Psychosocial and clinical factors predicting resumption of work following acute myocardial infarction in Japanese men

We investigated psychosocial and clinical factors related to work resumption, delay in returning to work and level of work activity after an acute myocardial infarction in Japanese male patients. A total of 111 married male patients experiencing a first acute myocardial infarction, aged less than 66 years and in full-time employment participated. Interviews and questionnaires were administered during hospitalization to assess potential predictors of work-related outcomes, with follow-up (81.6%) after an average of 8 months. We found that failure to return to work was predicated independently by older age (P=0.019), an introverted personality (P=0.011) and the presence of depressive symptoms during hospitalization (P=0.031). Delay in returning to work was predicted by greater concerns about health (P=0.011), low social support (P=0.021), and a failure to recognise a link between stress, coping style and illness (P=0.001). Resuming work at a lower activity level than before infarction was associated with older age (P=0.008), higher health concerns (P=0.012), and patients’ predictions of their lower work activity (P=0.001). Clinical indices of infarction size and disease severity did not predict work-related outcomes. We conclude that psychosocial factors are associated with work resumption in Japanese men characterised by a job-centred lifestyle, with different factors being important for different work outcomes. The psychosocial factors found to be important are similar to those identified in Western societies.