The Sense of Coherence (SOC) Score According to Antonovsky: A Reliable Predictor of Return to Work after Cardiac Surgery

Objectives: For cardiac surgery patients who were employed until surgery, the re-entry into their professional life is of special significance. Return to the workforce does not solely depend on the success of the surgery and post-operative recovery, however, influencing factors are multi-facetted and determine whether a patient will return, adjust, or retire from work. So far, clinical research considers socio-cultural factors that might influence the phase of convalescence after cardiac surgery only insufficiently. In light of above, this study examined whether the individual sense of coherence (SOC) is a possible predictor of the re-entry into the professional life after cardiac surgery.

Methods: After approval of the local ethics committee at the University Hospital RWTH Aachen, 278 patients were questioned via post in February 2015 with the SOC questionnaire according to Antonovsky. SOC is defined as a stable value over time. All German-speaking patients, who underwent first-time non-minimal invasive CABG or surgery on heart valves between January 1, 2010 and August 31, 2014, who were employed and less than 60 years of age on the day of surgery and were included in this study. Statistical analysis was performed using SPSS to obtain the Youden Index; Anova and Kaplan Meier analyses were performed where appropriate.

Results: Sixty-one questionnaires (61.6%) were considered as eligible and included in the analysis. Of those, 47 participants had returned to work (RTW) after undergoing cardiac surgery, 14 participants had not (no RTW). We observed significant differences in SOC values between the RTW and the no-RTW group (146 ± 29.76 versus 124 ± 27.75, mean difference 22, p = 0.026). Patients, that returned back to their professional life within the first 6 months after surgery showed even higher SOC scores (148 ± 29 versus 124 ± 27.75, mean difference 24, p = 0.034). The Youden index was used to calculate that patients with an SOC Score ≥ 130 were more likely to return to their professional life after cardiac surgery.

Conclusion: Identifying influencing factors for RTW after cardiac surgery is of utter importance; the SOC is an easily obtainable score that reliably predicts the probability of RTW after cardiac surgery.