Productivity in a Stroke Survivor: Development and Initial Testing of a Stroke-Specific Return to Work Instrument

Background: Stroke is a leading cause of sudden loss of work and productivity in adults. With no existing instrument to assess or predict a return to work for stroke survivors. There is a growing need as more survivors are discharged with expectations to return to productive life. This study focused on developing a new instrument called the Stroke-Specific Return to Work Instrument (SSRTWI) to assess and predict when stroke survivors can return to work. Given the increasing incidence of stroke and its impact on productivity, this is an important area of study.

Methods: This study used a mixed-method approach using qualitative exploratory in-depth semi-structured interviews. Fifty-three stroke survivors within productive age participated. Twenty survivors and fourteen experts were involved in the initial development through focus group discussions. Thematic analysis was used to analyze focus group data. There was a four-stage testing process to ensure internal consistency. 33 participants were involved in initial instrument testing. Content validity, internal consistency, and test-retest reliability were assessed.

Results: Participants were aged 26-55 years (mean age = 48.4 ± 5.5 years). Seventy-six items initially generated through focus group discussions were reviewed. Eighteen items were eliminated while twenty-two items were reworded. The Content validity index was 0.93, Internal consistency (Cronbach’s α) was 0.89, and the Intraclass correlation coefficient was 0.91.

Conclusion: This study addresses an important gap in stroke rehabilitation by providing a validated instrument to assess return-to-work readiness for stroke survivors. The mixed-method approach and involvement of survivors and experts in the development process strengthened the instrument’s relevance and validity.