A Study On The Status Quo And Influencing Factors Of Readiness To Return To Work In Young And Middle-Aged Stroke Patients

Objectives1.To understand the current situation of the return to work rate and readiness of the young and middle-aged stroke patients in a certain area of Hunan Province;2.To analyze the relationship between disease cognition,self-efficacy,social support and sociodemographic data,disease data and return to work rate and readiness to return to work in young and middle-aged stroke patients;3.To explore the factors affecting the readiness and return to work rate of young and middle-aged stroke patients;4.To in-depth discussion on the inner experience of returning to work and the quality of life of young and middle-aged stroke patients who have not returned to work and who have returned to work during the recovery period.MethodThis study adopts a design method that combines quantitative research and qualitative research.Quantitative study used a cluster sampling method was adopted to select 191 young and middle-aged stroke patients who were treated in 2 tertiary hospitals stroke centers and 2community health service centers in Yueyang City,Hunan Province from October 2019 to October 2020 as the study Subjects.Use self-designed general information questionnaire,return to work preparation scale,simple disease perception questionnaire,general self-efficacy scale,social support rating scale to collect patient-related information.Use Epidata3.0 and SPSS 25.0 for data entry and statistical analysis: including descriptive statistics,independent sample t test,rank sum test,Spearman correlation analysis,ordered multi-class logistic regression,two-class logistic regression,etc.Qualitative research using phenomenological research methods and according to the research purposes,select 9 middle-aged and young stroke patients who have returned to work to conduct semistructured interviews to obtain the patients’ true feelings and inner experiences about returning to work,and use MAXqda2020 software to organize them Data,using Colaizzi’s phenomenological data analysis method to analyze the interview data.Results1.Among the 191 young and middle-aged stroke patients in this study,102 did not return to work,and 89 have returned to work.The return to work rate was 46.6%.Among the young and middle-aged stroke patients who did not return to work,18 cases(17.65%)were in the pre-intention dimension in their readiness to return to work,30 cases(29.41%)were in the intention dimension,and 49 cases were in the action readiness-selfevaluation dimension.(48.04%),5 cases(4.9%)were in the action readiness-behavior dimension;among the young and middle-aged stroke patients who had returned to work,40 cases(44.94%)were in the uncertain maintenance dimension and were in the middle-aged and young stroke patients who had returned to work.There were 49 cases(55.05%)who actively maintained the dimension.2.The results of single factor analysis showed that age,residence,per capita monthly income of family,nature of work before illness,length of diagnosis,number of hospitalizations due to stroke,dysfunction,and other chronic diseases are not relevant to those who did not return to work The difference in the scores of young stroke patients’ readiness to return to work is statistically significant(P<0.05);gender,age,marital status,education level,and whether there is dysfunction are important for returning to work young stroke patients The difference in the score of work readiness was statistically significant(P<0.05).3.Correlation analysis showed that the readiness to return to work of young and middle-aged stroke patients who did not return to work was positively correlated with self-efficacy(r=0.519,P<0.01);the readiness to return to work of young and middle-aged stroke patients who had returned to work It was negatively correlated with disease perception(r=-0.264,P < 0.01),and positively correlated with social support and subjective support dimensions(r=0.494,r=0.332,P<0.01).4.The multi-factor analysis of readiness to return to work shows that whether there are other chronic diseases,the family’s per capita monthly income,the number of hospitalizations,and self-efficacy have statistically different effects on the scores of young stroke patients who have not returned to work.Significance(P<0.05);gender and whether there are dysfunctions on the scores of young stroke patients returning to work have statistical significance(P<0.05).5.In the multi-factor analysis of whether they can return to work,gender,work type,whether there is dysfunction,and disease perception have statistically significant differences in the impact of young and middleaged stroke patients on whether they can return to work(P<0.05).6.Interviews were conducted around the true feelings and inner experiences of young and middle-aged stroke patients about returning to work.A total of 9 patients were interviewed,and a total of 2 major themes and 11 sub-themes were extracted.They are motivation to return to work(increasing economic income,life adjustment methods,improving social relations,return of self-ability,support in the workplace),difficulties after returning to work(personal factors: decreased work ability,decreased activity ability;work-related Factors: overloaded work,insufficient support in the workplace,reduced attention from leaders,alienated relationships with colleagues).Conclusions1.The young and middle-aged stroke patients who did not return to work were at a moderate level of readiness to return to work,and the young and middle-aged stroke patients who returned to work were at a high level of readiness to return to work.2.The readiness to return to work of young stroke patients who have not returned to work is affected by physical function,whether they have other chronic diseases,family monthly income,number of hospitalizations,self-efficacy,and social support;young stroke patients who return to work Readiness to return to work is affected by physical condition,gender,and social support.3.Young and middle-aged stroke patients have various motivations for returning to work,the main motivation being financial pressure.Even after returning to work,they still have to face their own and work difficulties,which will affect their maintenance of good working conditions.