A randomized comparison between a goal-setting and a videotape and discussion intervention to improve return to work and quality of life among cardiac patients.

Abstract

Approximately 26% of Canadians who are not working due to disability report physical limitations caused by coronary heart disease (CHD). CHD accounts for 17% of all lost productivity in Canada. This is true despite the finding that cardiac treatment restores adequate functional capacity in a majority of patients. Two interventions were compared in their ability to increase the RTW rates of cardiac patients. The experimental condition involved the setting of weekly, specific, challenging and self-relevant goals. The comparison condition involved the viewing of four video-tapes focusing on RTW-related issues. Subjects were randomly assigned to goal-setting (N = 22) and video-tape (N = 24) groups. The first hypothesis was that goal-setting would lead to higher rates of RTW and to a higher percentage of eligible weeks worked at follow-up, compared to the video tape group. No significant treatment group differences were found. A related question was whether subject characteristics (i.e., risk of not returning to work, self-determination to participate in the intervention, depression, and anxiety) and implementation characteristics (i.e., group size, number of sessions attended, and duration of follow-up period) would interact with treatment group to affect rate of RTW and percentage of eligible weeks worked at follow-up. Risk of not returning to work predicted RTW and percentage of eligible weeks returned to work. Number of sessions attended also interacted with treatment group to predict percentage of eligible weeks worked. The second hypothesis was that there were group differences life satisfaction and job satisfaction (for subjects who returned to work) at follow-up, as well as satisfaction with treatment at post-treatment. No significant treatment group differences were found. A related question was whether subject characteristics and implementation characteristics interacted with treatment to affect life satisfaction, job satisfaction and satisfaction with treatment. There was a stronger positive correlation between life satisfaction at pre-treatment and life satisfaction at follow-up in the goal-setting group, than in the video-tape group. The third hypothesis was that the goal-setting group would show greater improvements over time in self-efficacy, self-determination, commitment to work, life satisfaction, depression, and anxiety, compared to the video-tape group. Self-efficacy and depression improved in both groups.