title: Work reintegration and cardiovascular disease: medical and rehabilitation influences.
abstract: BACKGROUND
  Research into work reintegration following cardiovascular disease onset is limited in its clinical and individual focus. There is no research examining worker experience in context during the return to work process.
  
  
  METHODS
  Qualitative case study method informed by applied ethnography. Worker experience was assessed through longitudinal in-depth interviews with 12 workers returning to work following disabling cardiac illness. Workplace context (Canadian auto manufacturing plant) was assessed through site visits and meetings with stakeholders including occupational health personnel. Data was analyzed using constant comparison and progressive coding.
  
  
  RESULTS
  Twelve men (43-63 years) participated in the study. Results revealed that unyielding production demands and performance monitoring pushed worker capacities and caused "insidious stress". Medical reassurance was important in the workers' decisions to return to work and stay on the job but medical restrictions were viewed as having limited relevance owing to limited understanding of work demands. Medical sanction was important for transient absence from the workplace as well as permanent disability. Cardiac rehabilitation programs were beneficial for lifestyle modification and building exercise capacity, but had limited benefit on work reintegration. Occupational health provided monitoring and support during work reintegration.
  
  
  CONCLUSIONS
  Medical reassurance can be an important influence on worker representations of disease threat. Medical advice as it pertained to work activities was less valued as it lacked considerations of work conditions. Cardiac rehabilitation lacked intensity and relevance to work demands. Occupational health was reassuring for workers and played an important role in developing return to work plans.
authors: Department of Psychology, Trent University, Peterborough, ON, K9J 7B8, Canada. fergalohagan@trentu.ca
authors: F T
authors: FT
authors: O'Hagan
authors: M F
authors: MF
authors: Coutu
authors: S G
authors: SG
authors: Thomas
authors: D J
authors: DJ
authors: Mertens
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001336:Automobiles; D002170:Canada; D000072038:Cardiac Rehabilitation; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004651:Employment; D006801:Humans; D007221:Industry; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D009786:Occupational Health Services / Q000458:organization & administration*; D009787:Occupational Medicine; D036301:Qualitative Research; D012050:Rehabilitation, Vocational; D018582:Sick Leave; D014937:Work