
support in daily life were perceived barriers and need
to be improved. These aspects should be considered
in the RTW process after stroke.
747
ACKNOWLEDGEMENTS
Financial support was received from the Färs and Frosta Founda-
tion, the Promobilia foundation, the Swedish Stroke Association
and the Norrbacka-Eugenia foundation.
The authors are grateful to the individuals who volunteered to
participate and to RPT, PhD Michael Miller for language editing
and Camilla Andersson, Sanna Forsgren and Ann Nilsson for
help with collecting the background data.
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