Stakeholder perspectives on a return-to-work cognitive intervention after stroke

Objective To investigate stakeholder experiences on return-to-work after stroke and preferences to co-design a return-to-work cognitive intervention, addressing a gap in post-stroke rehabilitation. Design In-depth semi-structured interviews were conducted and reflexive thematic analysis guided by Braun and Clarke's six-phase approach was employed to analyse transcribed data, with iterative coding to identify themes until thematic saturation was achieved. Setting Community, work, and healthcare settings. Participants Twenty purposively sampled participants across four stakeholder groups: stroke survivors ( n = 7), caregivers ( n = 4), healthcare professionals ( n = 5), and employers ( n = 4). Main measures Stakeholder perspectives on (i) the return-to-work process after stroke and (ii) preferences for the design and delivery of a return-to-work cognitive intervention after stroke. Results Three core themes emerged: (i) barriers to return-to-work, (ii) intervention content, and (iii) intervention delivery. Each theme comprised several subthemes and dimensions that offered deeper insight into participants’ perspectives. Barriers to return-to-work encompassed lack of awareness of resources, ineligibility of support schemes, and lack of understanding from workplace. Intervention content comprised subthemes of awareness, acceptance and adjustment, goal setting, strategies for self-management, and navigating the return-to-work journey. Intervention delivery included programme structure, social support, format and accessibility. While there was broad agreement, stakeholders also expressed divergent priorities shaped by their roles and experiences. Conclusions This study synthesises lived experiences, clinical expertise, and employer insights from stakeholders to inform the co-design of a return-to-work cognitive intervention. This work advances a paradigm shift towards a patient-centred and ecological approach to improve post-stroke workforce reintegration.