Scafa Fabrizio, Calsamiglia Giuseppe, Cadei Paola, Pettenuzzo Emanuela, Forni Giovanni, Candura Stefano Massimo
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Università di Pavia.
Med Lav. 2018 Feb 28;109(3):219-24. doi: 10.23749/mdl.v109i3.6451.
«Health and work after invasive heart procedures, rehabilitation and occupational evaluation».
: Our previous experience with the “CardioWork” protocol (activated in 2005) demonstrated the usefulness of the interaction between occupational physician and cardiologist to facilitate work resumption after invasive heart procedures and subsequent rehabilitation, adapting the work tasks of the patients to the changed physical capabilities.
: We surveyed the health conditions and employment status of the subjects previously studied, years after their completion of the protocol in order to verify its effectiveness over a long period of time.
: We contacted 125 patients included in the protocol from 2005 to 2011: 4 were deceased; 101 (94 males and 7 females; mean age: 49.2 years) participated in the study. We collected clinical data (from the hospital computer archive), as well as information on prescriptions compliance and occupation (by interview). Respondents were also asked to give a subjective judgment on their health, their re-employment, and the usefulness of the indications regarding job fitness.
: In addition to the high survival rate, the survey showed maintenance of satisfactory clinical conditions (good left ventricular function, exercise tolerance, rare cardiological relapses, few sick-leave days), adherence to prescriptions, high employment rate, high level of subjective satisfaction.
: The study confirms the importance of appropriate rehabilitation after acute cardiac event, and the need for an interdisciplinary approach involving the occupational physician. By following this strategy, patients not only can return to work early, satisfactorily and with minimal risks, but they also tend to keep their work and to reach retirement age in good health.
“侵入性心脏手术后的健康与工作、康复及职业评估”。
我们之前使用“心脏工作”方案(2005年启动)的经验表明,职业医师与心脏病专家之间的互动有助于促进侵入性心脏手术后的工作恢复及后续康复,使患者的工作任务适应其身体能力的变化。
我们对之前研究的对象在完成该方案数年之后的健康状况和就业情况进行了调查,以验证其长期有效性。
我们联系了2005年至2011年该方案纳入的125名患者:4人已去世;101人(94名男性和7名女性;平均年龄:49.2岁)参与了研究。我们收集了临床数据(来自医院计算机档案)以及关于处方依从性和职业的信息(通过访谈)。还要求受访者对他们的健康状况、再就业情况以及关于工作适应性的建议的有用性给出主观判断。
除了高生存率外,调查显示临床状况保持良好(左心室功能良好、运动耐量良好、心脏病复发罕见、病假天数少)、处方依从性好、就业率高、主观满意度高。
该研究证实了急性心脏事件后进行适当康复的重要性,以及职业医师参与的跨学科方法的必要性。通过遵循这一策略,患者不仅能够尽早、满意且风险最小地重返工作岗位,而且他们往往能够保住工作并健康地达到退休年龄。