Barriers and Facilitators to Psychosocial Management in Cardiac Rehabilitation at the South Francilien Hospital Center (CHSF)

Cardiac rehabilitation is recommended for patients with acute or chronic cardiovascular disease in accordance with national and international guidelines.

The World Health Organization (WHO) defines cardiac rehabilitation as "the sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life".

In France, the clinical practice guidelines issued by the French National Authority for Health (HAS) and the French Society of Cardiology emphasize the need for a multidisciplinary approach to cardiac rehabilitation, integrating psychosocial support and preparation for return to work, in addition to exercise training, cardiovascular risk factor management, optimization of pharmacological treatment, screening for comorbidities, therapeutic and dietary education.

According to experts, improving patients' working conditions and preparing their return to work before actual work resumption constitute major components of psychosocial care.

Such interventions can be facilitated through occupational health services, including workplace assessments and adjustments to job tasks or working hours.

Although psychosocial care is recognized as an essential component of both cardiac rehabilitation and successful return to work, its implementation within rehabilitation programs remains insufficient in practice.

• Self administered questionnaire of cardiac rehabilitation staff members (Other): Intervention Description : The patients will be asked about : * Their sociodemographic profile (age, gender, family status) * Their professional profile * Their current hospitalisation (reason for hospitalisation, and screening for symptoms of anxiety and depression) * Perceived barriers to psychological support * Perceived barriers to using occupational health services
• Self administered questionnaire of cardiac rehabilitation patients (Other): The staff members will be asked about : * Their sociodemographic profile * Their professional profile * Perceived barriers to psychological support * Perceived barriers to referral to occupational health services.
• Self administered questionnaire of occupational health physicians (Other): Occupational health physicians will be asked about their practices concerning employees returning to work after cardiac rehabilitation

Primary outcomes

• Perceived barriers to psychosocial management [at day 0]: likert scale

Secondary outcomes

• Anxiety (GAD-7 score scale) [at day 0]: Minimal, mild, moderate, severe
• Depression (PHQ9 score scale) [at day 0]: Minimal, mild, moderate, severe
• Practices concerning employees returning to work after cardiac rehabilitation [at day 0]: likert scale

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Male and female, legally adult patients, participating in a cardiac rehabilitation program in day hospital at the CHSF
* Active in the workforce
* Planning to return to work
* Patients informed of the study and who did not object to it

Exclusion Criteria:

* Patient under legal guardianship
* Presence of cognitive impairments
* Patients who do not speak nor understand French.

• François KOUKOUI, MD, Principal investigator, Centre Hospitalier Sud Francilien