The Net Return Side Barriers To Critical Thinking
The Home Series Side Barriers are specifically designed for use with The Net Return Home Series Net. The Side Barriers insure that mishit balls never leave the hitting area.
If using the Home Series net indoors or in an area where errant balls are a safety concern, the Side Barriers are required. Many golfers also choose to add the Side Barriers when considering "Friends and Family" hitting into the net.
If you are an accomplished golfer or using the Home Series outdoors where safety is not a concern, the Side Barriers are not required.
Understand also that the Home Series Side Barriers can be added at anytime and are not required for use with the Home Series net.
The Home Series Side Barriers are made of polyester netting, setup in under 5 minutes (using Velcro color coordinated tabs) and can be easily stored or transported in the Home Series duffle bag. Each Side Barrier is individually cut and sewn by hand.
Each pair of Side Barriers weigh approximately 6 lbs., are 6’8” high and extend out to 9’ - 10' in length. They are sold in pairs (right and left), can be extended straight out or setup on wider angles as needs dictate. Each set of Side Barriers are extended out by using sandbags, two are provided (one for each Side Barrier) and two on the rear of the frame. Remember your Home Series Multi-Sport Net comes with 4 Sandbags to weight down the existing base when outdoors in the wind.
When extending out the Side Barriers to their max distance (approximately nine feet or so) you may also want to weight (sandbag) or stake the back of the frame. Extending the Side Barriers to their maximum distance can often lift the back of the frame off the ground by several inches. The weighting of the rear of the frame will eliminate this.
Also Note -
The Side Barriers can be walked into the front of the frame when not in use, to recover any lost floor space. Simply pick up each sandbag, walk in and place on the side of the frame. It's that simple
Characteristics of stroke survivors included in the study
Sixty participants were included in the study, 51 were stroke survivors who posted on the forum themselves, while the remaining nine stroke survivors were posted about by family members. Both sexes were represented and median age was , ranging from 25 to 66 (table 1). Most people had a stroke, but some included in the study had a transient ischaemic attack (TIA). Most people returned to work between 3 and 6 months after their stroke, although time-lapse before returning to work varied greatly and was not described by half of the sample. All people, including the ones who experienced a TIA, described suffering from residual impairments that impacted on their working life. Impairments included fatigue, epilepsy, pain, psychological and cognitive problems. Only some had visible impairments, including walking difficulties and speech problems.
Characteristics of the Talkstroke online participants as identified in the posts
Themes
We found a wide range of barriers and facilitators of staying in work from the stroke survivors and carers perspectives, which are shown in table 2. Findings will be discussed within the three themes below:
Understanding stroke
A very important reason for people having difficulties at work, or even being at risk of losing their job, was having invisible impairments. Invisibility of impairments often led to a lack of understanding as they are not immediately obvious, in particular by the employer but also the general practitioner (GP) and stroke survivor themselves. If impairments or stroke were more visible, it was usually easier for other people as well as the patients themselves to understand their difficulties. The understanding and knowledge about stroke and stroke-related impairments among employers, as well as patients themselves and others such as GPs is very important to staying in work, as well as to receiving appropriate support from employers and GPs.
Support from others, in the form of formal adjustments at work, or making patients feel understood, was important to staying in work. Usually, employers who better understood the stroke-related problems were more supportive. However, people also described occasions in which they felt bullied, or others were making jokes about them. A main finding is that the invisibility of impairments greatly affects people's understanding of stroke, and as a result the support received, which may affect their ability to stay in work.
A range of impairments were described as reasons for not being able to staying in work, or for having difficulties at the workplace. Sometimes problems were brought on by being back at work. Medical interventions such as physiotherapy, and support from family members or GPs helped general recovery and therefore helped people successfully maintaining employment. Being able to cope with these impairments had a positive effect on work. There were also various indirect issues related to recovery that made working difficult (such as not being able to drive, or stress at work bringing on problems).
The findings did not seem to differ between people who suffered a stroke and TIA—people with a TIA also reported residual impairments and difficulties at the workplace. Moreover, people with invisible impairments and those with visible and invisible impairments did not seem to differ clearly in the way these issues were experienced (however, all individuals had invisible impairments to some extent). No particular differences were found regarding job type and time of returning to work, although these data were missing for quite a large part of the sample.
