Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, NO-5018 Bergen, Norway.
Scand J Public Health. 2011 Jul;39(5):517-24. doi: 10.1177/1403494811399650. Epub 2011 Feb 22.
Cardiac rehabilitation should safeguard that socioeconomic factors or other differences that affect people's cardiovascular health are not further aggravated after healthcare treatment. The study examines whether socioeconomic status, emotional problems, or the severity of disease affect people's ability to continue to work after heart disease. We also examined if these effects can be explained by differences in motivational factors.
217 patients (41 women) from the Krokeide Rehabilitation Centre in Bergen participated. Multiple linear regression analysis was used to examine motivational differences, and logistic regression analysis was used to examine whether socioeconomic factors or other differences affected people's ability to continue to work after heart disease.
Self-efficacy for future work strongly impacted the likelihood of being incapacitated for work during the 2-year follow-up. The household's total income and emotional problems were statistically significant related to patients dropping out from work in the course of the observation. The association between emotional problems and future work was mediated by motivational problems. The relation between income and future incapacity for work could not be explained by motivational factors.
The study shows a clear Matthew effect on people's ability to continue to work after heart disease as low-income groups and people with emotional problems are more at risk of dropping out of work. This Matthew effect was, however, only explained by the motivational difficulties for the association between emotional distress and dropping out of work and not for the impact of household income on the likelihood of leaving work.
心脏康复应当确保影响人们心血管健康的社会经济因素或其他差异在医疗保健治疗后不会进一步加重。本研究旨在探讨社会经济地位、情绪问题或疾病严重程度是否会影响心脏病患者的继续工作能力。我们还研究了这些影响是否可以用动机因素的差异来解释。
来自卑尔根 Krokeide 康复中心的 217 名患者（41 名女性）参与了该研究。采用多元线性回归分析来检查动机差异，采用逻辑回归分析来检查社会经济因素或其他差异是否影响心脏病患者在 2 年随访期间的工作能力。
未来工作的自我效能感强烈影响了在 2 年随访期间丧失工作能力的可能性。家庭总收入和情绪问题与患者在观察过程中失业有统计学上的显著关系。情绪问题与未来工作之间的关系受动机问题的影响。收入与未来工作能力之间的关系不能用动机因素来解释。
该研究表明，心脏病患者继续工作的能力存在明显的马太效应，低收入群体和情绪问题患者更有可能失业。然而，这种马太效应仅可以用情绪困扰与失业之间的动机困难来解释，而不能用家庭收入对离职可能性的影响来解释。
