Kobelt A, Pfeiffer W, Winkler M, vom Bauer V, Gutenbrunner Ch, Petermann F
Deutsche Rentenversicherung Braunschweig-Hannover.
Rehabilitation (Stuttg). 2009 Oct;48(5):312-20. doi: 10.1055/s-0029-1239548. Epub 2009 Oct 21.
Between 50 and 90% of patients in psychosomatic rehabilitation are affected by occupational problems and misdirected stress. The patients often find themselves in a vicious circle in which occupational problems lead to the development of mental illnesses before a background of lacking compensation possibilities and positive resources. Besides, mobbing can be understood as a special form of occupational stress, whereas in former studies, no differences in the magnitude of mental strain were discovered in comparison with rehabilitants who were in a psychosomatic remedial treatment.
Patients who are in psychosomatic remedial treatment and are norm-aberrantly limited in their occupational efficiency and patients who are affected by mobbing in the job show a higher psychosocial strain than other patients in treatment whose occupational efficiency is not limited. Do mobbing victims more frequently receive a recommendation that measures to strengthen their working life participation be considered?
A total of 189 patients were handed out a questionnaire at the beginning of their remedial treatment comprised of questions regarding their mobbing experiences, the IRES-3, the SCL-27, the Fatigue-Scale, the Incongruity questionnaire and the VDS-scale. The sample was split up into a group whose occupational efficiency was limited, a group affected by mobbing, and a group who had no efficiency limitations.
72.6% were clearly limited in their occupational efficiency. 27.4% felt neither affected in their occupational efficiency nor due to mobbing. 21% of the sample as a whole were affected by mobbing. Patients limited in their occupational efficiency differed neither from patients whose efficiency was unlimited, nor from those who were affected by mobbing. On the other hand, mobbing victims differed in all symptom scales evaluated from patients who had no occupational efficiency limitations. Also the scales on personality styles were substantially increased compared to this group. With mobbing victims it was recommended more often that the possibilities for working life participation measures should be checked.
Patients in psychosomatic rehabilitation are strongly affected by occupational limitations and have a huge need for counselling and support. Therapy concepts should pick up the occupational problems at hand in a differentiated manner, with job-oriented linked-up rehabilitation being recommended. The increased mental strain of mobbing victims must always be borne in mind.
在身心康复患者中，50%至90%受到职业问题和应激方向错误的影响。患者常常陷入恶性循环，在缺乏补偿可能性和积极资源的背景下，职业问题导致精神疾病的发展。此外，职场霸凌可被理解为职业压力的一种特殊形式，而在以往研究中，与接受身心康复治疗的患者相比，未发现精神紧张程度存在差异。
接受身心康复治疗且职业效率异常受限的患者，以及在职场中受到霸凌的患者，与其他职业效率未受限的接受治疗患者相比，是否表现出更高的社会心理压力？职场霸凌受害者是否更频繁地收到关于考虑采取措施加强其工作生活参与度的建议？
在189名患者康复治疗开始时发放问卷，问卷包含有关他们的职场霸凌经历、IRES - 3、SCL - 27、疲劳量表、不协调问卷和VDS量表 的问题。样本分为职业效率受限组、受职场霸凌影响组和无效率限制组。
72.6%的患者职业效率明显受限。27.4%的患者感觉职业效率和职场霸凌均未对其产生影响。整个样本中有21%受到职场霸凌影响。职业效率受限的患者与效率不受限的患者以及受职场霸凌影响的患者均无差异。另一方面，职场霸凌受害者在所有评估的症状量表上与职业效率无限制的患者存在差异。与该组相比，人格类型量表也大幅增加。对于职场霸凌受害者，更频繁地建议检查工作生活参与措施的可能性。
身心康复患者受到职业限制的严重影响，迫切需要咨询和支持。治疗理念应以差异化方式处理当前的职业问题，建议采用以工作为导向的联合康复。必须始终牢记职场霸凌受害者精神紧张加剧的情况。
