Coronary patients who returned to work had stronger internal locus of control beliefs than those who did not return to work

Abstract

Return To Work (RTW) is an important indicator of recovery from coronary artery disease (CAD), associated with social and economical benefits, and improved quality of life. Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery are effective procedures relieving symptoms and reducing the risk for new events, but psychosocial problems are frequent among these patients. The aim was to determine psychosocial and treatment-related factors associated with RTW among PCI and CABG patients in Northern Norway. Cross-sectional design based on questionnaire data from CABG and PCI patients 3-15 months following discharge, and from hospital records. Of the 348 responding patients, 168 were younger than 67 years and working prior to hospitalization. Factors associated with RTW were examined in a logistic regression analysis. A total of 108 (64%) had RTW within 3-15 months. Four factors made unique significant contributions to the model, including higher education, time since hospital discharge and Internal Locus of Control (LoC) of the Multidimensional Health Locus of Control Scale (MHLC) as positively associated factors, and Powerful Others LoC as a negatively associated factor. Analyses controlled for data on demographics, emergency status, type of treatment, number of days at the hospital, physical exercise, attending a rehabilitation program, mental distress, Type D personality, and for the CABG patients additional data on coronary health. Patients' control beliefs and educational level are significant psychosocial factors associated with RTW following PCI and CABG treatment. Implications for hospital treatment and rehabilitation programs are discussed.