Recent findings on return to work after an acute myocardial infarction or coronary artery bypass grafting

Citation
H. Boudrez et G. De Backer, Recent findings on return to work after an acute myocardial infarction or coronary artery bypass grafting, ACT CARDIOL, 55(6), 2000, pp. 341-349
Citations number
40
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
ACTA CARDIOLOGICA
ISSN journal
00015385 → ACNP
Volume
55
Issue
6
Year of publication
2000
Pages
341 - 349
Database
ISI
SICI code
0001-5385(200012)55:6<341:RFORTW>2.0.ZU;2-W
Abstract
Objective - To examine during recent years the rate of work resumption afte r an acute myocardial infarction or coronary artery bypass surgery, and to analyse variables that predicted return to work. Setting - Referral centre for cardiac rehabilitation at the university hosp ital in Gent. Patients - 227 consecutive patients (90 after a first AMI; 137 after a firs t CABG) were selected for participation. All patients were less than 60 yea rs old and in a social state that still allowed return to work. During hosp italisation, a set of questionnaires, validated as well as self-developed, was presented, measuring psychological and social variables. Medical variab les were collected from the medical records. One year later, a follow-up qu estionnaire was sent by mail, measuring return to work, reasons for not ret urning, morbidity, and psychological well-being. Results - Return to work was observed in 185/222 (83.3%) of the total study group; 75/86 (87.2%) of the AMI patients and 110/136 (80.8%) of the CABG p atients. The mean delay for return to work was 14.8 weeks. After one year, patients who returned to work, showed more positive affect, less negative a ffect, less somatic complaints and less cognitive complaints. This better p sychological profile was not affected by the morbidity score. Variables pre dicting return to work in CABG patients were different from those in AMI pa tients. Only two medical variables could be retained in CABG patients (good left venticular function and a larger degree of revascularisation). Mainly psychological variables had predictive power (trust, job security, positiv e expectations concerning return, no attribution to stress, less somatic co mplaints, less physical exertion of the job). Conclusions - Return to work remains one of the main issues in cardiac reha bilitation after AMI or CABG. If resumption is sufficiently emphasized, a h igh success rate can be achieved. This approach should include a psychosoci al strategy starting already during hospitalisation.