Correlation Between Self-reported Outcomes And Health-related Work Efficiency In Young And Middle-aged Patients With Coronary Heart Disease After Returning To Work

Objective1.To understand the self-reported outcomes,health-related work efficiency after returning to work for young and middle-aged people with coronary heart disease(CHD).2.To explore the relationship between self-reported outcomes and health-related work efficiency in young and middle-aged patients with CHD after returning to work.MethodsA total of 259 young and middle-aged patients with CHD who admitted to the Department of Cardiology of the First Affiliated Hospital of Soochow University from December 2021 to June 2022 were selected as subjects by convenience sampling method.In this study,patients’ general data,work efficiency after returning to work,self-reported outcomes,and perceived health ability were collected.The research tools included self-made questionnaire(patient demographic and sociological data),Patient Reported Outcome Instruments for Chronic Disease-Coronary Heart Disease(PROISCD-CHD),Stanford Presenteeism Scale(SPS-6),Perceived Health Competence Scale(PHCS).SPSS26.0 statistical software was used for data analysis.Measures that conformed to normal distribution were expressed as mean ± standard deviation,data that did not conform to normal distribution were expressed as M(P25,P75),Count data were expressed as frequency and percentage(%),and t-test,Mann-Whitney U test,Chi-square test or Wilcoxon rank-sum test were used for comparison between groups.Multiple linear regression was used to analyze the influencing factors of self-reported outcomes.Binary Logistic regression model was used to analyze the influencing factors of health-related work efficiency decline.P<0.05 on both sides(α=0.05)indicated statistically significant difference.ResultsA total of 280 questionnaires were distributed in this study,7 were excluded from missing items,5 were answered regularly,and 9 were contradicted between forward and reverse questions.259 questionnaires were effectively recovered with effective recovery of 92.5%.1.General conditions:The average age of 259 patients was(48.74±7.83)years,222 were male(85.7%)and 37 were female(14.3%);60 cases(23.3%)with primary school education or below,62 cases(23.9%)had junior high school education;149 cases(57.5%)with monthly income>5000 yuan;160 cases(61.7%)were overweight.Smoking 123 cases(47.5%);109 cases(42.1%)drank alcohol;151 cases(58.3%)had poor sleep quality;The average return to work time of 259 patients was(36.75±31.13)days;The average hours worked in the past week were(42.34±13.22)hours.Sickness absence associated with CHD disease symptoms in the past week averaged(1.56±2.04)hours.2.The self-reported outcomes score of young and middle-aged patients with CHD was(180.82±15.79),The score of the four dimensions were as follows:physiological function(38.28±4.16),mental function(46.78±5.17),social function(34.78±5.17),and specific symptoms of coronary heart disease(60.77±5.46).The results of multivariate analysis showed that age,N-terminal B-type natriuretic peptide(NT-proBNP),education level,work nature,number of diseased vessels,number of stents,cardiac function grade,time to return to work and absence were independent influencing factors of self-reported outcomes score of patients(P<0.05).3.The perceived health competence score of young and middle-aged patients with CHD was(23.01±6.70),including the behavioral expectation score was(11.54±3.49),and the outcome expectation score was(11.47±3.63).Univariate analysis showed that age,body mass index,smoking,number of diseased vessels,hypertension,diabetes and hyperlipidemia had significant differences in perceived health competence scores of patients(P<0.05).4.The health-related productivity score of young and middle-aged patients with CHD after returning to work was(16.1 ±5.22).The high efficiency loss rate was 123 cases(47.5%)and the low efficiency loss rate was 136 cases(52.5%).Univariate analysis showed that age,number of children,return to work time,payment method,staying up late,smoking,weekly working hours,disease type,number of diseased vessels,number of stents,hypersensitive C-reactive protein,high-sensitivity troponin T,NT-proBNP had statistical significance with health-related work efficiency loss(P<0.05).The results of multivariate analysis showed that patient self-reported outcomes age,staying up late,return to work time,NT-proBNP,number of children,number of stents,weekly working hours and the behavioral expectancy dimension of perceived health competence were independent factors on health-related work inefficiency in young and middle-aged patients with CHD(P<0.05).Conclusions1.The self-reported outcomes of young and middle-aged patients with CHD were at a moderate level,which needed to be improved.Care interventions for patients with advanced age,abnormal NT-proBNP,low literacy,work strain,high number of diseased vessels and stents,poor cardiac function,and absenteeism conditions upon return to work should be enhanced.2.The health-related work productivity of young and middle-aged CHD patients returning to work was at a low to moderate level.Age,late nights,return to work time,NT-proBNP,number of children,number of stents,number of hours worked in a week,patient self-reported outcomes,and behavioral expectancy dimension in perceived health capacity were independent factors on health-related work efficiency in young and middle-aged patients with CHD.It is necessary for healthcare workers to pay attention to patients who return to work,and to provide continuity of care for such patients so as to reduce the physical impact of the disease.