Work Role After Myocardial Infarction, Article Critique Example

Purpose/Aims of the Study

The article by Valdez-Lowe addresses the importance of role identification for patients who have experienced myocardial infarctions (MIs), including an evaluation of self-esteem and other indicators as related to the workplace setting (2013). It is important to identify these challenges and to take the steps that are necessary to consider how work plays an important role for patients who have experienced MIs within the past year (Valdez-Lowe, 2013). The study explores the importance of lost productivity and other concerns that play an important role in shaping outcomes for patients and in determining how self-esteem, personal growth, and value judgments are impacted by the workplace. The study aims to illuminate the issues raised when getting individuals back to work following an MI for all involved parties, including workers, employers, and health care providers. These study aims are appropriate for further consideration and demonstrate the impact of patient care outcomes in the support of new approaches in improving outcomes for employees (Valdez-Lowe, 2013).

Hypothesis of the Study

Although not explicitly stated, this article hypothesizes that a disruption in the work role following an MI can cause identity disruption, and negatively impact an individual’s self-esteem and self-worth (Valdez-Lowe, 2013). Due to the specific nature of MIs and their impact on personal health, it is likely that there is limited knowledge and expertise in supporting employees who return to work after an MI, given the proposed method of statistical analysis and evaluation. This hypothesis is important because it addresses a segment of the population that is not always given the proper attention and consideration, including the tendency to experience low self-esteem and even depression after experiencing an MI and returning to the workplace sometime later. This hypothesis is also relevant because it conveys the importance of psychological wellbeing upon return to work after an MI has occurred (Valdez-Lowe, 2013).

Methodology

The study methodology evaluates the specific variables that are most relevant in role identification for individuals with past MIs who have returned to the workplace, such as self-esteem, the intrusion of the illness, and general wellbeing (Valdez-Lowe, 2013). The study explores these subject areas through a detailed literature review in order to determine the importance of key variables in the creation of assessment tools that capture the essence of role identification for this specific population group. A questionnaire instrument was employed as a means of evaluating specific factors associated with self-esteem as it is related to work roles and responsibilities. Furthermore, the questionnaire was designed to explore other factors in depth, such as the intrusion of illness on this population group. This pilot feasibility study evaluated the importance of different factors for employees who have experienced MIs, using a correlation analysis method (Valdez-Lowe, 2013).

Descriptive Statistics

The study evaluated the responses of 30 participants, using 0.45 as the effect size, 0.80 as the statistical power, and 0.05 as the significance level (Valdez-Lowe, 2013). All participants had experienced an MI within the past year, were 18 years of age or older, and were employed at least 20 hours per week. The study instrument used was the Identity Subscale of Luhtanen and Crocker’s Collective Self-Esteem Scale to determine role identification (Valdez-Lowe, 2013). The subscale was defined as a Likert-type scale with 0.80 as the alpha coefficient. In addition, the study employed Devin’s Illness Intrusiveness Scale in order to determine the impact of disruptions as a result of illness, specifically MI in this instance. This scale provided a level of consistency of 0.80 to 0.90. These scales all have proven validity and are explicitly stated by the author, however, reliability is only addressed in one of the scales, Devin’s Illness Intrusive Scale. These scales were used in the study to determine the impact of MI on self-esteem and other key indicators in the workplace (Valdez-Lowe, 2013). The authors do not express the level of measurement used in this study, but there are a variety of different statistics collected from the scales as well as from the demographic data.

Inferential Statistics

The statistics generated in the study results demonstrate that there are significant factors associated with self-esteem and MI as it relates to the work environment (Valdez-Lowe, 2013). The results also indicate that there are no significant measurable differences between depression, self-esteem, and the intrusion of illness across the scales. However, there was an important determining factor associated with the intrusion of illness and the role of son or daughter, as well as the ability to experience greater self-esteem and personal image as related to social group status (Valdez-Lowe, 2013). The study utilized correlation analysis to better understand if different demographic and other variables are related or are not statistically significant (Valdez-Lowe, 2013).

