[Rehabilitation and the socio-occupational reintegration of workers who have had a myocardial infarct: a pilot study]. / La réadaptation et la réinsertion socio-professionnelle des travailleurs ayant subi un infarctus du myocarde: étude pilote.

OBJECTIVE: To evaluate in a pilot study some psychosocial impacts of a multidisciplinary rehabilitation program on work reintegration of postmyocardial infarction (MI) patients. PATIENTS AND METHODS: Two groups of 19 workers among public and governmental enterprises of the greater Quebec city area admitted to hospital for uncomplicated MI where recruited for the study. One group received multidisciplinary cardiac rehabilitation intervention and a structured return to work program. The second group received the usual care post-MI (no organized rehabilitation program). Over a period of 15 months, the following variables were measured patients' perception of their loss of autonomy, and loss of capacity to manage their emotions, physical work capacity and their capacity to meet work requirements. The impact of the intervention on convalescence time and patients' stability at work were also evaluated. RESULTS: The rehabilitation group showed a better development than the usual care group of capacity to manage emotions (P=0.004) and of capacity to return to work (P=0.006). Furthermore, the patients in the intervention group reintegrated their work environment following a convalescence of 84.32+/-35.39 days compared with 151.39 +/-75.53 days for the usual care patients (P=0.0007). CONCLUSION: A multidisciplinary rehabilitation program and a structured return to work program are beneficial for sociovocational reintegration of post-MI patients.

Social support, social networks and coronary artery disease rehabilitation: a review.

OBJECTIVE: To provide information to the medical community about the importance of social support and networks through examination and definition of social support and network variables, and by reviewing the evidence found in the literature showing a relationship among social support, social networks, coronary artery disease (CAD) and rehabilitation. DATA SOURCES: Psyclit and Sociofile were searched for September 1979 through December 1994. STUDY SELECTION: All publications covering social support, social networks and rehabilitation from CAD as well as large mortality studies. Fifty-one articles were reviewed. DATA EXTRACTION: Original articles were summarized. DATA SYNTHESIS: Individuals who benefit from social support are less likely to become disease-stricken and live longer than those with less support. Social support and networks may have a substantial influence on the speed and quality of recovery following myocardial infarction (MI). CONCLUSIONS: A review of the literature indicates that social support plays an important role in recovery from and adaptation to chronic disease such as CAD and is of equal importance to the primary and secondary prevention of MI. Future research should pay special attention to what types of functional support are of most importance to recovery from MI and bypass surgery, thus allowing for the development of rehabilitation programs and interventions that will emphasize functions that are most needed. Interventions may involve the patient's natural support group to enhance the potential support providers' awareness of the patient's support needs. Social support may be especially important for maintaining compliance with rehabilitation programs for patients with CAD.