Table 2 Themes from First Round of Delphi Survey

Theme 1:

RTW intervention components addressing functional and work skills of stroke survivors

Assessment of functional capacity, work abilities and job analysis

“Initial rehabilitation assessment, including assessment of the workers and employer’s needs- job and duties, expectations is the first thing needed” (Expert 9)

Basic functional skills training

“It depends on what the patient presents with. Impairments and activity limitations will be managed like any other stroke survivor focusing on cognitive function, activities of daily living (including instrumental) and mobility functional ability” (Expert 8)

Work skills training

“This might need facilitating enrolment of the worker into a suitable programme to address gaps in skill requirements for the roles (Expert 9).

“… include simulations of work environment within therapy sessions; Mobility - including endurance and speed; work tolerance and stamina, work conditioning” (Expert 7)

Adaptation of the work and work environment

“… intervention should include adaptation of work setting- such as wheelchair ramps, support rails, elevators, wider corridors for wheelchair access” (Expert 5)

“Phased return to work: gradually increase 1. Time at work, 2. Level of complexity of job functions.” (Expert 2)

Psycho-education of family, caregivers and employers

“Psycho-education for patient and employer will help” (Expert 2)

“Liaison and advocacy with employer; family, caregiver and co-workers to ensure stability for survivor over the period of work re-entry” (Expert 12)

Theme 2:

Strategies for implementation

Use of rehabilitation consultant or case manager

Use of rehabilitation consultant or case manager who might be an occupational therapist to facilitate the RTW plan. He will need to coordinate the RTW plan, complete assessments with key parties to identify their needs. (Expert 9)

Use of team-based approach

“Communication and collaboration among all stakeholders through team process, especially the rehabilitation practitioners working as a team during the return to work plan implementation. This might involve the employer if need be” (Expert 3)

Client centredness and individualized tailoring of intervention

“The interventions should be client-centred, it should revolve around and be directly by the stroke survivor’s wish and be occupation focused.” (Expert 4)

Early implementation of RTW

“Early implementation of the RTW plan immediately survivor is medically stable” (Expert 11)

“Therapists should set long term goals that include possible work resumption for patients at onset of treatment. These goals can be in achievable phases” (Expert 12)

Theme 3:

Essential elements of RTW intervention

Objective assessment of work abilities and job analysis.

Objective assessment of abilities is crucial. It is through objective assessment that RTW plan can meet the actual need of the client. (Expert 11)

Team work and communication among stakeholders

Team based approach should be used in implementing interventions. (Expert 7)

Clear communication in terms of treatment goals between therapist and workplace (Expert 11)

Work skills intervention

Skills training especially work hardening, vocational counselling and career planning are important elements that should be in the program. (Expert 5)