title: Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease.
abstract: BACKGROUND
  During the last decades mortality has declined in patients with coronary heart disease due to improvements in treatments and changes in life style, resulting in more people living with chronic heart disease. This implies that focus on rehabilitation and re-integration to the work-force becomes increasingly important. Previous studies among healthy workers suggest that the psychosocial working environment is associated with sickness absence. Whether the psychosocial working environment plays a role for patients with existing cardiovascular disease on return to work and sickness absence is less studied.
  
  
  METHODS
  A cohort of patients under 67 years and treated with percutaneous coronary intervention (PCI) was established in 2006. Three months after the procedure the patients (n = 625) answered a questionnaire about their psychosocial working environment. Patients were followed in registers for the following year. We examined the association between psychosocial working environment and sickness absence at 3 months, 1 year and new sick-listings during the first year with logistic regression.
  
  
  RESULTS
  A total of 528 patients had returned to work 3 months after the PCI, while 97 was still sick-listed. After 1 year one was dead, 465 were working and 85 were receiving health related benefits, while 74 had left the workforce permanently. A number of 106 patients were sick-listed during the whole first year or had left the workforce permanently. After the initial return to work, 90 experienced a new sickness absence during the first year while the remaining 429 did not. High work pace, low commitment to the workplace, low recognition (rewards) and low job control were associated with sickness absence at 3 months, but not after 1 year. Low job control as well as job strain (combination of high demands and low control) was associated with new sick-listings.
  
  
  CONCLUSIONS
  The psychosocial working environment was associated with sickness absence 3 months after the PCI, but not 1 year after.
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, 7400, Herning, Denmark. karbie@rm.dk.
authors.forename: Karin
authors.initials: K
authors.lastname: Biering
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, 7400, Herning, Denmark.|National Centre for Occupational Rehabilitation, Rauland, Norway.|Research and Development, Public Health and Quality Improvement, Central Denmark Region, MarselisborgCentret, Århus, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lund
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, 7400, Herning, Denmark.
authors.forename: Johan Hviid
authors.initials: JH
authors.lastname: Andersen
authors.affiliation: Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, 7400, Herning, Denmark.|WestChronic, Regional Hospital West Jutland, Herning, Denmark.|Department of Clinical Epidemiology, Aarhus University Hospital, Århus, Denmark.
authors.forename: Niels Henrik
authors.initials: NH
authors.lastname: Hjollund
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D017009:Professional Autonomy; D062707:Return to Work / Q000706:statistics & numerical data*; D012201:Reward; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace / Q000523:psychology*
keywords: Coronary heart disease; Psychosocial working environment; Rehabilitation; Return to work; Sickness absence