Effects of Cardiac Rehabilitation on Job Stress and QOL in Patients with Acute Myocardial Infarction

Abstract

PURPOSE: To clarify the effects of phase II cardiac rehabilitation (CR) on job stress and quality of life (QOL) after return to work by middle-aged patients with acute myocardial infarction (AMI). METHODS: Forty-eight middle-aged outpatients (57±7 yrs) who completed a phase I CR program because of AMI were divided into 2 groups; 34 patients who participated in a phase II CR program for 5 months after AMI (CR group), and 14 who discontinued the phase II CR program after hospital discharge (non-CR group). Job stress was assessed 6 months after AMI using a Brief Job Stress Questionnaire consisting of questions related to job stressors (quantitative job overload, qualitative job overload, physical demand, interpersonal conflict, poor physical environment, job control, skill underutilization, suitable job, and rewarding job), worksite support (supervisor support, coworker support, and family support), and psychological distress (lack of vigor, irritability, fatigue, anxiety, depressed mood, and somatic symptoms). QOL were assessed using the Short-Form 36-Item Health Survey (SF-36) consisting of physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health at hospital discharge and 3 and 6 months after AMI. RESULTS: The scores of rewarding job among job stressors was significantly higher in the CR group than in the non-CR group (P<0.01). The scores for lack of vigor, irritability, fatigue, depressed mood, and somatic symptoms among psychological distress were significantly higher in the CR group than in the non-CR group (P<0.01, P<0.05, P<0.01, P<0.01, and P<0.05, respectively). The bodily pain (BP) and social functioning (SF) scores in SF-36 improved significantly 6 months after AMI in the CR group, compared with hospital discharge (P<0.05 and P<0.05, respectively), although the BP score decreased significantly 6 months after AMI (P<0.05) and the SF score showed no changes during the study period in the non-CR group. The BP and SF scores 6 months after AMI were significantly higher in the CR group than in the non- CR group (P<0.05 and P<0.05, respectively). CONCLUSION: These findings suggest that discontinuing a phase II CR program induced chronic psychosocial stress after return to work in the middle-aged post- AMI patients.