Return to Work after Aneurysmal Subarachnoid Hemorrhage: The Mediating Role of Illness Perception

Aneurysmal subarachnoid hemorrhage (aSAH) is a type of stroke that affects women and men with a mean age of 50 years. Return to work (RTW) has been cited as a strategic goal of patients after injury, however, success rates are low in multiple studies. Illness perception is known to impede recovery after illness in older adults, yet its role after injury in the aSAH population has not been evaluated. The purpose of this study was to investigate the role of illness perception in RTW after aSAH. This study used mixed methods with a cross sectional design to assess work status at 1-2 years post injury. Participants were recruited at one hospital setting via mailed invitations. Participants were screened over the telephone for eligibility using the Telephone Interview for Cognitive Status test. Consent was obtained for chart review and to participate in the study. One hundred and thirty four participants were asked to complete two questionnaires: the Brief Illness Perception Questionnaire (BIPQ) and the Functional Status Questionnaire. Data analysis was accomplished using bivariate analysis, t-tests, chi square analysis, correlation and binary logistic regression depending on the outcome of RTW as a dichotomous or continuous variable. Kaplan-Meier analysis was used to estimate cumulative RTW. There was a moderate negative correlation between illness perception and RTW. Illness perception was found to significantly predict RTW. The model correctly predicted RTW 62.7% of the time and accounted for 12.4% of the variance in RTW. Further post hoc analysis found that 2 subcategories of the BIPQ (consequences and concern) and marital status improved the prediction model. This study addressed a gap in the literature regarding work status after aSAH and has provided direction for further investigation. Addressing issues surrounding patients' perception of illness, in particular the consequences associated with aSAH and concerns surrounding it, may serve as an important conduit to removing barriers to RTW. Recognition of these barriers to RTW in assessing a person's illness perception may be the key to the development of interventions in the recovery process. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Nursing First Advisor Therese S. Richmond