{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:40:43Z","timestamp":1791308443874,"version":"4.3.1"},"reference-count":31,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,2,2]]},"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore barriers and facilitators to staying in work following stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative analysis of posts regarding staying in work following stroke using the archives of an online forum for stroke survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>60 stroke survivors (29 male, 23 female, 8 not stated; mean age at stroke 44\u2005years) who have returned to work, identified using terms \u2018return to work\u2019 and \u2018back at work\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Posts from UK stroke survivors and family members on Talkstroke, the forum of the Stroke Association, between 2004 and 2011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Stroke and transient ischaemic attack (TIA) survivors reported residual impairments that for many had impact on work. Most impairments were \u2018invisible\u2019, including fatigue, problems with concentration, memory and personality changes. Participants described positive (eg, back at work being better than expected) and negative work experiences, including being at risk of losing the job because of stroke-related impairments. Barriers to successfully staying in work included lack of understanding of stroke\u2014in particular invisible impairments\u2014of survivors, employers and general practitioners (GPs), and lack of support in terms of formal adjustments, and \u2018feeling supported\u2019. Stroke survivors described how they developed their own coping strategies, and how workplace and employer helped them to stay in work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite having been able to return to work after a stroke, people may still experience difficulties in staying in work and risking losing their job. There is a need to improve awareness, in particular of invisible stroke-related impairments, among stroke survivors, work personnel and clinicians. This might be achieved through improved assessments of residual impairments in the workplace and in general practice. Future studies should investigate the effect of unrecognised fatigue and invisible impairments on staying in work following stroke, and explore the potential role for primary care in supporting stroke survivors who have returned to employment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009974","type":"journal-article","created":{"date-parts":[[2016,4,7]],"date-time":"2016-04-07T01:18:01Z","timestamp":1459991881000},"page":"e009974","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":82,"title":["Barriers and facilitators to staying in work after stroke: insight from an online forum"],"prefix":"10.1136","volume":"6","author":[{"given":"Chantal","family":"Balasooriya-Smeekens","sequence":"first","affiliation":[{"name":"The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bateman","sequence":"additional","affiliation":[{"name":"The Oliver Zangwill Centre, The Princess of Wales Hospital, Ely, Cambridgeshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Mant","sequence":"additional","affiliation":[{"name":"The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"De Simoni","sequence":"additional","affiliation":[{"name":"Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,4,6]]},"reference":[{"key":"2025121605364856000_6.4.e009974.1","unstructured":"National Audit Office. 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