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      Resumption and Maintenance of Employment after a First Acute Myocardial Infarction: Sociodemographic, Vocational and Medical Predictors

      a , c , b , b

      Cardiology

      S. Karger AG

      Employment, Myocardial infarction

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          Abstract

          In a community cohort of 833 women and men aged <60 years, employed at the time of a first acute myocardial infarction (AMI), the relation of sociodemographic, vocational, and medical variables to the following three aspects of employment was investigated longitudinally: resumption of employment anytime within 5 years after AMI, resumption of employment within 3 months of the AMI, and maintenance of employment 5 years after AMI. Different sets of characteristics of persons with a first AMI were related to the different criteria of employment. Only sociodemographic and vocational variables were related to early resumption of employment, whereas maintenance of employment 5 years after AMI was influenced by both medical and nonmedical variables. These results support the importance of examining different aspects of resumption and maintenance of employment after AMI. They also suggest that early resumption of employment after AMI and employment anytime 5 years after AMI are more a function of the sociodemographic and vocational characteristics of the person with the AMI than of that person’s medical condition, whereas long-term maintenance of employment after an AMI is also related to the person’s medical condition.

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          Most cited references 22

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          Recent findings on return to work after an acute myocardial infarction or coronary artery bypass grafting.

          To examine during recent years the rate of work resumption after an acute myocardial infarction or coronary artery bypass surgery, and to analyse variables that predicted return to work. Referral centre for cardiac rehabilitation at the university hospital in Gent. 227 consecutive patients (90 after a first AMI; 137 after a first CABG) were selected for participation. All patients were less than 60 years old and in a social state that still allowed return to work. During hospitalisation, a set of questionnaires, validated as well as self-developed, was presented, measuring psychological and social variables. Medical variables were collected from the medical records. One year later, a follow-up questionnaire was sent by mail, measuring return to work, reasons for not returning, morbidity, and psychological well-being. Return to work was observed in 185/222 (83.3%) of the total study group; 75/86 (87.2%) of the AMI patients and 110/136 (80.8%) of the CABG patients. The mean delay for return to work was 14.8 weeks. After one year, patients who returned to work, showed more positive affect, less negative affect, less somatic complaints and less cognitive complaints. This better psychological profile was not affected by the morbidity score. Variables predicting return to work in CABG patients were different from those in AMI patients. Only two medical variables could be retained in CABG patients (good left venticular function and a larger degree of revascularisation). Mainly psychological variables had predictive power (trust, job security, positive expectations concerning return, no attribution to stress, less somatic complaints, less physical exertion of the job). Return to work remains one of the main issues in cardiac rehabilitation after AMI or CABG. If resumption is sufficiently emphasized, a high success rate can be achieved. This approach should include a psychosocial strategy starting already during hospitalisation.
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            Return to work after an initial myocardial infarction and subsequent emotional distress.

             K Rost,  J. G. Smith (1992)
            We examined how return to work predicted subsequent change in emotional distress in 143 patients who had been employed at the time of initial myocardial infarction. Ninety patients (63%) returned to work by 4 months and remained employed at 12 months. There were no differences in mental health at baseline between those who returned to work and those who did not, but emotional distress decreased significantly between 4 and 12 months only in the group who returned to work. Emotional distress declined after resuming work even when employees returned to jobs with which they reported dissatisfaction at the time of the myocardial infarction. The relationship between return to work and decreasing emotional distress remained after controlling for initial physical and psychological adjustment as well as sociodemographic and social support characteristics. The improvements in mental health associated with return to work should reassure clinicians who emphasize the emotional as well as economic value of work after an initial myocardial infarction.
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              Return to work after myocardial infarction/coronary artery bypass grafting: patients’ and physicians’ initial viewpoints and outcome 12 months later

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2005
                November 2004
                24 November 2004
                : 103
                : 1
                : 37-43
                Affiliations
                Departments of aRehabilitation and bEpidemiology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, and cDepartment of Psychology, Bar Ilan University, Ramat Gan, Israel
                Article
                81850 Cardiology 2005;103:37–43
                10.1159/000081850
                15528899
                © 2005 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 3, References: 48, Pages: 7
                Categories
                Coronary Care

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