Recent findings on return to work after an acute myocardial infarction or coronary artery bypass grafting.
OBJECTIVE
To examine during recent years the rate of work resumption after an acute myocardial infarction or coronary artery bypass surgery, and to analyse variables that predicted return to work.


METHODS
Referral centre for cardiac rehabilitation at the university hospital in Gent.


METHODS
227 consecutive patients (90 after a first AMI; 137 after a first CABG) were selected for participation. All patients were less than 60 years old and in a social state that still allowed return to work. During hospitalisation, a set of questionnaires, validated as well as self-developed, was presented, measuring psychological and social variables. Medical variables were collected from the medical records. One year later, a follow-up questionnaire was sent by mail, measuring return to work, reasons for not returning, 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 patients. 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 affect, less somatic complaints and less cognitive complaints. This better psychological profile was not affected by the morbidity score. Variables predicting return to work in CABG patients were different from those in AMI patients. 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, positive expectations concerning return, no attribution to stress, less somatic complaints, less physical exertion of the job).


CONCLUSIONS
Return to work remains one of the main issues in cardiac rehabilitation after AMI or CABG. If resumption is sufficiently emphasized, a high success rate can be achieved. This approach should include a psychosocial strategy starting already during hospitalisation.
Cardiac Rehabilitation Centre Gent, University Hospital, Belgium. hedwig.boudrez@rug.ac.be
H
H
Boudrez
G
G
De Backer
D001026:Coronary Artery Bypass; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D011184:Postoperative Period; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires