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Return-to-work and associations with psychosocial well-being and health-related quality of life in CHD patients: results from EUROASPIRE IV

Author
Organization
Abstract
Background Coronary heart disease (CHD) can lead to loss of workability and early retirement. We aimed to investigate return-to-work (RTW) and its relationship towards psychosocial well-being and health-related quality of life (HRQoL). Design Secondary analyses were applied on cross-sectional data from the EUROASPIRE IV survey (European Action on Secondary and Primary prevention through Intervention to Reduce Events). Methods Participants were examined and interviewed in 6 - 36 months following the recruiting event. Psychosocial well-being and HRQoL were evaluated by completing the ‘Hospital Anxiety and Depression Scale’ (HADS) and ‘HeartQoL’ questionnaire. Using generalized mixed models we calculated odds ratios for RTW. Depression, anxiety and adjusted means of HeartQoL were estimated accounting for RTW. Results Out of 3291 employed patients, the majority (76.0%) returned to work, of which 85.6% were men but there was a general underrepresentation of women. Young (p<0.001), high educated (p<0.001) patients without prior cardiovascular events (p<0.05) were better off regarding RTW. No significant associations with CHD risk factors and cardiac rehabilitation were established. Those that rejoin the workforce were less susceptible to psychosocial distress (anxiety/depression p<0.001) and experienced a better quality of life (p<0.001). Conclusion These findings provide evidence that non-modifiable factors (sociodemographic factors, cardiovascular history), more than classical risk factors, are associated with RTW and that patients who resume work display better psychosocial well-being and HRQoL. Our results illustrate a need for tailored cardiac rehabilitation with a focus on work-related aspects, mental health- and HRQoL indicators to reach sustainable RTW, especially in vulnerable groups like less educated and elderly patients.
Keywords
return-to-work, coronary heart disease, psychosocial well-being, anxiety, depression, health-related quality of life

Citation

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Chicago
Van de Cauter, Joy, Dirk De Bacquer, Els Clays, Delphine De Smedt, Kornelia Kotseva, and Lutgart Braeckman. 2019. “Return-to-work and Associations with Psychosocial Well-being and Health-related Quality of Life in CHD Patients: Results from EUROASPIRE IV.” European Journal of Preventive Cardiology.
APA
Van de Cauter, J., De Bacquer, D., Clays, E., De Smedt, D., Kotseva, K., & Braeckman, L. (2019). Return-to-work and associations with psychosocial well-being and health-related quality of life in CHD patients: results from EUROASPIRE IV. European Journal of Preventive Cardiology.
Vancouver
1.
Van de Cauter J, De Bacquer D, Clays E, De Smedt D, Kotseva K, Braeckman L. Return-to-work and associations with psychosocial well-being and health-related quality of life in CHD patients: results from EUROASPIRE IV. European Journal of Preventive Cardiology. 2019;
MLA
Van de Cauter, Joy et al. “Return-to-work and Associations with Psychosocial Well-being and Health-related Quality of Life in CHD Patients: Results from EUROASPIRE IV.” European Journal of Preventive Cardiology (2019): n. pag. Print.
@article{8608944,
  abstract     = {Background
Coronary heart disease (CHD) can lead to loss of workability and early retirement. We aimed to investigate return-to-work (RTW) and its relationship towards psychosocial well-being and health-related quality of life (HRQoL). 
Design
Secondary analyses were applied on cross-sectional data from the EUROASPIRE IV survey (European Action on Secondary and Primary prevention through Intervention to Reduce Events). 
Methods
Participants were examined and interviewed in 6 - 36 months following the recruiting event. Psychosocial well-being and HRQoL were evaluated by completing the {\textquoteleft}Hospital Anxiety and Depression Scale{\textquoteright} (HADS) and {\textquoteleft}HeartQoL{\textquoteright} questionnaire. 
Using generalized mixed models we calculated odds ratios for RTW. Depression, anxiety and adjusted means of HeartQoL were estimated accounting for RTW.
Results 
Out of 3291 employed patients, the majority (76.0\%) returned to work, of which 85.6\% were men but there was a general underrepresentation of women. Young (p{\textlangle}0.001), high educated (p{\textlangle}0.001) patients without prior cardiovascular events (p{\textlangle}0.05) were better off regarding RTW. No significant associations with CHD risk factors and cardiac rehabilitation were established. Those that rejoin the workforce were less susceptible to psychosocial distress (anxiety/depression p{\textlangle}0.001) and experienced a better quality of life (p{\textlangle}0.001). 
Conclusion
These findings provide evidence that non-modifiable factors (sociodemographic factors, cardiovascular history), more than classical risk factors, are associated with RTW and that patients who resume work display better psychosocial well-being and HRQoL. Our results illustrate a need for tailored cardiac rehabilitation with a focus on work-related aspects, mental health- and HRQoL indicators to reach sustainable RTW, especially in vulnerable groups like less educated and elderly patients. 
},
  author       = {Van de Cauter, Joy and De Bacquer, Dirk and Clays, Els and De Smedt, Delphine and Kotseva, Kornelia and Braeckman, Lutgart},
  journal      = {European Journal of Preventive Cardiology},
  language     = {eng},
  title        = {Return-to-work and associations with psychosocial well-being and health-related quality of life in CHD patients: results from EUROASPIRE IV},
  year         = {2019},
}