Zdravniški Vestnik (Sep 2005)
Impact of physical, sociodemographic, and psychological factors on return to work after acute coronary syndrome
Abstract
Background: In Slovenia there is a lack of data regarding the return to work for patients after acute coronary syndrome (ACS) for last two decades. We evaluated how return to work is affected by several physical, sociodemographic and psychological factors.Methods: In retrospective cohort study we screened 174 patients, younger than 60 years and fully employed before the disease, who participated in out-patient rehabilitation programme between years 1999 and 2002. The data on clinical characteristics, the mode of treatment of ACS and exercise capacity were obtained from medical charts. The psychosocial factors and the data about working ability were compiled by structured questionnaire.Results: Eighty-two patients returned complete questionnaire and 58 (71%) of them returned to work. The patients returned to work had less diabetes (9% vs. 29%, p = 0.02), were more frequently treated with acetylsalicylic acid (79% vs. 50%, p = 0.01), had higher exercise capacity after the rehabilitation (8.6 ± 2.4 MET vs. 7.4 ± 1.9 MET, p = 0.03), and in everyday life (heavy activities 60% vs. 25%, p = 0.004), were more frequently supported by their friends (88% vs. 67%, p = 0.02) and co-workers (67% vs. 38%, p = 0.01), had greater desire to return to work (50% vs. 25%, p = 0.04) and were more often advised to return to work by the doctor (72% vs. 8%, p < 0.001). In multiple logistic regression model return to work was associated with doctor’s advice (risk ratio 63.9, 95% confidence interval 5.4 – 754, p = 0.001) and great desire to return to work (risk ratio 7,3, 95% confidence interval 1.1 – 49.5, p = 0.04).Conclusions: Doctor’s advice and great desire to return to work were the most important predictors of return to work.
