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Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation.
Vasc Health Risk Manag 2019; 15:301-308VH

Abstract

Objective

We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR).

Methods

We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered.

Results

A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2-0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3-0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1-0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated.

Conclusion

Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients' occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care.

Authors+Show Affiliations

Department of Rehabilitation Research, University of Potsdam, Potsdam, Germany.Cardiological Outpatient Clinik Am Park Sanssouci, Potsdam, Germany.Department of Rehabilitation Research, University of Potsdam, Potsdam, Germany.Department of Cardiology, Klinik Am See, Rehabilitation Centre of Cardiovascular Diseases, Rüdersdorf, Germany.Department of Rehabilitation Research, University of Potsdam, Potsdam, Germany. Department of Cardiology, Klinik Am See, Rehabilitation Centre of Cardiovascular Diseases, Rüdersdorf, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31616150

Citation

Salzwedel, Annett, et al. "Patients' Expectations of Returning to Work, Co-morbid Disorders and Work Capacity at Discharge From Cardiac Rehabilitation." Vascular Health and Risk Management, vol. 15, 2019, pp. 301-308.
Salzwedel A, Reibis R, Hadzic M, et al. Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation. Vasc Health Risk Manag. 2019;15:301-308.
Salzwedel, A., Reibis, R., Hadzic, M., Buhlert, H., & Völler, H. (2019). Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation. Vascular Health and Risk Management, 15, pp. 301-308. doi:10.2147/VHRM.S216039.
Salzwedel A, et al. Patients' Expectations of Returning to Work, Co-morbid Disorders and Work Capacity at Discharge From Cardiac Rehabilitation. Vasc Health Risk Manag. 2019;15:301-308. PubMed PMID: 31616150.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation. AU - Salzwedel,Annett, AU - Reibis,Rona, AU - Hadzic,Miralem, AU - Buhlert,Hermann, AU - Völler,Heinz, Y1 - 2019/08/14/ PY - 2019/05/17/received PY - 2019/06/28/accepted PY - 2019/10/17/entrez PY - 2019/10/17/pubmed PY - 2019/10/17/medline KW - cardiac rehabilitation KW - negative expectation KW - occupational prognosis KW - return to work KW - work capacity SP - 301 EP - 308 JF - Vascular health and risk management JO - Vasc Health Risk Manag VL - 15 N2 - Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR). Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered. Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2-0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3-0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1-0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated. Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients' occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care. SN - 1178-2048 UR - https://www.unboundmedicine.com/medline/citation/31616150/Patients'_expectations_of_returning_to_work,_co-morbid_disorders_and_work_capacity_at_discharge_from_cardiac_rehabilitation L2 - https://dx.doi.org/10.2147/VHRM.S216039 DB - PRIME DP - Unbound Medicine ER -