Themes, divided in barriers and facilitators in retaining work among people who have returned to work: findings from the Talkstroke online webforum
Understanding stroke
Invisibility of impairments and misunderstanding
All individuals reported invisible impairments to some extent, of which the most common was fatigue (table 2, 1a). Other invisible impairments that were described included cognitive impairments such as memory problems, personality changes and pain. People described that having an invisible impairment often led to misunderstanding, in particular by the employer but also the GP, as well as by the person themselves (table 2, 1d). The lack of visibility of the impairment or the fact that they were lasting beyond the planned period of phased return to work led to stroke survivors being perceived as ‘making up’ their problems, being lazy, too often sick and underperforming. This caused a lot of frustration to the forum users. In a few cases, this even led to the risk of losing the job. “A man shared his experience that his boss tells him that he is being lazy, and that he cannot blame the stroke anymore for not having motivation for work. (Male, 43, age at stroke 43, stroke type not stated, job type not stated, N42)”.
Two people described their GPs lack of understanding about their stroke-related problems (table 2, 1d). “One person described that she thinks that, except for people who have experienced a stroke, no one understands the consequences of stroke, and her GP definitely does not understand it either. (Female, 50, age at stroke 47, stroke, office/professional job, N3)”.
Normality
Having invisible impairments was sometimes described by patients in relation to normality, as looking normal but not feeling normal. The contrast between looking and sounding normal from the outside and the presence of fatigue and other invisible impairments often led to difficulties, and a lack of understanding by others (table 2, 1a, b, d); others could not see anything different to how people were before the stroke, and therefore treated them in the same way as usual. “A wife of a stroke survivor wrote that it was frustrating that workmates were treating her husband in the same way as before his, as if he was fully recovered (Male, 49, age at stroke 49, stroke type not stated, job not stated, written by carer, N51)”.
Invisibility of problems also caused difficulties for patients themselves, and some felt they should be back to ‘normal’ because they looked normal, but were not able to work as before because of invisible impairments (table 2, 1a, b). One person wrote that he was feeling a fraud. “A person discusses that at on the one hand, he experienced something life-changing with long lasting consequences, whereas on the other hand, he feels a fraud, because he did not have major (visible) impairments (Male, 61, age at stroke 61, stroke, office/professional job, N28)”.
Some people described that they were trying to act normal, although the ‘denial’ of problems led to difficulties; when people pushed themselves too hard, this became a barrier to staying in work (table 2, 1f). Although the contrast between looking normal, but not feeling normal usually caused difficulties from the patient and others' perspectives, there were a few people whose goal to return to work to go ‘back to normal’ led to a positive work experience (table 2, 1b). However, realistically accepting the situation and adjusting accordingly were important factors in successfully ‘staying in work’ experience (table 2, 1f, see also box 1, coping strategies).
Strategies as described by participants in dealing with work, staying in work, or problems at work or related to work
Cognition-focused coping‘Not giving up’
Not giving up/keep going/keep trying
Pushing oneself/going on like before the stroke
Getting on with it
‘Slowing down’
Taking it easy/not overdoing things/building up gradually
Working slower than before/take it slowly
Not pushing oneself/be kind to oneself
Pacing oneself/taking one day a time/doing a little bit every day
‘Accepting change’
Acceptance (eg, of the impairments, of the new self, or the new situation)
Listen to body
Be positive
Being patient
Be prepared for bad days
‘Thoughts’
Thinking about stroke survivors in worse situations
Not thinking about the problem
Back to work as a way to forget/to be ‘normal’
Thinking of what one can do instead of cannot do
Action-focused copingDealing with fatigue
Learning about fatigue
Learning how to manage fatigue
Taking naps/going to bed early
Exercise to fight tiredness
Dealing with stroke-related problems
Asking work colleagues for help with mobility
Asking work colleagues for help with communication
Using voice recognition software
Proofreading/using spelling check
Taking breaks at work (eg, to deal with background noise)
Reducing travel to work (eg, by staying overnight at parents’ house which is nearer to work)
Practicing driving before return to work
Taking antidepressant to improve confidence at work
Planning in advance and in detail how to fix a problem at work
Concentrating when moving the weak side of the body at work
Dealing with other people
Providing explanations to others (about being different than before stroke, especially about ‘invisible’ impairments)
Using humour when dealing with negative comments
Give employer information about stroke, especially about ‘invisible’ impairments
Ignore people who are making negative comments/making fun
Thinking about what to say (as a reply to potential comments) before meeting colleagues
Getting support/advice
Setting up a young stroke group to get support
Reading the Stroke Association website for advice helps recovery
General
Making changes in lifestyle
Going back to work as a way to improve recovery and satisfaction
Not working excessively
Setting goals
Keeping active
Expecting and accepting physical difficulties, and not doing too much too soon
Some elements mentioned here may additionally appear in table 2. The aim of box 1 is to offer to the readers and stakeholders (patients, carers, employers and representatives, GPs and Occupational Therapists) strategies that have been distilled over time and with efforts by those patients who managed to endure the process of returning and staying in work.
