Author/Editor		Farkaš, Jerneja; Černe, Katja; Lainščak, Mitja; Keber, Irena
Title		Vpliv telesnih, socialno-demografskih in psiholoških dejavnikov na vrnitev na delo po akutnem koronarnem sindromu
Translated title		Impact of physical, sociodemographic, and psychological factors on return to work after acute coronary syndrome
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 9
Publication year		2005
Volume		str. 519-23
Language		slo
Abstract		Background. In Slovenia there is a lack of data regarding the return to work for patients after acute coronary syndrome (ACS) for last two decades. We evaluated how return to work is affected by several physical, sociodemographic and psychological factors. Methods. In retrospective cohort study we screened 174 patients, younger than 60 years and fully employed before the disease, who participated in out-patient rehabilitation programme between years 1999 and 2002. The data on clinical characteristics, the mode of treatment of ACS and exercise capacity were obtained from medical charts. The psychosocial factors and the data about working ability were compiled by structured questionnaire. Results. Eighty-two patients returned complete questionnaire and 58 (71%) of them returned to work. The patients returned to work had less diabetes (9% vs. 29%, p = 0.02), were more frequently treated with acetylsalicylic acid (79% vs. 50%, p = 0.01), had higher exercise capacity after the rehabilitation (8. 6 ± 2.4 MET vs. 7.4 ± 1.9 MET, p = 0.03), and in everyday life (heavy activities 60% vs. 25%, p = 0.004), were more frequently supported by their friends (88% vs. 67%, p = 0.02) and co-workers (67% vs. 38%, p = 0.01), had greater desire to return to work (50% vs. 25%, p = 0.04) and were more often advised to return to work by the doctor (72% vs. 8%, p< 0. 001). In multiple logistic regression model return to work was associated with doctors advice (risk ratio 63.9, 95% confidence interval 5.4 - 754, p = 0.001) and great desire to return to work (risk ratio 7,3, 95% confidence interval 1.1 - 49.5, p = 0.04). Conclusions. Doctors advice and great desire to return to work were the most important predictors of return to work.
Summary		Izhodišča. Podatkov o vrnitvi na delo bolnikov po akutnem koronarnem sindromu (AKS) v Sloveniji za zadnjih dvajset let nimamo. Z raziskavo smo želeli pri bolnikih po AKS oceniti vpliv telesnih, socialno-demografskih in psiholoških dejavnikov raa vrnitev na delo. Metode. V retrospektivno kohortno raziskavo smo zajeli 174 bolnikov z AKS, mlajših od 60 let, ki so bili pred AKS zaposleni polni delovni čas in med letoma 1999 in 2002 vključeni v ambulantni rehabilitacijski program. Demografske podatke ter podatke o zdravljenju in telesni zmogljivosti smo povzeli iz medicinske dokumentacije. Podatke o dejavnikih vračanja na delo, smo pridobili z vprašalnikom, ki smo ga bolnikom, poslali na dom. Rezultati. Popolno izpolnjen vprašalnik je vrnilo 82 bolnikov, od katerih se je na delo vrnilo 58 (71%) bolnikov. Tisti, ki so se vrnili na delo, so imeli redkeje sladkorno bolezen (9% vs. 29%, p = 0,02), pogosteje so bili zdravljeni z acetilsalicilno kislino (79% vs. 50%, p = 0, 01), imeli so večjo telesno zmogljivost pri obremenitvenem testiranju ob koncu rehabilitacije (8, 6± 2,4 MET vs. 7,4 ± 7,9 MET; p = 0, 03), navajali so večjo zmogljivost za telesne obremenitve v vsakdanjem življenju (težke dejavnosti 60% vs. 25%, p = 0,004), bili so pogosteje deležni opore prijateljev (88% vs. 67% p = 0, 02) in sodelavcev (67% vs. 38%, p = 0,01), pogosteje so imeli veliko željo po vrnitvi na delo (50% vs. 25%, p = 0, 04) in so pogosteje prejeli zdravniški nasvet o vrnitvi na delo (72% vs. 8%, p<0,001). V modelu multiple logistične regresije sta vrnitev na delo napovedovala nasvet zdravnika (razmerje tveganj 63,9, 95-odstotni interval zanpanja 5,4 - 754, p = 0,001) in velika želja po vrnitvi na delo (razmerje tveganj 7,3, 95-odstotni interval zaupanja 1,1 - 49,5, p = 0, 04). Zaključki. Vrnitev na delo sta neodvisno napovedovala nasvet zdravnika o vrnitvi na delo in velika želja bolnika po vrnitvi na delo.
Descriptors		CORONARY DISEASE MYOCARDIAL INFARCTION ANGINA, UNSTABLE WORKPLACE SOCIOECONOMIC FACTORS QUESTIONNAIRES RETROSPECTIVE STUDIES