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Purpose: The study evaluated work experience changes and its determinants after return to work (RTW) in angioplasty or heart surgery patients. Methods: During a 1-year period (2014) in a Rehabilitation Hospital in northwestern Italy, we approached 253 patients (19.3% of inpatients). 199 patients consented to complete a survey on job characteristics, job satisfaction, job involvement, illness perception, depression, anxiety, adherence to therapy, and sociodemographic characteristics. The data were analysed with paired sample t tests and random intercept regression models. Results: 156 patients completed both the baseline and the 6-month follow-up assessments. After 6 months, 137 (88%) patients return to work (86% male, M age = 51.9 ± 8.1). The patients predominantly underwent angioplasty/bypass (46%) or valve replacement/repair (38%). Work hours (WO), job satisfaction (JS), and job involvement (JI) significantly decreased after RTW (WO: t(132)= 2.07, p < 0.05; JS: t(134)= 2.56, p < 0.05; JI: t(129)= 4.14, p < 0.001). The decrease in work hours over time was associated with a within-subjects decrease in psychological job demands (Î2 = 5.107, t(112.1) = 2.21, p < 0.05) and job satisfaction (Î2 = 2.498, t(112.92)= 2.265, p < 0.05) and an increase in physical job demands (Î2 = − 1.314, t(112.07)= − 2.416, p < 0.05). The decrease in job satisfaction over time was related to a within-subjects decrease in decision latitude (Î2 = 0.505, t(116.43)= 2.825, p < 0.01) and an increase in psychological job demand (Î2 = − 0.586, t(116.78)= − 3.141, p < 0.01). The decrease in job involvement over time was associated with a decrease in physical job demands (Î2 = 0.063, t(117.19) = 2.157, p < 0.05) within-subjects. Conclusions: The study showed that many patients who RTW after angioplasty or heart surgery have poorer work experiences relative to changes in psychological and physical demands and more passive roles.

Diversi studi hanno analizzato i fattori clinici e psicosociali che influenzano il rientro lavorativo dopo un evento cardiovascolare[1]. Diversamente poca attenzione è stata posta alla qualità del rientro e su quei fattori psicosociali che possono differenziare un reintegro lavorativo pieno e attivo da un reinserimento formale e passivo [2]. Lo studio indaga questi aspetti attraverso una ricerca longitudinale condotta presso l’Istituto Cardiovascolare di Camogli. 74 pazienti sono stati valutati in tre momenti: all’inizio del percorso riabilitativo (t0) alle dimissioni dall’istituto (t1) sei mesi dopo (t2), quando il paziente aveva ripreso l’attività lavorativa. Le analisi effettuate mostrano un sostanziale peggioramento delle condizioni lavorative percepite e di benessere. Nonostante tra t0 e t2 vi sia una diminuzione delle ore lavorative e del carico di lavoro percepito, la Discrezionalità Decisionale e il Supporto Sociale percepiti sul posto di lavoro subiscono un calo significativo, così come il Job Involvement. Il percorso riabilitativo (t0 – t1) determina un generale miglioramento, con una flessione degli indici di Depressione, Ansia e Percezione d’intrusività della malattia. Il trend cambia al t2, dopo il rientro lavorativo (t1 – t2) con un forte incremento degli indici di Depressione e Ansia e un calo della Self-Efficacy sia di adesione alla terapia che di gestione dello stress. I risultati mostrano una sostanziale efficacia del percorso riabilitativo mentre rilevano una condizione di forte disagio psicosociale che il paziente affronta tra le dimissioni dall’istituto riabilitativo e il rientro lavorativo.

The objectives of this research are to present two different educational interventions in CR and to assess their effectiveness in improving the psychological state of patients. In Cardiovascular Institute of Camogli 153 patients were enrolled: 113 participated in a closed structured group intervention (control group) consisting of three meetings with a fixed number of patients in which the fundamental themes of CR were treated. The other 40 patients participated in the open semi-structured group (experimental group) develop to better meet the needs of patients in CR: providing a minimum of three meetings for each patient. All patients were evaluated at entrance and discharge with a set of questionnaires related to different psychological characteristics. The results show that the two interventions lead to positive outcomes, which are substantially overlappable in the short term. If these findings were confirmed on a larger group, this could give important organizational alternatives to the operator, without reducing the effectiveness of intervention.