These are descriptions of actual quotes—they have been paraphrased to respect the identity and intellectual property of forum participants (see Ethics section in the Methods).
Fatigue: a common invisible impairment
The most important invisible impairment causing difficulties at work was fatigue. More than half of people described fatigue in their posts, and some described how fatigue affected their productivity at work, or that needing to rest after work affected their day-to-day activities. “A woman described that she tries to keep her part-time job, but that she feels sore and fatigued, and needs to sleep after getting home. She has to stay in bed the rest of the day, until her husband comes home and cares for her. (Female, age at stroke and current age not stated, stroke, office/professional job, N13)” (table 2, 1a).
Several people described difficulties they had understanding the impact of fatigue, and how it was brought on by stress and day-to-day work (tab1e 2, 1a, d, e). “A stroke survivor wrote about how he did not realise what stroke-related fatigue was, until he quit his job and felt better, and talked to an occupational therapist after he could make more sense of how he felt (Male, 50, age at stroke 47, stroke, office/professional job, N19)”.
The impact of fatigue was sometimes greater than people had originally anticipated, in particular if they had suffered a TIA, as people were supposed to only have temporary problems as a result of a TIA (table 2, 1e). “A man who had a TIA described that, after returning to work, he was surprised that he felt so exhausted. He then realised that he was still having problems (Male, 46, age at stroke 45, TIA, office/professional job, N59)”.
Impairments becoming ‘visible’
Four people described having their stroke at the workplace. One of them said that their stroke became ‘visible’ to others because it happened at the workplace, and suggested that this helped being supported and understood by the employer and colleagues despite ‘invisible’ impairments. “A woman wrote that her employer has been very understanding, which she thought may have been because she has had her stroke in front of everyone at work (Female, 51, age at stroke 51, stroke, office/professional job, N20)” (table 2, 1a).
A few people did not want to share their stroke-related difficulties with their employer, or felt embarrassed about sharing their problems with others (table 2, 1c). This created interpersonal problems and acted as a barrier, as impairments were not disclosed. People around them could therefore not be aware of the extent of the difficulties the stroke survivor was experiencing and could not be supportive. “A woman wrote that her husband had a stroke, and was recovering well. He returned to work part-time, but was still having difficulties with writing. He was able to hold a pen, but could not write in the way he wanted to. She said he felt embarrassed about it, and was reluctant to ask the health and safety team for support. (Male, 38, age at stroke 38, stroke, office/professional job, written by carer, N37)”.
Support
Support, in the form of formal adjustments as well as ‘feeling’ supported, was an important facilitator in retaining work (table 2, 2a, b). Having an employer who was patient and supportive helped the person ease back into work. Talking with the employer about problems and with Human Resources and Occupational Health helped create a supportive environment, through increasing all parties' awareness of stroke-related impairments, especially the non-apparent ones. This also made it possible to make appropriate work adjustments. For most stroke survivors, adjustments were gradual return, reduced hours and working at home. “One person describes that no appropriate adjustments were made. He looked the same as before, and even though he told his employer about his problems, they never offered him help. His productivity declined, and he went to the GP for advice, who told him to talk to HR. Although he did have an Occupational Health assessment, he felt that no adjustments were made he was expected to function as usual, and he was at risk of losing his job. (Male, 41, age at stroke 37, stroke, office/professional job, N15)”.
Understanding of stroke-related impairments was closely related to support. After learning more about stroke and impairments of an employee, an initially ‘difficult’ employer changed his attitude and supported his employee better (table 2, 1d, 2a, b). “A man reported that his manager was initially not good at communicating and understanding him, however, after he heard at the assessment about the problems he was having, he became much more understanding and supportive. (Male, 61, age at stroke 61, stroke, office/professional job, N28)”.
However, being supportive also varied person to person, and change in management personnel affected the ability of staying in work. One person was back at work for a long time, with an understanding manager. The arrival of a new manager unaware of the person's stroke-related impairments lead to the employee being bullied. He/she described considering leaving the job. When employers were not being supportive (eg, by not making suitable adjustments, or not believing the person's problems), stroke survivors suffered great distress, in particular when feeling they were at risk of losing their job. Another person described how it became too difficult to deal with an unsupportive, bullying employer and considered early retirement. Others felt they were bullied by colleagues, and although they usually coped with this by ignoring them, or making jokes, it affected them negatively (table 2, 2b, c).
The GP's role
The role or support from the GP was not commonly mentioned, but mostly in the context of writing or not writing sick notes. Experiences with the GP writing sick notes varied. One person mentioned that her GP was supportive and let her decide when she felt ready to return to work. “She wrote that her GP said that it was up to her when she was ready to return to work. She then went back to work after 8 weeks. (Female, 52, age at stroke 51, stroke, office/professional job, N24)” (table 2, 2e).
