A Study Of The Current Situation And Needs Of Young And Middle-Aged Stroke Patients In Terms Of Readiness To Return To Work

Objectives1.To understand the current level of readiness to return to work among young and middle-aged stroke patients and to explore the influencing factors through a questionnaire method,in order to provide a scientific basis for developing interventions to reduce work retention among young and middle-aged stroke patients and to facilitate their early return to society.2.A semi-structured interview was used to further explore the needs and expectations of returning to work from the perspective of young and middle-aged stroke patients who had not returned to work,to uncover their true needs for return to work and to provide evidence for facilitating their return to society.MethodThis study is divided into two parts:Part Ⅰ: Analysis of the current state of readiness to return to work and the factors influencing it in young and middle-aged people with stroke patients.A total of 203 middle-aged and young apoplexy convalescent patients were selected from the Department of Neurology,neurosurgery and rehabilitation of a Grade A hospital in Zhengzhou,Henan Province by convenience sampling method,Henan Province were selected.The Chinese version of the Readiness to Return to Work Scale,Social Support Scale,Stroke Rehabilitation Self-Efficacy Scale and Fatigue Severity Scale were used as research instruments;excel and SPSS 26.0 statistical software were used for data entry and data analysis: measurement The data were entered and analysed using excel and SPSS 26.0statistical software: means and standard deviations were used for measurement data,and the number of cases and composition ratios were used for count data;rank sum test and Spearman’s correlation analysis were used for single factor analysis;ordered multicategorical logistic regression analysis was used for multi-factor analysis.Part Ⅱ: A qualitative study of the needs and expectations of young and middle-aged stroke patients for return to workA qualitative study of 11 young and middle-aged stroke patients who participated in the first part of the status survey was conducted using a purposive sampling method.Further exploration of the real needs of young and middle-aged stroke patients in terms of their return to work will complement relevant information such as inner thoughts that cannot be obtained from quantitative studies.Data was collected using semistructured interviews,collated using MAXqda 2020 software and analysed using the Colaizzi seven-step analysis.ResultPart Ⅰ:(1)The results showed that of the 203 young and middle-aged stroke patients in this study,60(29.6%)were in the pre-intention stage,35(17.2%)in the intention stage,81(39.9%)in the action-r eadiness-self-assessment stage and 27(13.3%)in the action-readiness-action stage.(2)Middle-aged and young patients with cerebral apoplexy(36.91 + 10.92)points for the social support level;the total mean score of rehabilitation self-efficacy was(77.20±10.92);121(59.6%)patients had poststroke fatigue,and the total mean score of fatigue level was(37.35±6.53).(3)Univariate analysis showed that residence,education level,monthly income,payment method of medical expenses,year of diagnosis,time to start rehabilitation exercise,occupation type and occupation nature were correlated with the readiness of young and middle-aged stroke patients to resume work,and the difference was statistically significant(P<0.05).(4)The results of the correlation analysis showed that readiness to return to work among young and middle-aged stroke patients was positively correlated with social support(r=0.837),with a statistically significant difference(p<0.01);with stroke rehabilitation self-efficacy(r=0.760),with a statistically significant difference(p<0.01);and with fatigue severity(r=-0.554),with a statistically significant difference(p<0.01).-0.554),with a statistically significant difference(P < 0.01).(5)The results of multiple ordered regression analysis showed that education level of college(OR=4.816,P=0.018),monthly income of 3000-4999(OR=3.831,P=0.037),social support(OR=1.330,P<0.001)and rehabilitation self-efficacy(OR=1.051,P<0.001)were protective factors for patients’ readiness to return to work.The time to start rehabilitation(OR=0.251,P=0.035)and the severity of fatigue(OR=0.895,P=0.002)were risk factors for patients’ readiness to return to work.Part Ⅱ: Based on the interview results,the following four themes and 13 sub-themes were identified:self-management needs(disease symptom management;continuous rehabilitation exercises),social support needs(need for care from family and friends;need for professional medical support;need for improvement of work environment and content;need for motivation by peer role models;need for public welfare assistance),and need for return to work-related support.(the need for assistance),the need for information about returning to work(Identifying the need for effective return to work timing;the need for information about employment and job search;the need for information about welfare and legal policies;the need for assistance from various sources),and the need for personal development(the need to seek self-fulfilment;the need to develop new skills).Conclusion(1)The readiness of young and middle-aged stroke patients to return to work is generally low to moderate,with nearly half of the patients having a low readiness level,and the motivation of patients to return to work needs to be further improved.Patients’ readiness to return to work is influenced by their education level,monthly income,time to start rehabilitation exercises,social support,rehabilitation selfefficacy,and severity of fatigue.(2)The needs of young and middle-aged stroke patients for return to work are broad and diverse,involving self-management,social support,return-to-work information and personal development.Health care professionals need to pay attention to patients’ needs in terms of illness,psychology,job search information and skills training,and strengthen communication and cooperation among surrounding stakeholders to provide comprehensive and comprehensive return-to-work support for patients in order to facilitate their successful return to work.