Effort-Reward Imbalance at Work and Overcommitment in Patients with Acute Myocardial Infarction (AMI): Associations with
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Effort‑Reward Imbalance at Work and Overcommitment in Patients with Acute Myocardial Infarction (AMI): Associations with Return to Work 6 Months After AMI Sarah Ruile1,2,3 · Christine Meisinger1,4,5 · Katrin Burkhardt6 · Margit Heier7,8 · Christian Thilo9 · Inge Kirchberger1,4,5,10 Accepted: 29 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Stress-related factors influence the adaptation to life after acute myocardial infarction (AMI), including return to work. The goal of this study was to investigate the effect of work-related stress, (expressed by the effort-reward imbalance (ERI) model) on return to work after AMI. Methods A longitudinal study with AMI patients was conducted in order to assess associations between the independent variables effort, reward, ERI and overcommitment and the outcome return to work after AMI. Return to work was inquired at 6 months follow-up. Logistic regression models were applied in the analysis. The fully-adjusted model included demographic, clinical, social, stress-related and health-related quality of life (HRQOL) covariables. Results Of the 346 enrolled patients aged 31 to 82 years, 239 (69.1%) were included in the regression analysis. In the unadjusted model ERI presented an odds ratio (OR) of 1.72 (95% confidence interval (CI) 0.86–3.42). Associations for effort and overcommitment were 0.98 (95% CI 0.83–1.15) and 1.09 (95% CI 0.99–1.18). However, reward showed a significantly inverse association with return to work with an OR of 0.90 (95% CI 0.83–0.99). In the fully adjusted model the OR of ERI decreased to 1.20 (95% CI 0.49–2.96). Effort, reward and overcommitment also showed attenuated ORs without significant results in all models. Diabetes mellitus, current smoking, low physical and low mental HRQOL presented significantly negative relations with return to work. Conclusions Work-related stress appears less important than HRQOL and resilience in terms of return to work after AMI. Keywords Myocardial infarction · Occupational stress · Return to work
* Inge Kirchberger I.Kirchberger@unika‑t.de 1
Chair of Epidemiology, UNIKA‑T Augsburg, LudwigMaximilians-Universität München, Neusässer Str. 47, 86156 Augsburg, Germany
Institute for Medical Information Processing, Biometry and Epidemiology‑IBE, Ludwig-Maximilians-Universität München, Munich, Germany
2
3
Pettenkofer School of Public Health, Munich, Germany
4
MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany
5
Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
6
Department of Laboratory Medicine and Microbiology, University Hospital of Augsburg, Augsburg, Germany
7
Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
8
KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
9
Department of Internal Medicine I – Cardiolo
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