[Why do workers apply for disability pension although their vocational ability is maintained? - a qualitative study of patients after cardiac events]

The central question of this study is why workers in the employable age group apply for disability pension although from a medical point of view their vocational ability is maintained. The aim is to identify factors in the system and of the applicant which may serve as subjective prognostic indicators for maintaining employment and for determining influences which may be of prognostic value for a pension application. Concomitantly, it is aimed to obtain guidelines for practical rehabilitation and to generate impulses for further research in this field. Within a qualitative research project 16 problem-focused interviews with patients insured by "Deutsche Rentenversicherung Nord" and treated in a cardiac rehabilitation centre in Mecklenburg-Vorpommern were undertaken. Patients with either a positive or a negative subjective prognosis concerning employment were interviewed. In addition, the interviews were followed by a questionnaire one year later. The results show differences and similarities in the motivation of patients applying for disability pension. This can be traced back to psychosocial variables, sociodemographic characteristics, moderating factors and the effects of socialisation. Physical impairment was of secondary importance to the patients' motivation to apply for disability pension. The results of the follow-up questionnaire show that an existing job significantly improves the subjective prognosis for maintaining gainful employment. The application for disability pension offers the affected individual a possibility to ensure a basic existence in the case of illness and unemployment. The identified factors may be influenced by modifying the interventions and improving medical counselling during the rehabilitation period.