Muschalla B, Vilain M, Lawall C, Lewerenz M, Linden M
Forschungsgruppe Psychosomatische Rehabilitation an der Charité, Universitätsmedizin Berlin, und Abteilung Verhaltenstherapie und Psychosomatik am Rehabilitationszentrum Seehof der Deutschen Rentenversicherung Bund, Teltow/Berlin.
Rehabilitation (Stuttg). 2009 Apr;48(2):84-90. doi: 10.1055/s-0029-1202292. Epub 2009 Apr 17.
Primary care physicians play a crucial role in the assessment of restrictions in of participation, i. e. especially sick leave. In this study we investigated to which degree patients in primary care suffer from disorders of participation and how this is related to problems at the workplace and sick leave.
A total of 382 patients, aged 18-65, were investigated in primary care office practices. Self-reported disorders of participation were measured with the IMET, together with sociodemographic and work-related information.
27,4% of 299 patients who were at present working reported to have problems at the workplace. 19% were at present on sick leave. These patients did significantly more often report mobbing at the workplace. No differences were found with respect to quantitative or qualitative overtaxation or with respect to context variables. Restrictions in of participation were strongest related to the workplace but were also reported for the domain of family or social activities. Patients on sick leave also showed more impairment in these private areas than patients at work. The treating physicians saw psychosocial problems as a primary cause for disorders of participation at the workplace.
Chronic illness does impair occupational as well as general social participation, and such patients are frequently seen in primary care. Physicians in primary health care therefore play an important role in the treatment of restrictions in of participation and especially in early intervention.
初级保健医生在评估参与受限情况,即特别是病假方面发挥着关键作用。在本研究中,我们调查了初级保健中的患者在多大程度上存在参与障碍,以及这与工作场所问题和病假之间的关系。
在初级保健诊所对总共382名年龄在18 - 65岁的患者进行了调查。使用IMET测量自我报告的参与障碍,并收集社会人口统计学和与工作相关的信息。
在目前正在工作的299名患者中,27.4%报告在工作场所有问题。19%目前正在休病假。这些患者更频繁地报告在工作场所遭受欺凌。在工作量或质量过重方面以及背景变量方面未发现差异。参与受限与工作场所的关联最为紧密,但在家庭或社会活动领域也有报告。与在职患者相比,休病假的患者在这些私人领域也表现出更多的功能受损。主治医生将心理社会问题视为工作场所参与障碍的主要原因。
慢性病确实会损害职业以及一般社会参与,并且这类患者在初级保健中很常见。因此,初级卫生保健医生在治疗参与受限情况,特别是早期干预方面发挥着重要作用。