Abstract 11787: The Influence of Depression on Treatment Adherence Among Older Workers with Coronary Heart Disease (CHD)
Older workers with CHD must meet the challenges of today's work processes including increased stress and intense production demands while managing complex treatment regimens. Depression is very common in individuals with CHD and may further impede older workers ability to adhere to medication, diet, exercise and symptom monitoring recommendations; especially when jobs are stressful. The purpose of this study was to explore the relationship of depression to treatment adherence among older workers with CHD.
Methods: In this cross-sectional study; 121 older workers (>age 50) with CHD (mean age 63.3 years ± 7.1) completed standardized instruments about adherence (Medical Outcomes Study Specific Adherence Survey α= .74), depression (PHQ-9 α = .84), job characteristics (Job Content Questionnaire α= .71) and physical functioning (Duke Activity Status Index α= .79). Correlational and regression methods were used in the analysis.
Results: The sample was 56.8% female, 34.4% African American, 79.6% were employed (59% full or part time; 20% self-employed). Older individuals (>age 62) had better adherence (p=.04). Depressive symptoms were associated with poorer adherence (p=.01). Those with better adherence also reported higher levels of physical functioning (p=.002). Increased job demands was negatively correlated to adherence (r=-0.302, p=.007). Hierarchical multiple regression was used to assess the ability of job characteristics (job control, job demands and workplace support) to predict adherence after controlling for the influence of depression and physical functioning. In step 1, depression and physical functioning explained 11.9% of the variance in adherence. Job characteristics were entered in step 2 and explained an additional 9.6% of variance in adherence (R squared change =.096 F change (3,97) 3.948, p=.011). The total variance explained by the model was (21.4%, F (5, 97) =5.298, p<.0001).
Conclusions: Since older workers with CHD are vulnerable to multiple psychological stressors that may influence treatment adherence, clinicians should routinely assess depression and job demands. As the workforce ages, worksite cardiovascular programs to address job stress are needed.
- © 2011 by American Heart Association, Inc.