Prädiktoren der beruflichen Wiedereingliederung nach stationärer kardiologischer Rehabilitation im Rahmen der Arbeiterrentenversicherung

Abstract

Vocational reintegration is one of the major goals of cardiac rehabilitation. 70 % of blue-collar workers under 50 years of age resume their job after in-patient cardiac rehabilitation. 10 % are hindered to do so by cardiac problems. Specific measures exist that may facilitate work resumption. As these measures should be started as soon as possible there is a need for predictors of return to work which can be obtained easily and at an early stage. Subjects of this prospective study were 650 patients (10 % female) under 50 years of age who participated in an in-patient cardiac rehabilitation programme under the workers' pension insurance scheme. At the beginning of programme participation, problems in work resumption as expected by the patient and by his physician were obtained, as well as depression and anxiety scores (HADS-D). Physicians' and patients' expectations concerning problems in resuming work turn out to be significant predictors of the vocational situation of the male patients six months following medical rehabilitation. The depression score obtained at the outset of the programme is the only predictor of return to work in female patients.

Resumption and Maintenance of Employment after a First Acute Myocardial Infarction: Sociodemographic, Vocational and Medical Predictors

“…Studies of such patients have examined the contribution of a wide range of sociodemographic, vocational, and medical variables to these patients’ reemployment. A survey of empirical studies of the qualitative and quantitative aspects of employment after an AMI, published between 1988 and 2003, uncovered 46 investigations [3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48]. An examination of these investigations revealed the following limitations: (1) most studies involved selected samples of participants (e.g., randomized intervention studies), (2) most studies examined employment within the first year after AMI, (3) most studies did not distinguish between employment status, resumption of employment, and maintenance of employment, (4) few studies investigated long-term maintenance of employment after AMI, (5) few studies were longitudinal community cohort studies, and (6) most studies included participants who had reached an age at which employment is no longer central.…”

<p>Patients’ expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation</p>

“…In this investigation, patients in subsequent CR after acute coronary syndrome and cardiac revascularization or coronary bypass surgery were excluded. In another German single-center study, approximately 30% of younger patients (<50 years) stated that they probably or certainly expected problems with resuming their occupation following an acute cardiac event, whereas patients recovering from CABG or with severe comorbid disorders were not considered 24. A more comparable patient population was investigated in our own recent population, describing that only 17.5% of cases did not expect to return to work 3.…”

Deutsche Leitlinie zur Rehabilitation von Patienten mit Herz-Kreislauferkrankungen (DLL-KardReha)

“…verstärken und die sozialen Aktivitäten erheblich beeinträchtigen [276,[381][382][383][384][385][386]. Partnerschaft, psychologischer und sozialer Rückhalt sowie soziale Netzwerke haben wahrscheinlich einen protektiven Effekt und vermindern das Risiko für zukünftige tödliche und nicht-tödliche Koronarereignisse sowie für die Gesamtsterblichkeit [387][388][389].…”