What is the clinical evidence from this study?

Study design: Other. Population: Coronary artery bypass grafting (CABG) (n=10). Intervention: Return to work after coronary artery bypass grafting. Primary outcome: Barriers obstructing return to work.

August 16, 2020Open Access

Barriers That Obstruct Return to Work After Coronary Bypass Surgery: A Qualitative Study

FBFredrike BlokzijlUniversity Medical Center Groningen MOMarisa OnrustUniversity Medical Center Groningen WDWillem DieperinkUniversity Medical Center Groningen

Key Result

Personal barriers, particularly affective and physical factors, along with a lack of or contradictory guidance from healthcare professionals, were the most frequently reported obstacles to returning to work after coronary bypass surgery.

Structured PICO

Population

10 working patients who underwent elective, isolated coronary artery bypass grafting, interviewed 6 to 7 months post-surgery to explore barriers to returning to work.

Outcome

Barriers that obstruct return to work after coronary artery bypass grafting

Return to work after CABG is hindered by personal, healthcare, work, and regulatory barriers, highlighting the potential need for early, coordinated case management.

Limitations

Small sample size of 10 participants limits generalizability.
Only included patients with a spouse, paid work, and without severe comorbidities or complicated recovery.
Study population included only one woman.
Did not use member checking or participant feedback to verify results.
Focused only on perspectives of patients and spouses, excluding supervisors, coworkers, and healthcare professionals.
Results may differ in countries without a social security system.

Abstract

Purpose Coronary artery bypass grafting is the most frequently performed cardiac surgical procedure. Despite its benefits on survival and quality of life, it is associated with a considerable financial burden on society including sick leave. Our study aimed to explore the barriers that obstruct return to work after coronary artery bypass grafting. Methods We performed a qualitative study with in-depth interviewing of patients 6 months after their surgery. We included ten working patients and interviewed them and their spouses at home. The interviews were transcribed and two investigators independently searched the transcriptions for barriers that had obstructed return to work. Results Based on the interviews we were able to distinguish four main groups of barriers: 'personal', 'healthcare', 'work' and 'law & regulation.' The personal barriers were subgrouped in affective, physical, cognitive, social and individually determined factors. Conclusion In a qualitative study we showed that personal barriers as well as barriers regarding healthcare, work and law & regulation, were perceived by patients as important factors obstructing return to work after coronary artery bypass grafting. To overcome the identified barriers, the process of return to work could preferably be initiated during the hospital phase, started during cardiac rehabilitation, and coordinated by a case-managing professional.

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