Effects of Phase II Cardiac Rehabilitation on Job Stress and Health-Related Quality of Life After Return to Work in Middle-Aged Patients With Acute Myocardial Infarction

Abstract

SummaryThe aim of the present study was to clarify the effects of phase II cardiac rehabilitation (CR) on job stress and health-related quality of life (HRQOL) after return to work in middle-aged patients with acute myocardial infarction (AMI). A total of 109 middle-aged outpatients (57 ± 7 years) who completed a phase I CR program after AMI were enrolled, 72 of whom participated in a phase II CR program for 5 months after hospital discharge (CR group) and 37 who discontinued the phase II CR program after the discharge (non-CR group). Job stress was assessed at 6 months after the AMI using a brief job stress questionnaire containing questions related to job stressors, worksite support, level of satisfaction with work or daily life, and psychological distress. HRQOL was assessed using the short-form 36-item health survey (SF-36) at hospital discharge and at 3 and 6 months after the AMI. There were no significant differences in clinical and occupational characteristics between the CR and non-CR groups. The CR group patients exhibited significantly better results for job stressors and psychological distress and higher SF-36 scores at 6 months after the AMI, as compared with those in the non-CR group. These findings suggest that discontinuing a phase II CR program induced chronic psychosocial stress after return to work in these middle-aged post-AMI patients. (Int Heart J 2009; 50: 279-290)

Return to work after coronary revascularization procedures and a patient’s job satisfaction: A prospective study

“…Specifically, the results showed that the best predictors of a satisfying RTW after cardiac invasive procedures were: job satisfaction for the pre-illness work environment, depression and ambition, independently of sociodemographic factors, medical factors and a type of RTW (full or partial). The key role in the RTW process after an acute cardiac event played by non-medical factors has been also explored by earlier research [3][4][5]9,[15][16][17][18][19][20][21][22][23]. Recent studies have shown that the perception of work environment, which can be reflected in work stress and job satisfaction, has a strong effect on both people's decision to RTW [16,21,22] and duration of sickness absence [15,16].…”

“…Most of these studies have found that predictors of HRQL after a heart surgery or coronary angioplasty were primarily psychological and not related to the illness severity [13][14][15][16]. Instead, research on professional life and work reintegration after cardiac interventions have focused mainly on the identification of factors predicting RTW (i.e., working/not working) or time for RTW [3,4,[17][18][19], while very few studies have investigated the quality of work resumption, in terms of a patient's job satisfaction and re-adaptation to work [15][16][17][18][19][20][21][22]. Recent studies suggested an important role of psychosocial work environment in the RTW process, with particular emphasis on work stress and job satisfaction [15,16,18,19,21,22].…”

“…Instead, research on professional life and work reintegration after cardiac interventions have focused mainly on the identification of factors predicting RTW (i.e., working/not working) or time for RTW [3,4,[17][18][19], while very few studies have investigated the quality of work resumption, in terms of a patient's job satisfaction and re-adaptation to work [15][16][17][18][19][20][21][22]. Recent studies suggested an important role of psychosocial work environment in the RTW process, with particular emphasis on work stress and job satisfaction [15,16,18,19,21,22]. Dekkers-Sànchez et al [23] have recently explored factors promoting sustained RTW of employees on long-term sick leaves and underlined the key role played by the work environment and subjective attitude towards work (e.g., work motivation, positive meaning of work, cognitions and RTW expectations).…”

“…In view of the influence of job satisfaction on the RTW process, it is important to understand which factors produce job satisfaction among employees who return to work after a long-term period of sick leave due to cardiac health problems. However, few studies have investigated the work adjustment process in terms of workers' perception of their psychosocial work environment after a longterm sick leave [12,[15][16][17][18][19]. For example, a recent study by Waszkowska et al has found that patients maladapted to work have higher levels of depression, anxiety and lowered work ability compared to the well-adapted group after myocardial infarction [12].…”

Effects of Phase II Comprehensive Cardiac Rehabilitation on Coronary Plaque Volume After Acute Coronary Syndrome

“…1) Comprehensive cardiac rehabilitation (CR) is an established program for patients with ACS after treatment by coronary artery bypass grafting (CABG) and heart failure 2) that helps to modify coronary risk factors and improve quality of life. 3,4) A metaanalysis has shown that CR reduces all-cause mortality by 20% and cardiac mortality by 25%. 5) The mechanisms through which CR improves mortality risk are attributed to improvements in lipid profiles, glucose metabolism, neurohormonal factors, autonomic nerve system, endothelial function, and reduced vascular inflammation.…”