| Objective:The purpose of this study was to investigate the readiness of AMI patients to return to work,self-efficacy of return to work,utilization of chronic disease resources and positive degree of patients within 6 months after discharge from hospital.Method:In this study,301 patients with acute myocardial infarction who received inpatient treatment in the cardiology department of a tertiary care general hospital in Changchun City for 6months after the hospitalization between October 2020 and June 2021 were selected based on the inclusion and exclusion criteria using a convenience sampling method.The study instruments included:general information questionnaire,readiness to return to work scale,return to work self-efficacy questionnaire,chronic disease resource questionnaire,and patient motivation scale.Data were entered and analyzed using IBM SPSS Statistics 24.0,and AMI patients’general information,disease-related factors and scores of each scale were statistically described and analyzed,with measures conforming to a normal distribution expressed as mean±standard deviation and those not conforming to a normal distribution expressed as median and quartiles;count data were expressed as frequency and composition ratio.The t test,χ~2 test,and rank sum test were used to analyze the differences of patients’general information and disease-related factors in each dimension of readiness to return to work.Spearman correlation was used to explore the correlation between general information,return-to-work self-efficacy,chronic disease resource utilization,patient motivation and return-to-work readiness of non-returning patients.Ordinal logistic regression was used to explore the important factors influencing the readiness to return to work of patients who had not returned to work with myocardial infarction;Binary logistic regression was used to analyze the main factors influencing the readiness to return to work of patients who had returned to work with myocardial infarction.The difference was considered statistically significant at P<0.05.Result:1.A total of 301 patients with acute myocardial infarction were investigated in this study,of whom 53.8%（162）AMI patients failed to return to work and 46.2%（139）AMI patients had returned to work.The readiness to return to work scores for AMI patients who did not return to work were intention stage（3.62±0.51）,pre-intention stage（3.33±0.59）,action readiness-self-assessment stage（2.50±0.53）,and action readiness-behavior stage（3.07±0.70）;the readiness to return to work scores for AMI patients who did return to work were active maintenance stage（3.84±0.62）and uncertainty maintenance stage（3.19±0.56）.2.The level of return-to-work self-efficacy of patients with unreturned AMI was（38.77±1.28）,the total chronic disease resource utilization score was（47.35±2.33）,and the level of patient motivation was（47.78±1.90）;the level of return-to-work self-efficacy of patients with returned AMI was（48.84±4.74）,the total chronic disease resource utilization score was（59.63±5.87）and the level of patient motivation was（57.07±5.72）.3.Univariate analysis revealed that the readiness to return to work of AMI patients who had not returned to work was statistically significant in terms of gender,education level,place of residence,monthly personal income,medical payment method,conscious family burden,type of occupation,work intensity,number of days in hospital,level of patient motivation,chronic disease resource utilization and return to work self-efficacy（P<0.05）;the readiness to return to work of AMI patients who had returned to work The readiness to return to work was statistically significant in age,education,place of residence,monthly personal income,medical payment method,perceived family burden,type of occupation,work intensity,return to work time,number of vascular branches,number of readmissions,level of patient motivation,chronic disease resource utilization and return to work self-efficacy（P<0.05）.4.Multifactorial analysis found that among patients who did not return to work AMI,personal monthly income<2000（OR=0.003,P<0.001）versus personal monthly income2000 to 4000（OR=0.080,P=0.004）,mild（OR=0.081,P=0.016）and moderate（OR=0.077,P=0.007）work intensity were risk factors for return-to-work readiness,and the action dimension（OR=2.370,P<0.001）and belief dimension（OR=2.586,P=0.001）of patient positivity,chronic illness resource utilization（OR=1.707,P=0.001）,and return-to-work self-efficacy（OR=2.016,P=0.001）were return-to-work readiness protective factors;among returned AMI patients,age（OR=0.701,P=0.009）and number of diseased vascular branches（OR=0.202,P=0.023）were risk factors for readiness to return to work,and the skill dimension（OR=1.799,P=0.018）in the positive degree of patients in the enterprise and institution（OR=38.000,P<0.001）and belief dimensions（OR=3.293,P=0.015）were protective factors for readiness to return to work.Conclusion:1.The overall return-to-work rate of AMI patients was low,and the readiness to return to work of non-returned AMI patients was at a low stage,mainly at the pre-intention and intention stage;the readiness to return to work of returned AMI patients was at a high level,mostly at the active maintenance stage.2.AMI patients’education,place of residence,monthly personal income,medical payment method,perceived family burden,occupation type,work intensity,patient motivation level,chronic disease resource utilization,and return-to-work self-efficacy affected the return-to-work readiness of both non-returned and returned patients;whereas gender and days of hospitalization only affected the return-to-work readiness of non-returned AMI patients,while age,return-to-work time,number of lesioned vascular branches,and number of readmissions only affected the return-to-work readiness of returned AMI patients.Age,time to return to work,number of vascular branches,and number of readmissions only affected the readiness to return to work of patients with AMI who had returned to work.3.Personal monthly income<4000 and light to moderate work intensity were risk factors for return-to-work readiness in patients with unreturned AMI,action and belief dimensions of motivation,chronic disease resource utilization,and return-to-work self-efficacy level were protective factors for return-to-work readiness in patients with unreturned AMI;age and number of diseased vascular branches were risk factors for return-to-work readiness in patients with returned AMI,and corporate and institutional personnel,skill and belief dimensions of motivation were protective factors for return-to-work readiness in patients with returned AMI. |
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