Rogers E Sally, Millner Uma Chandrika, Brandt Diane, Chan Leighton, Jette Alan, Marfeo Elizabeth, Ni Pengsheng, Rasch Elizabeth
Center for Psychiatric Rehabilitation, Sargent College, Boston University, Boston, MA, USA.
Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD, USA.
Work. 2018;61(1):11-20. doi: 10.3233/WOR-182776.
Assessing functioning and disability among individuals with mental and behavioral health disorders has historically relied on deriving accurate psychiatric diagnoses and assessing symptoms. However, growing empirical evidence suggests that this approach is inadequate to determine real world performance, particularly with respect to work.
We examined a performance-based approach to the assessment of work functioning and its relationship to mental and behavioral health status.
A cross-sectional study was conducted at two mental health programs. Trained employment providers conducted performance-based assessments of work function and ratings of mental and behavioral health while study participants self-reported their mental/behavioral health functioning. We hypothesized that participant and provider ratings of mental/behavioral health would be moderately correlated with performance-based assessments of work function.
We found no significant correlation between participants' self-report of their mental and behavioral health and performance-based assessments of work. Employment providers' ratings of participants' mental/behavioral health were moderately correlated with performance-based measures of work. Finally, we found low concordance between employment providers and study participants' with respect to ratings of their mental/behavioral health.
Contrary to our hypotheses, ratings of mental/behavioral health were only moderately correlated with performance-based measures of work. Results confirm earlier research suggesting that it is difficult to predict work performance from participants' self-reports of their mental/behavioral health alone. Performance-based assessments of work capacity as well as ratings of mental and behavioral health may both be needed for a more complete and complimentary picture of the ability of individuals with mental and behavioral health disorders to function in the work place.
历史上，评估精神和行为健康障碍患者的功能和残疾情况一直依赖于得出准确的精神科诊断并评估症状。然而，越来越多的实证证据表明，这种方法不足以确定实际工作表现，尤其是在工作方面。
我们研究了一种基于表现的方法来评估工作功能及其与精神和行为健康状况的关系。
在两个心理健康项目中进行了一项横断面研究。训练有素的就业服务人员对工作功能进行基于表现的评估，并对精神和行为健康进行评级，而研究参与者则自我报告他们的精神/行为健康功能。我们假设参与者和服务人员对精神/行为健康的评级与基于表现的工作功能评估之间存在中度相关性。
我们发现参与者对其精神和行为健康的自我报告与基于表现的工作评估之间没有显著相关性。就业服务人员对参与者精神/行为健康的评级与基于表现的工作指标存在中度相关性。最后，我们发现就业服务人员和研究参与者在精神/行为健康评级方面的一致性较低。
与我们的假设相反，精神/行为健康评级与基于表现的工作指标仅存在中度相关性。结果证实了早期的研究，即仅根据参与者对其精神/行为健康的自我报告很难预测工作表现。对于更全面和互补地了解精神和行为健康障碍患者在工作场所的功能能力，可能既需要基于表现的工作能力评估，也需要精神和行为健康评级。
