Study examines effect of heart surgery on employment

A new studying appearing in Congenital Heart Disease compares the careers and long-term occupational successes of men and women who underwent surgery for congenital heart disease to those of the general population.

The project has produced evidence that shows how medicine may provide preconditions for individuals with congenital defects to live a successful life.

In recent decades, survival rates and the life expectancy of patients with congenital heart disease have improved. Medical care is no longer focused solely on chances of survival, but on patients' social and psychological adjustments to day-to-day life. For many people, a key aspect of recovery is the chance of finding appropriate employment.

The findings show that male patients were less likely to be employed full-time than part-time. This was largely dependent on disease severity. Few differences in employment patterns were found between female patients and the general population.

Men were also found to suffer much more from the psychological consequences of their disease than women. The researchers found evidence that males rated considerably higher than female patients on a series of psychological measures; in particular anxiety, depression and hostility.

The researchers believe the occupational differences apply to differing workforce expectations. "Men are expected to be employed, and particularly in full-time engagements, but for women this does not hold to the same extent," says Dr. Siegfried Geyer of Hannover Medical School, co-author of the study. "Their decision to take a part-time job or not to be employed at all is more in accordance with conventional norms." Thus, women and men may make decisions by the same reasons, but the consequences with respect to labor market participation may differ.

The researchers believe that, in giving advice, physicians should convey appropriate optimism about patients' abilities to fulfill occupational demands. This may also include a shift in occupational goals. The findings show that, even if patients did not get the job they wanted, no differences in job satisfaction were found between them and the general population.

Encouragingly, it was shown that patients had prospects of making good careers and had the same opportunities to attain occupational positions as their counterparts from the general population.

"The basis for counseling should not necessarily be patients' subjective state of health, as it is strongly influenced by other factors than disease severity," says Geyer. "Instead, physicians should also take into account clinical parameters that are independent of subjective perceptions."

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