Monica Lamberti1, Gennaro Ratti2, Donato Gerardi3, Cristina Capogrosso2, Gianfranco Ricciardi4, Cosimo Fulgione4, Salvatore Latte4, Paolo Tammaro2, Gregorio Covino2, Albert Nienhaus5, Elpidio Maria Grazillo3, Mario Mallardo4, Paolo Capogrosso2. 1. Second University of Naples, Naples, Italy (Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, School of Medicine). monica.lamberti@unina2.it. 2. S. Giovanni Bosco Hospital, Naples 1 Local Health Unit, Naples, Italy (Cardiology/Intensive Care Unit). 3. Second University of Naples, Naples, Italy (Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, School of Medicine). 4. S. Gennaro Hospital, Naples 1 Local Health Unit, Naples, Italy (Cardiology/Cardiac Rehabilitation). 5. University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Institute for Health Services Research in Dermatology and Nursing).
Abstract
OBJECTIVES: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). MATERIAL AND METHODS: We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H). Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire and as "days missed from work" (DMW) in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in the CR program (CR+ and CR-). RESULTS: One hundred thirty (66%) patients took part in the CR program. Total WPS scores for CR+ and CR- subgroups were VL group: 18±4 vs. 14±4 (p < 0.001), L group: 18±3 vs. 14±3 (p < 0.0001), M group: 19±3 vs. 16±3 (p < 0.003), and H group: 20±4 vs. 17±3 (p < 0.006). Fewer DMW were reported by the CR+ group. CONCLUSIONS: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in the workplace, in particular among clerical workers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
OBJECTIVES:Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). MATERIAL AND METHODS: We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H). Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire and as "days missed from work" (DMW) in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in the CR program (CR+ and CR-). RESULTS: One hundred thirty (66%) patients took part in the CR program. Total WPS scores for CR+ and CR- subgroups were VL group: 18±4 vs. 14±4 (p < 0.001), L group: 18±3 vs. 14±3 (p < 0.0001), M group: 19±3 vs. 16±3 (p < 0.003), and H group: 20±4 vs. 17±3 (p < 0.006). Fewer DMW were reported by the CR+ group. CONCLUSIONS: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in the workplace, in particular among clerical workers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Authors: Janice Hegewald; Uta E Wegewitz; Ulrike Euler; Jaap L van Dijk; Jenny Adams; Alba Fishta; Philipp Heinrich; Andreas Seidler Journal: Cochrane Database Syst Rev Date: 2019-03-14
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Authors: Bernhard Rauch; Annett Salzwedel; Birna Bjarnason-Wehrens; Christian Albus; Karin Meng; Jean-Paul Schmid; Werner Benzer; Matthes Hackbusch; Katrin Jensen; Bernhard Schwaab; Johann Altenberger; Nicola Benjamin; Kurt Bestehorn; Christa Bongarth; Gesine Dörr; Sarah Eichler; Hans-Peter Einwang; Johannes Falk; Johannes Glatz; Stephan Gielen; Maurizio Grilli; Ekkehard Grünig; Manju Guha; Matthias Hermann; Eike Hoberg; Stefan Höfer; Harald Kaemmerer; Karl-Heinz Ladwig; Wolfgang Mayer-Berger; Maria-Inti Metzendorf; Roland Nebel; Rhoia Clara Neidenbach; Josef Niebauer; Uwe Nixdorff; Renate Oberhoffer; Rona Reibis; Nils Reiss; Daniel Saure; Axel Schlitt; Heinz Völler; Roland von Känel; Susanne Weinbrenner; Ronja Westphal Journal: J Clin Med Date: 2021-05-19 Impact factor: 4.241