Another person felt upset because he felt that the GP did not seem to consider the problems the person was having and did not want to write a sick note. “He described that the GP was not willing to extend the sick leave, as the GP thought he was fit enough to return to work, even with impairments such as walking problems, communication problems, limb spasms and fatigue, because he could sit at a desk and could move all limbs. (Male, 61, age at stroke 61, stroke, office/professional job, N28)”.
In only two cases, a person received advice from the GP about returning to work. “A woman said that her GP advised her to return to work on reduced hours. (Female, 39, age at stroke 39, stroke, job not stated, N58)”.
Impairments and recovery
Stroke-related impairments and recovery
Stroke survivors did experience a wide range of visible and invisible impairments (including but not limited to physical, psychological, language and cognitive) that affected to some extend their performance or staying in work, for example “a man who explained that he realised he could not do his job (machinery setter) anymore physically and mentally, and was interested in receiving training to do a different job. (Male, 32, age at stroke 32, stroke, manual job, N16)” (table 2, 3a).
Some people described their problems that affected specific aspects of their job. “A woman described a situation in which she was talking to a customer, and she could not get her words out. Her secretary had to take over the conversation, and she could not function well afterwards as she was shaky and tired. (Female, 48, age at stroke 46, stroke, self-employed, N25)”.
In some cases, problems were brought on by being back at work, and people did not realise the extent of their problems before returning. “The wife of a stroke survivor described how her husband did not think that he still had major problems, however, trying to do things like before the stroke (computer work) made him realise that his problems were more severe than he previously thought (Male, 54, age at stroke 52, stroke, manual job, written by carer, N21)”.
Stress was described as a source of greater difficulties than before stroke, and sometimes worsened stroke-related impairments (eg, fatigue and pains). Reducing stress helped people being able to stay in work, although it meant for some having to change jobs to reduce the stress (table 2, 3c). “Someone with his own company described having gone back to work, but realised he could now only work part-time and was getting strange feelings in arms and legs when he was stressed. (Male, 59, age at stroke 56, stroke, self-employed, N32)”.
Rehabilitation and medical interventions such as physiotherapy did help people in their general recovery, and as a result improved their ability to stay in work. A few people reported that there was improvement over time (table 2, 3a). “This person described having a weak left arm and that it was only possible to type with one hand, which did not go very well. About a month later the person could type with both hands again, almost up to the level as before the stroke, to explain that things can improve over time. (Male, 61, age at stroke 61, stroke, office/professional job, N28)”.
Indirect problems affecting return to work
Various other issues indirectly related to work affected successfully staying in work, including not being able to drive, needing to sleep a lot, and needing a long time to get ready in the morning. Having not enough money, especially if not entitled to benefits or retirement, was an important reason for people to keep working, even though it proved difficult for them (table 2, 2d, 3b). “A woman wrote that her husband was having a difficult time with his full-time work. It would have been better if he had more time at home, however, he had no choice but to go back to work as they have little financial support. Apart from tax credit, they did not get anything because they were self-employed. They only had some statutory sick pay from a previous part-time job. (Male, 54, age at stroke 52, stroke, manual job, written by carer, N21)”.
Coping with impairments
If people were able to cope with their impairments, this sometimes led to a more positive experience at work. Some people reported that once they had accepted their changed abilities, and ‘listened to their body’, paced their work, or were ‘patient with themselves’, it became easier to deal with their impairments and day-to-day activities. Several people describe how if they pushed themselves and overdid it, they felt worse later. However, at the same time people advised others on the forum to keep trying, and in a few occasions push oneself. “A woman explained that with time she started to feel more like the person she was before stroke, but that she still tended to overdo things, which had consequences the next day. She drove her son back to university, and found the long distance journey very tiring. She wrote however that she had to get used to it, as her car journey to work was also long. She was planning to go into work earlier to try the driving, and catching up on work. (Female, 46, age at stroke 45, TIA, office/professional job, N59)” (table 2, 3b).
Others developed clear strategies that they used to deal with specific problems, such as work issues, or problems related to (getting to) work, such as getting ready in the morning. Box 1 is summarising coping strategies developed by the study participants to successfully staying in work after stroke/TIA. A description of quotes has been used to protect the identity and intellectual property of forum participants (see also the Ethics section in the Methods). “A woman described that she needed to get up earlier in the morning because she had become slower after her stroke. Getting her clothes ready the night before, and having a shower in the evening was also helpful. (Female, 51, age at stroke 51, stroke, office/professional job, N20)”.