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A Cross-Sectional Study of Return to Work Rate Following Heart Transplantation and the Contributing Role of Illness Perceptions

Thomson, David BSc; Maddison, Anna MSc; Sharp, John DClinPsychol

Journal of Cardiopulmonary Rehabilitation and Prevention: July 2019 - Volume 39 - Issue 4 - p 253–258
doi: 10.1097/HCR.0000000000000365
Cardiac Rehabilitation

Background: Social rehabilitation, including return to work (RTW), is a key indicator of transplant success. However, little is known regarding the RTW rate following heart transplantation or the factors influencing this. The objective of this study was to examine RTW among heart transplant recipients and identify associated predictors.

Methods: Attendees of the post–heart transplant clinic based at the Golden Jubilee National Hospital, Scotland, were invited to respond to a mailed survey comprising a demographic form, an employment history questionnaire, and a modified Brief Illness Perception Questionnaire. Frequency distributions, χ2 test, and stepwise regression were used to examine employment history and associated factors.

Results: Sixty percent of transplant recipients reported working 12 mo prior to transplant compared with 50% of recipients at 1-y post-transplant. Forty-four percent of all working-age recipients were currently employed, a relatively median rate compared with those found in previous studies. Univariate analysis revealed “receipt of benefits,” “time off work pre–heart transplant,” “employment 12 mo pre–heart transplant,” “employment at listing,” “perceived work ability,” “discharge age,” “illness consequences,” “illness concern,” and “emotional representation” as predictors of RTW. Logistic regression modeling revealed “time off work pre–heart transplant” and “perceived work ability” to have the most significant influence on RTW, explaining 62% of the variance in outcome.

Conclusions: Psychological and demographic variables influence RTW after heart transplant. Knowledge and understanding of these variables facilitate the design of interventions and services to help promote RTW and social rehabilitation. Study limitations are discussed, and suggestions for similar research and the outpatient clinic are provided.

This study examined return to work (RTW) among heart transplant recipients. Sixty percent reported working 12 mo prior to transplant compared to 50% at 1-y post-transplant. “Time off work pre–heart transplant” and “perceived work ability” had significant influence on RTW. Knowledge and understanding of these variables facilitate the design of interventions.

Department of Psychology, University of Glasgow, Glasgow, Scotland, United Kingdom (Mr Thomson); and Golden Jubilee National Hospital, Scottish National Advanced Heart Failure Service, Clydebank, Scotland, United Kingdom (Ms Maddison and Dr Sharp).

Correspondence: John Sharp, DClinPsychol, Golden Jubilee National Hospital, Agamemnon St, Clydebank, G81 4DY, Scotland, United Kingdom (

The authors declare no conflicts of interest.

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