OCCUPATIONAL WORK EVALUATION SOON AFTER CORONARY SURGERY

冠状动脉手术后不久的职业工作评估

• 批准号: 3351937
• 负责人: ROBERT Frank DEBUSK
• 金额: $ 57.65万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-04-01 至 1993-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3351937
• 关键词: cardiovascular stress test; disabling disease; disease /disorder proneness /risk; health economics; health education; heart revascularization; human subject; managed care; myocardial infarction; occupational health /safety; postoperative state

Despite its success in alleviating angina pectoris, coronary artery surgery (CAS) does not enhance employment status. This project is designed to test the efficacy of an intervention, the Occupational Work Evaluation (OWE), in facilitating a safe, early return to work after CAS. The OWE is directed toward improving the confidence of physicians and patients that patients classified as low risk can safely resume their occupational tasks significantly earlier than the current standard. The OWE has two parts: 1) a treadmill exercise test which demonstrates patients' capacity for occupational work followed by a counseling session with patient and spouse regarding the results of this test and 2) a written recommendation to the physician that the patient return to work 28 - 56 days after CAS, depending on the results of the test. The proposed trial is based on experience in a similar trial in which post-MI patients undergoing the OWE returned to work 24 days sooner than those receiving usual care (median of 51 vs. 75 days). The 500 previously employed men and women aged 60 or less who are medically eligible to undergo symptom-limited treadmill testing 28-35 days after CAS will be randomized to the Occupational Work Evaluation or to usual care. This is the first trial to evaluate an intervention our reducing occupational disability after CAS. The primary outcome of the proposed trial is the interval between CAS and return to full-time work. Pilot studies of patients undergoing CAS in the same 4 participating hospitals indicate that the present interval of approximately 88 days can be shortened to 55 or fewer days. A secondary outcome is the cost-benefit of the intervention. In the previous trial the 3 week earlier return to work after acute MI equated to $2100 in additional salary and $500 in lesser costs for diagnostic tests, rehospitalization and medical and surgical therapy. Incremental costs for the OWE approximated $250. .A tertiary outcome is the quality of life after CAS as assessed by standardized survey instruments. This multi-hospital project, coordinated by a single academic research group aided by an advanced system of microcomputers, represents a more cost-effective research design. Personnel, equipment and facilities required for OWE currently exist within community hospitals. The results of this trial will encourage the more effective use of these resources in diminishing occupational disability after CAS.

尽管冠状动脉手术成功缓解了心绞痛， (CAS)并不能提高就业水平。 该项目旨在测试 职业工作评价（OWE）是一种干预措施， 帮助患者在CAS后安全、早日重返工作岗位。 OWE是针对 提高医生和病人的信心， 被列为低风险的人可以安全地恢复职业任务 远远早于目前的标准。 OWE有两个部分： 1)跑步机运动试验，证明患者的能力， 职业工作，然后与患者和配偶进行咨询 关于本测试的结果和2）书面建议， 医生建议患者在CAS后28 - 56天恢复工作，具体取决于 测试的结果。 拟议的试验是根据一个 一项类似的试验，在该试验中，接受OWE的MI后患者重返工作岗位 比接受常规护理的患者提前24天（中位数为51 vs. 75天）。 500名年龄在60岁或60岁以下的男性和女性， 有资格在CAS后28-35天接受限制活动的跑步机测试 将被随机分配到职业工作评估或常规护理。 这是第一次试验来评估一种干预， CAS后的职业残疾 建议的主要成果 试用期是CAS和恢复全职工作之间的间隔。 试点 在相同的4家参与医院接受CAS的患者研究 这表明，目前的间隔约88天， 缩短至55天或更短。 一个次要的结果是成本效益， 干预。 在上一次试验中，3周前返回工作岗位 急性心肌梗死后相当于2100美元的额外工资和500美元的较低工资 诊断测试、再住院以及医疗和手术费用 疗法 OWE的增量成本约为250美元。 .第三级 结果是通过标准化调查评估CAS后的生活质量 仪器. 这个多医院项目，由一个单一的学术协调， 一个由先进的微型计算机系统辅助的研究小组，代表了一个 更具成本效益的研究设计。 人员、设备和设施 目前，在社区医院中存在OWE所需的。 结果 这项试验将鼓励更有效地利用这些资源， 减少CAS后的职业残疾。