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Purpose: Effective cardiac rehabilitation interventions must provide adequate support to overcome psychosocial return-to-work (RTW) barriers. No validated instrument is available for this aim for cardiovascular patients. The Return-to-work Obstacles and Self-Efficacy Scale (ROSES) measures RTW obstacles workers perceive and the self-efficacy for overcoming them through 46 items and ten dimensions. This study aimed to adapt and validate ROSES for cardiovascular disease (CVD) in the Italian context. Methods: This prospective study involved 183 CVD working patients at baseline and 121 six months later. ROSES-CVD internal consistency, construct, and predictive validity was evaluated with Cronbach’s α, Confirmatory factor analyses (CFA), and ANCOVAs. Results: CFAs adequately replicated the original ROSES model (CFI =.92–.96; TLI =.91–.94; RMSEA =.042–.057; SRMR =.046–.071) with α close or higher than.70 for all dimensions. Four ROSES-CVD dimensions significantly predicted the number of days to RTW controlling for age, gender, educational level, and surgery type. Workers who perceived salient RTW obstacles and low self-efficacy in any of these dimensions in mean returned to work from 38 to 53 days later. Conclusions: The study supported the validity and reliability of ROSES-CVD. This tool can be used in rehabilitation to detect CVD patients at risk of a longer RTW process and define appropriate cardiac rehabilitation intervention.IMPLICATIONS FOR REHABILITATION Vocational rehabilitation interventions should provide tailor-made support to overcome RTW barriers based on individual risk assessment The Italian translation of ROSES-CVD is a valid and reliable tool to measure psychosocial barriers to RTW among CVD working patients The use of ROSES-CVD would allow detection of CVD patients at risk of longer RTW process Administering ROSES-CVD can help focus traditional vocational intervention on individually relevant obstacles to RTW.

Depression is a leading factor of work disability throughout the world. However, a paucity of studies investigated factors related to the development of depression in the workplace prior to sick leave. This qualitative study aims to describe the factors related to the onset of depression at work prior to sick leave.This study followed a descriptive interpretive design. Interviews were conducted with 22 individuals (15 women) who experienced depression while they were employed within an organization. The verbatim transcripts were coded using QDA-Miner software.Participants (n = 22) reported that their depression was partially or completely related to their work. From the analysis of all 22 participants' interviews transcripts, three major themes emerged: (1) work-related psychosocial risk factors (e.g. factors related to supervisors' attitudes and behaviors), (2) the individual's experience in employment (e.g. reactions to symptoms) and (3) the period preceding the sick leave of individuals who experienced depression (e.g. communication with the supervisor).These results support the importance of preventive intervention oriented toward decreasing psychosocial risks within organizations, and detecting workers at risk. Future studies should focus on factors that might influence individuals in their decision to reveal or not their difficulties to their supervisors.The conditions in which employees were working before they started their leave of absence should be identified; notably (1) relationships with organizational stakeholders (e.g. immediate supervisor, colleagues) and (2) psychosocial risk factors (e.g. work overload, over-commitment). A good relationship between the immediate supervisor and the employee is an important factor to prevent sick leave due to depression. The supervisors should be informed quickly after the first appearance of depressive symptoms in employees in order to implement feasible and appropriate accommodations as soon as possible.