Background:
Vocational rehabilitation interventions are recommended to support work and working after stroke, yet there is very little information about what interventions and components are used in practice. The importance of drawing on expert opinion and experience-based evidence to apply results of international research in the Australian clinical setting is acknowledged yet often overlooked.
Aims:
To determine interventions of choice and allied health clinicians’ perceived usefulness and clinical reasoning for vocational rehabilitation components when providing services to adults with stroke.
Methods:
Allied health professionals who participated had all provided rehabilitation with adults with stroke with identified vocational rehabilitation goals; adults with stroke were identified from a return-to-work after stroke trial (the WORK Trial). A multiple-choice and short-answer survey was developed and piloted before electronic distribution; content thematic analysis was conducted on qualitative data while descriptive statistics were used to analyse quantitative data.
Results:
Seventeen experts participated in this study. Most (88%) were experienced working with adults after stroke (i.e. >5 years) and were occupational therapists (88%), although professionals from speech pathology and physiotherapy were represented. Vocational rehabilitation was predominantly provided face-to-face, although nine (53%) of participants did use e-health initiatives (telephone and video-conferencing). No clinicians reported being confident that their programs addressed all necessary components of vocational rehabilitation within their clinical services. Clinicians identified a great need for further training in conducting cognitive functional capacity evaluations as well as vocational skills assessments, and training in developing suitable duties programs, worksite assessments and graded return to work schedules. All commented on a lack of suitable clinical-training programs within Australia.
Conclusion:
Findings emphasise the challenges of providing stroke-specific vocational rehabilitation programs and the need to have dedicated and ongoing education for clinicians irrespective of their years of practice. The lack of suitable skills-based training programs identifies a key barrier for service delivery here in Australia.