Tables and Graphs

The study summarizes the relevant data across several tables, including the correlation between specific variables that are relevant to the study hypothesis and objectives (Valdez-Lowe, 2013). The data within these tables provided further evidence of the most relevant issues associated with MI and its role in returning to the workplace in the desired manner. For example, While Tables 1 and 2 provide a summary of the basic characteristics of the chosen sample, Table 3 addresses key demographic and model variables and their impact on the population in question (Valdez-Lowe, 2013). The r value for education and illness intrusion is negative, while the p value is higher, which demonstrates that there is a limited correlation between the demographic and model variables, while on the other end of the spectrum, there is a significant correlation between social roles and self-esteem with this set of demographics (Valdez-Lowe, 2013). In Table 4, it was determined that there is a significant correlation between illness intrusion and the role of daughter or son within the family unit (Valdez-Lowe, 2013). Other variables within this chart do not provide any real statistical significance for the study and its objectives (Valdez-Lowe, 2013). In Table 5, it was determined that self-esteem has a significant correlation to social status and belonging to different groups (Valdez-Lowe, 2013). These findings strongly suggest that the ability to return to work is a critical factor in promoting greater self-esteem and self-confidence for employees after MI, along with the recognition of specific roles to promote greater self-identity (Valdez-Lowe, 2013). From a statistical point of view, this study is limited in its scope and applicability for a larger population; however, it may provide some degree of significance in supporting the exploration of self-esteem and other personal self-identification characteristics in returning to work after a major illness that has required significant time away from the workplace (Valdez-Lowe, 2013). This information is relevant because it supports the continued evaluation of individuals and the value of the workplace setting in supporting and/or restoring self-esteem in cases where employees are required to be out of work for health reasons (Valdez-Lowe, 2013).

Findings

Based upon the statistical analyses, it was determined that the existence of MI plays a significant role in shaping outcomes and future roles in the workplace setting (Valdez-Lowe, 2013). For persons who have experienced MIs in the past, their ability to return to work in a successful manner is integral to their general health and wellbeing as part of a larger group. It was determined that these individuals place great value on their ability to be effective contributors within the workplace setting and strive to belong to this group and other social groups. Based upon the study results, there were expected correlations between some groups, while others did not have the same statistical impact. The power value was stated in this study, and addressing this value is of the utmost importance in designing a valid study. It is important to address the study limitations and other factors that play a role in supporting effective outcomes for members of this study population. These findings have an impact on future employees who have experienced MIs and their ability to return to work in the desired manner (Valdez-Lowe, 2013).

This study did boast a statistical power of 0.8, meaning there is an 80 percent chance that a statistical difference does exist (Dawson and Trapp, 2004). According to Eng, high power is always “desirable,” and that a number greater than or equal to 0.8 is statistically significant; although some experts are now support the idea that a power of 0.9 should be sought (2003).  Based on more conventional standards, however, the statistical power does show that the sample size, n=30, although small, does prove statistical significance (Dawson andTrapp, 2004).

It is important to note that this is a pilot feasibility study, and not a randomized control trial.  A lot of factors are missing in this study that would deem it completely insignificant if it were a randomized control trial. However, as a pilot feasibility study, it does lend some important information for the creation of future studies. According to Fain, pilot feasibility often studies lack the statistical power to make generalizations about a larger population of interest (2010). The small sample sizes also lend to this concern and therefore, deem the study less significant than originally anticipated.

Summary

It is important to develop new strategies and directives for individuals who have experienced MIs so that they are able to return to work with the appropriate frame of mind and psychological status (Broadbent et.al, 2009). It is important to identify the issues that may arise in individuals who have experienced MIs so that they are able to be successful in the workplace setting without extreme negativity and emotional consequences (Williams et.al, 2011). Based upon the statistics generated through the questionnaires, in some individuals, depression is likely to occur as a result of the MI diagnosis and its short and long-term impacts on health and wellbeing, while others might experience greater support and lower rates of depression when they are able to return to work without hesitation and significant difficulties (O’Neil et.al, 2010). As a result, it is important to identify factors that will be effective contributors to improved quality of life and the success of treatment objectives so that the ability to return to the workplace is not delayed (O’Neil et.al, 2010). The ability to regain employment and to return to work with a routine in place is significant to patients who have experienced MIs because their self-esteem is often low and depression is likely to occur (O’Neil et.al, 2010). Therefore, the findings of the Valdez-Lowe study are relevant because they provide further evidence for the ability of the workplace role to be effective in supporting self-esteem and personal identity after this serious and often debilitating health concern (2013).

References

Broadbent, E., Ellis, C.J., Thomas, J., Gamble, G., and Petrie, K.J. (2009). Further development of an illness perception intervention for myocardial infarction patients: a randomized controlled trial. Journal of Psychosomatic Research, 67(1), 17-23.

O’Neil, A., Sanderson, K., and Oldenburg, B. (2010). Depression as a predictor of work resumption following myocardial infarction (MI): a review of recent research evidence. Health and Quality of Life Outcomes, 8(95), 1-11, retrieved from http://www.biomedcentral.com/content/pdf/1477-7525-8-95.pdf

Valdez-Lowe, C. (2013). Role identity and the work role after myocardial infarction. Workplace Health & Safety, 61(2), 65-72.

Williams, L., O’Connor, R.C., Grubb, N.R., and O’Carroll, R.E. (2011). Type D personality and illness perceptions in myocardial infarction patients. Journal of Psychosomatic Research,70(2), 141-144.