Factors Associated with Work Readiness and Adjustment in Cardiac Rehabilitation Patients

Abstract

1477 Work recovery is challenging for many cardiac patients. Many do not return to work and many have limitations following return to work. Studies have focused on the endpoint of work status and have not examined readiness to return to work and adjustment following return to work. PURPOSE: This preliminary study was undertaken to examine the influence of cardiac rehabilitation (CR) exposure, selfefficacy, sickness, job demands and social support on work readiness and adjustment (WRA) in patients with cardiac disease. METHODS: Cross-sectional design with questionnaire (N = 102) and clinical data (N = 45) collected at from patients at program entry, 6 and 12 months of CR. Dependent measures included a novel, visual analogue scale (0 – not ready return to work; 10 – back to work and managing well) of work adjustment. Independent measures included self-report of morbidity, illness perception, disease impact, functional ability, self efficacy, job demands and social support. Clinical variables included measures of disease severity and functional capacity. Data were analysed through correlation and multiple regression methods. RESULTS: Participants had and average age of 57 ± 10.7 years with a median duration of illness of 31 weeks. Eighty-two percent were male, 73% were married or equivalent. Fifty-three percent had undergone coronary artery bypass grafting, 57% had suffered a myocardial infarction, and 37% were experiencing angina. Sixty nine percent of participants in the sample were working. Patients who were working differed significantly in their selfrating of WRA (8.37/10 ± 2.05) from those not working (4.25/10 ± 2.57, t test, p<.001). Significant associations were found between WRA and measures of self-efficacy, illness perceptions and impact, morbidity, depression, angina and self-report of function. No association was observed between WRA and clinical measures of disease severity or functional capacity. Forward stepwise regression produced a model of WRA consisting of self-efficacy (B = .30), employer support (B = .31), physical job demands (B = .18), emotional function (B = .257) and illness identity (B = −.16). Patients with more exposure to CR indicated better WRA (B = .199, adjusted R2 = .58). CONCLUSIONS: A continuous measure of WRA is associated with work status and multiple individual and social factors. Measuring WRA in this fashion may provide a more expansive picture of the role of interventions such as CR and other factors in returning patients to optimal role function and quality of life.