Stakeholder perspectives on a return-to-work cognitive intervention after stroke.

Abstract

ObjectiveTo investigate stakeholder experiences on return-to-work after stroke and preferences to co-design a return-to-work cognitive intervention, addressing a gap in post-stroke rehabilitation.DesignIn-depth semi-structured interviews were conducted and reflexive thematic analysis guided by Braun and Clarke's six-phase approach was employed to analyse transcribed data, with iterative coding to identify themes until thematic saturation was achieved.SettingCommunity, work, and healthcare settings.ParticipantsTwenty purposively sampled participants across four stakeholder groups: stroke survivors (n = 7), caregivers (n = 4), healthcare professionals (n = 5), and employers (n = 4).Main measuresStakeholder perspectives on (i) the return-to-work process after stroke and (ii) preferences for the design and delivery of a return-to-work cognitive intervention after stroke.ResultsThree core themes emerged: (i) barriers to return-to-work, (ii) intervention content, and (iii) intervention delivery. Each theme comprised several subthemes and dimensions that offered deeper insight into participants' perspectives. Barriers to return-to-work encompassed lack of awareness of resources, ineligibility of support schemes, and lack of understanding from workplace. Intervention content comprised subthemes of awareness, acceptance and adjustment, goal setting, strategies for self-management, and navigating the return-to-work journey. Intervention delivery included programme structure, social support, format and accessibility. While there was broad agreement, stakeholders also expressed divergent priorities shaped by their roles and experiences.ConclusionsThis study synthesises lived experiences, clinical expertise, and employer insights from stakeholders to inform the co-design of a return-to-work cognitive intervention. This work advances a paradigm shift towards a patient-centred and ecological approach to improve post-stroke workforce reintegration.