Professional reintegration after stroke: experiences of Portuguese stroke survivors

Stroke incidence among working-age adults is increasing, making return to work (RTW) a key milestone in recovery and quality of life. However, post-stroke professional reintegration remains challenging, often requiring survivors to manage physical and cognitive impairments, fatigue, and insufficient workplace adaptations, in the absence of specific policies or guidelines and qualitative evidence.

This brief report explores Portuguese stroke survivors' RTW experiences, focusing on perceived consequences, barriers, and enablers.

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A total of 1,175 stroke survivors completed a questionnaire 18-24 months after stroke, and a heterogeneous subsample participated in semi-structured interviews (n = 22). Qualitative data from stroke survivors who were employed before the event were analyzed using thematic analysis.

Five major themes emerged. RTW was facilitated by employer and coworker support, workplace adaptations, and lower levels of post-stroke impairment. Survivors who returned to work reported positive emotional and social outcomes, such as restored normalcy and reduced social isolation, alongside negative experiences, including insecurity, stress, and fear of reduced performance. Barriers to RTW included persistent impairments, changes in workplace dynamics, and the lack of formal reintegration support. Participants highlighted the need for flexible working conditions, personalized and long-term monitoring, legal protection, and financial support. Conclusions: These findings emphasize the need for tailored, evidence-based professional reintegration strategies to support stroke survivors' sustainable RTW and overall well-being.