Efficacy of cardiac rehabilitation. 1: a critique of the research

This article, the first of two parts, suggests that cardiac rehabilitation has two primary foci: the reduction of morbidity and mortality, and the amelioration of distress associated with cardiac pathology. While exercise programmes figure prominently in cardiac rehabilitation, empirical studies attest to their relatively modest impact on the recurrence of myocardial infarction. Other interventions such as stress management programmes reduce psychological distress and increase effective coping mechanisms, but only for a limited period. Traditional educational programmes compare unfavourably with cognitive-behavioural interventions. Empirical research appraising the efficacy of many cardiac rehabilitation interventions are tainted by numerous design problems. The second part of this article considers research into the efficacy of smoking cessation and type A behaviour modification programmes

A developmental conceptualization of return to work

INTRODUCTION: Although return to work (RTW) is a phenomenon that has been researched for many years, our ability to understand and improve outcomes is still limited. As an avenue for advancing the field, this paper presents an alternative way of thinking about RTW. METHOD: The conceptualization was constructed based on a review of the literature and the comments of RTW and workers' compensation researchers. RESULTS: RTW is presented as an evolving process, comprising four key phases: i.e., "off work," "work re-entry," "retention," and "advancement." In addition, multiple phase-specific outcomes that may be used to evaluate RTW success are advanced. CONCLUSION: Broadening thinking about RTW to take into consideration the complexities of its developmental nature holds promise for understanding and improving RTW, as it not only clarifies the importance of incremental milestones, but also facilitates intervention choice and evaluatio