Abstract 13739: Increased Psychological Demands of Work are Associated with Poor Adherence and Poor Health-Related Quality of Life Among Workers with Cardiovascular Disease
Over 3.5 million workers have cardiovascular disease (CVD) with significant work limitations and increased disability. Workers must meet the challenges of today's work processes including increased stress and intense production demands while managing complexities of their CVD. Yet, little is known about adherence behaviors (i.e., medication, diet, exercise and symptom monitoring) of workers with CVD.
Purpose: To explore the relationship of job characteristics (job stress, job control, physical demands and workplace support), adherence to treatment regimens and health-related quality of life (HRQL) among workers with CVD.
Methods: In this cross-sectional, descriptive study 127 workers ≥45 with CVD were recruited from clinical and community settings and completed standardized instruments on adherence (General Adherence Scale α=.74), job characteristics (Job Content Questionnaire α =.71) and HRQL (Macnew α=.835). Correlational and regression analyses examined relationships between job characteristics, adherence and HRQL.
Results: The sample was 56.7% female, 38.6% African American, mean age 59.29 years ± 8.83; 79.1% actively employed. Hypertension was reported in 43% of the sample; 34% had coronary heart disease (prior MI, angina or heart failure). Medication adherence was reported by most (71%); few adhered to diet (18%), exercise (18%) or symptom monitoring (31%). Psychological demands of work (increased job stress and low job control) were significantly correlated to adherence behaviors (r=−0.234, p=.014). Better adherence was reported by those who felt supported by coworkers (r=0.274, p=.004) or supervisors (r=.299, p=.002) and correlated to HRQL (r=0.277, p=.004). Overall, job characteristics explained 22% of variance in adherence. Increased psychological demands of work was a significant determinant of HRQL (p=.017).
Conclusion: Generally, adherence is poor among workers with CVD. Since psychological demands of work may interfere with adherence to treatment regimens and impact HRQL, clinicians should assess job demands and include stress management as part of patient counseling. Research to develop and test interventions that foster worksite programs that facilitate adherence behaviors among workers with CVD is needed.
- © 2010 by American Heart Association, Inc.