Determinants of return to work among Nigerian stroke survivors

Abstract

Purpose: Employment, an important aspect of life, could be adversely affected by a disabling condition like stroke. This study explores the frequency and determinants of return to work (RTW) among Nigerian stroke survivors. Method: One-hundred and one stroke patients attending Physiotherapy clinics at seven teaching and specialist hospital centers in north-eastern Nigeria participated in the study. Socio-demographic, clinical and RTW data were obtained from participants while the modified Rankin Scale was used to assess functional ability. Chi-square statistics and multivariable logistic regression analysis was used to identify the determinants of RTW among the participants. Results: About half of the participants (55%) had returned to work. Absence of disability [Odds Ratio (OR) = 57.7; 95% CI = 12.0–276.8) and mild disability (OR = 15.1; 95% CI = 3.9–58.3) were the significant determinants of RTW, while post-stroke duration of a year or less was associated with lower chance of returning to work (OR = 0.2; 95% CI = 0.0–0.8). Conclusions: The prominence of functional independence among the determinants of RTW implies that rehabilitation efforts and support programmes to optimize functional ability, especially within the first year after stroke, will greatly enhance RTW among Nigerian stroke survivors.Implications for RehabilitationFunctional outcome influenced vocational outcome, hence the need for rehabilitation efforts at improving functional status of stroke survivors to encourage return to work (RTW).The low rate of RTW within the first year after stroke may be addressed by the establishment of specilized sub-acute and long-term rehabilitation centers in Nigeria instead of depending only on existing inadequate outpatient rehabilitation practices