Return to work with fatigue after stroke: A complex occupational adaptation process.
Jessica Vollertsen, Mathilda Björk, Anna-Karin Norlin and 1 others
PMID 41517907WHAT IT FOUND
People with post-stroke fatigue described a paradox: structure and routines are essential to sustain work, but the fatigue itself makes them impossible to maintain.
Invisible task limitations were dismissed by supervisors, while noise sensitivities were accommodated.
Key findings
01Participants described a paradox where establishing the routines needed to manage fatigue was consistently undermined by the fatigue itself.
02Workplace accommodations were easier to obtain for visible sensory issues like noise and light than for invisible cognitive demands such as task flexibility.
03Support from employers often stopped abruptly once participants reached full-time hours, despite ongoing need for vocational rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Recruitment was limited to Facebook groups, which may exclude marginalized individuals or those less active online, reducing sample diversity. Telephone interviews were used without audio recordings, relying on interviewer notes and synthesized summaries, which may have limited the nuance of verbatim analysis. The study period included the COVID-19 pandemic, which altered social interactions and workplace norms, potentially influencing participants' experiences of remote work and support. The sample was highly educated (64% university level) and predominantly female (77%), which may not reflect the broader population of stroke survivors.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Swedish Ethical Review Authority.
The easy way to misread this
Do not interpret the high rates of 'work enjoyment' in the ratings as evidence that participants were successfully sustaining work. The qualitative data reveals that many were struggling with invisible cognitive limitations and were often forced into part-time work or sick leave despite wanting to work, indicating that enjoyment does not equate to capacity or sustainability.