Wie hast du's mit der Arbeitsfähigkeit? Fähigkeitserleben und Arbeitsplatzprobleme bei Patienten mit psychischen Erkrankungen
Aim:
Chronic mental disorders are not only present with symptoms, but also negative consequences on activities / capacities and life participation. This is especially relevant in the context of work. Diagnosis and treatment of mental disorders, which are often long-term disorders, must therefore be based on a bio-psycho-social understanding of illness according to the
ICF (
WHO, 2001). Differentiated description of capacities needs specific measurements. An established instrument for the description of 13 psychomental capacities, which is often used for work ability description and judgement, is the Mini-
ICF-APP (Linden
et al., 2009, 2015).
Method:
In parallel to the Mini-
ICF-APP, a self-rating version has been developed, the Mini-
ICF-APP-
S. This article reports data from 1134 patients with chronic mental disorders. Patients with workplace problems, patients without workplace problems and patients without workplace are compared concerning their self-reported capacity profiles.
Results:
Patients without workplace and patients with workplace problems have the most serious social-medical problems. The stronger the workplace problem, the lower do the patients report their capacities. Patients without workplace problem had partly better results in a cognitive ability test as compared to patients with workplace problem or without workplace. All three patient groups were with similar frequencies in a psychotherapeutic treatment. In their capacity profiles, the most often impaired capacities were proactivity, endurance, assertiveness, and flexibility. Dyadic relationships of capacity to adjust to rules or routines were seldomly perceived as impaired.
Discussion:
The variance of rating in the capacity profiles shows that patients described their capacity profiles differentiatedly (rather than giving the same scoring in several dimensions). Conclusion: The Mini-
ICF-APP can be used economically in diagnostics, therapy planning and social-medicine decision making (work ability decisions). By focusing on “capacities” (instead of symptoms), clinicians and occupational physicians may introduce the topic work ability to their patients. Speaking about capacities offers a concrete, behavior-oriented, and potentially resource-oriented view on work-related health problems and findings solutions.
