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Return to work, sexual activity, and other activities after acute myocardial infarction
E S Froelicher1, L L Kee, K M Newton
1Department of Physiological Nursing, School of Nursing, University of California, San Francisco 94143-0610.
Objectives:
(1) To examine the effects of exercise alone and the additional benefit of a teaching-counseling program with exercise when compared with usual medical and nursing care on the rate of return to previous activities, and (2) to describe the rates of return to former activities of daily living after an acute myocardial infarction.
Design:
Prospective randomized clinical trial.
Setting:
Seven Northwestern hospitals.
Sample:
258 patients, 70 years of age or younger, with the diagnosis of acute myocardial infarction, admitted to coronary care units of participating hospitals.
Outcome Measures:
Return to work, sexual activity, driving, previous maximum level of activity, and activities out of the home.
Intervention:
Subjects were randomly assigned to control group A, which received usual medical and nursing care; group B1, which received usual care plus exercise; or group B2, usual care plus exercise plus teaching-counseling sessions. Home exercise programs were prescribed for patients in groups B1 and B2. Those in group B2 also participated in the outpatient teaching-counseling program that consisted of eight group sessions pertaining to risk factor reduction and psychosocial adjustment to myocardial infarction. All subjects completed Activity Summary Questionnaires, a 12-item self-report paper and pencil questionnaire about the week's activity, each week, for 12 consecutive weeks, and at week 24 after hospital discharge.
Results:
There were no significant differences between the three groups. Previously employed patients who returned to work did so by week 24. Patients who returned to their previous maximum level of activity resumed by week 24. Most patients returned to sexual activity, driving, and activities out of the house by week 12.
Conclusions:
The rates of return to activities were not significantly different between the three groups. Most patients were active earlier than previously reported. Over 50% of patients returned to sexual activity, driving, and outdoor activities by 3 weeks after acute myocardial infarction. These results are useful for health care professionals who counsel patients about expectations in activity resumption.