43725
2019
2019
eng
301
308
8
15
article
Dove Medical Press
Albany, Auckland
1
2019-08-14
2019-08-14
--
Patients’ expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation
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.
Vascular Health and Risk Management
10.2147/VHRM.S216039
1176-6344
1178-2048
Universität Potsdam
PA 2019_70
1882.58
<a href="https://doi.org/10.25932/publishup-43726">Zweitveröffentlichung in der Schriftenreihe Postprints der Universität Potsdam : Humanwissenschaftliche Reihe ; 574</a>
CC-BY-NC - Namensnennung, nicht kommerziell 4.0 International
Annett Salzwedel
Rona Katharina Reibis
Miralem Hadzic
Hermann Buhlert
Heinz Völler
eng
uncontrolled
cardiac rehabilitation
eng
uncontrolled
return to work
eng
uncontrolled
work capacity
eng
uncontrolled
negative expectation
eng
uncontrolled
occupational prognosis
Medizin und Gesundheit
open_access
Strukturbereich Kognitionswissenschaften
Referiert
Publikationsfonds der Universität Potsdam
Open Access
43726
2019
2019
eng
301
308
8
574
postprint
1
2019-10-30
2019-10-30
--
Patients’ expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation
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.
Postprints der Universität Potsdam Humanwissenschaftliche Reihe
10.25932/publishup-43726
urn:nbn:de:kobv:517-opus4-437263
1866-8364
Vascular Health and Risk Management 15 (2019) S. 301–308 DOI: 10.2147/VHRM.S216039
<a href="http://publishup.uni-potsdam.de/43725">Bibliographieeintrag der Originalveröffentlichung/Quelle</a>
CC-BY-NC - Namensnennung, nicht kommerziell 4.0 International
Annett Salzwedel
Rona Katharina Reibis
Miralem Hadzic
Hermann Buhlert
Heinz Völler
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
574
eng
uncontrolled
cardiac rehabilitation
eng
uncontrolled
return to work
eng
uncontrolled
work capacity
eng
uncontrolled
negative expectation
eng
uncontrolled
occupational prognosis
Medizin und Gesundheit
open_access
Strukturbereich Kognitionswissenschaften
Referiert
Open Access
Universität Potsdam
https://publishup.uni-potsdam.de/files/43726/phr574.pdf