Myocardial infarction: patients views of their illness related to work behaviour.

Clinical bottom line (level 2c)

  1. Patients who have had a myocardial infarction and returned to work early perceived their illness as less severe and less likely to be chronic than comparators, but had no difference in their length of stay in hospital.
Petrie et al: British Medical Journal 1996; 312: 1191-1194
Expires March 2003

The study

Inception cohort study with unblinded, unobjective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: two teaching hospitals in New Zealand

143 patients (aged mean 53.2y (sd 8.4y), 87% male) myocardial infarction

Excluded if
  • aged >65y



    • Factors studied:
  • scores on illness perception, mental health and disability scales (all validated) and self-report of return to work
  • perception of chronicity of illness mean scores higher=percieved more chronic: early return 8.3 vs late return 9.3
  • index of perceived severity of illness mean scores high=more severe; early return 25.7 vs late return 29.4
  • days in hospital early return = 7.2d vs late return = 7.5d




    • Multivariate analysis was performed.

    80% followed for 6 months
    Outcomes studied:
  • return to work

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    return to work 6 months / %
    (% to %)

    Comments

    1. Large number of variables assessed with many intercomparisons.
    2. Requires reassessment if a scale of qualitative research is developed.

    Citation

    1. Petrie KJ, Weinman J, Sharpe N, et al: Role of patients' view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. British Medical Journal 1996; 312: 1191-1194
    Contributor: Bob Phillips and Clare Wotton, November 1999
    Reviewer:

    Clinical Question.
    Patient had a myocardial infarction
    Intervention or Exposure beliefs about the infarction
    Outcome work; disability