This study investigated subjective biopsychosocial effects of coronary heart disease (CHD), coping strategies and social support in patients undergoing cardiac rehabilitation (CR) and having extensive work-related problems. A qualitative investigation was performed in 17 patients (48.9±7.0 y, 13 male) with extensive work-related problems (SIMBO-C>30). All patients were interviewed with structured surveys. Data analysis was performed using a software that is based on the content analysis approach of Mayring. In regard to effects of disease, patients indicated social aspects including occupational aspects (62%) more often than physical or mental factors (9 or 29%). Applied coping strategies and support services are mainly focused on physical impairments (70 or 45%). The development of appropriate coping strategies was insufficient although social effects of disease were subjectively meaningful for patients in CR.
People with social problems and risks very often also suffer from health problems and risks. This refers to at least 10% of the population. We were interested to learn how many articles in the leading German journal of Public Health "Das Gesundheitswesen" are dealing with this topic of social inequality and health. From 1990 to 1999 just 5.4% of the 1399 published articles deal with this topic. The authors mainly came from social epidemiology; practical research was rare. This also seems to be a consequence of a lack of research in the departments of social work education.
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