Return to work after percutaneous transluminal coronary angioplasty.
A prospective study of 82 patients employed in the 6-month period before percutaneous transluminal coronary angioplasty (PTCA) was performed to determine the patterns of lag time in work resumption and the factors associated with early return to work. One month after PTCA, 59% of patients had resumed work whereas 87% were employed 6 months after PTCA. Patients who had a myocardial infarction in the month before PTCA, as well as those with less than 12 years of education, blue collar jobs and low levels of self-efficacy (self-confidence) for return to work had a lower probability of work resumption at every point in the 24 weeks of follow-up. Cox proportional hazards analysis revealed the psychosocial construct, self-efficacy, to be the strongest predictor of return to work 1 month after PTCA, independent of having a recent myocardial infarction, disease severity, age, job classification, gender and physician advice (p = 0.0006). Kaplan-Meier analysis for return to work after PTCA confirmed that patients with high self-efficacy estimates obtained just before hospital discharge after PTCA resumed employment earlier than those with low self-efficacy levels (p = 0.0001). The same relation was observed in those patients with and without a myocardial infarction in the month before PTCA, p = 0.0022 and 0.0012 respectively. These findings suggest that although PTCA is considered relatively safe and minimally invasive by physicians, patients may still lack confidence in their ability to return to work even when physically capable of doing so.
Fitzgerald
S T
ST
Department of Environmental Health Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Becker
D M
DM
Celentano
D D
DD
Swank
R
R
Brinker
J
J
D000041:Absenteeism; D000787:Angina Pectoris / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary / Q000523:psychology; D004651:Employment / Q000523:psychology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000523:psychology; D009790:Occupations; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012649:Self Concept; D013997:Time Factors