@article{MuschallaPoguntkeLinden2019,
  author    = {Muschalla, Beate and Poguntke, Kim Joy and Linden, Michael},
  title     = {Assessment of Capacity Impairment in Patients with Mental Disorders by Routine Clinical Assessment and by Structured Assessment with the Mini-ICF-APP},
  series = {Psychopathology},
  volume    = {52},
  journal   = {Psychopathology},
  number    = {4},
  publisher = {Karger},
  address   = {Basel},
  issn      = {0254-4962},
  doi       = {10.1159/000502123},
  pages     = {248 -- 255},
  year      = {2019},
  abstract  = {Background: Physicians and therapists are also consulted to give judgments on working ability. Ability to work cannot simply be derived from the patient's symptom status but from the illness-related capacity impairments in relation to the work demands. A structured assessment of capacity impairments has been evaluated and applied internationally: the Mini-ICF-APP Social Functioning Scale. It is currently unclear whether a free-text clinical report (i.e., usual clinical practice: clinical exploration according to clinical standards, but without a standardized documentation form, instead a text is written) and a structured capacity assessment correspond to the overall work ability judgment, i.e., the decision whether a patient is "fit for work" or "unfit for work." Objectives: This investigation assessed, for the first time, whether usual clinical judgment and the additional structured capacity rating support the work ability decision. Methods: A total of 100 medical reports from patients in a psychotherapy hospital were excerpted for psychopathological symptoms and capacity disorders using a checklist. Additionally, a structured assessment of capacity disorders was documented on the Mini-ICF-APP rating for all patients. Results: In the free-text clinical medical report, endurance, flexibility, and contacts to others were the things mainly reported as impaired. This was similar to the structured Mini-ICF-APP rating. However, other capacity impairments were also reported in the Mini-ICF-APP, i.e., adherence to rules and regulations, planning and structuring, assertiveness, and group integration. When the free-text clinical report and the structured Mini-ICF-APP rating were compared, there was a higher rate of stated impairments covering all capacity dimensions in the Mini-ICF-APP rating. Conclusions: The free-text report in the medical report shows the differences between patients who are fit for work and those who are not, and thus speak for the validity of work ability decisions. However, optimization is possible in terms of depth and differentiation of capacity impairment description by adhering to the standard set by the Mini-ICF-APP.},
  language  = {en}
}
@article{Muschalla2017,
  author    = {Muschalla, Beate},
  title     = {Is it a Case of "Work-Anxiety" When Patients Report Bad Workplace Characteristics and Low Work Ability?},
  series = {Journal of Occupational Rehabilitation},
  volume    = {27},
  journal   = {Journal of Occupational Rehabilitation},
  publisher = {Springer},
  address   = {New York},
  issn      = {1053-0487},
  doi       = {10.1007/s10926-016-9637-2},
  pages     = {106 -- 114},
  year      = {2017},
  abstract  = {Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.},
  language  = {en}
}
@article{Muschalla2016,
  author    = {Muschalla, Beate},
  title     = {Different work capacity impairments in patients with different work-anxieties},
  series = {International archives of occupational and environmental health},
  volume    = {89},
  journal   = {International archives of occupational and environmental health},
  publisher = {Springer},
  address   = {New York},
  issn      = {0340-0131},
  doi       = {10.1007/s00420-015-1099-x},
  pages     = {609 -- 619},
  year      = {2016},
  abstract  = {Purpose Persons with work-anxieties are especially endangered for work capacity impairment and sick leave. Work capacity impairment is not directly due to symptoms but due to illness-related capacity disorders. Work capacity impairments can be described on different dimensions (e.g., social interaction, decision making and judgment, endurance, mobility). Understanding the type of work capacity impairment is important for reintegration interventions. This is the first study to investigate work capacity impairment in risk patients with different work-anxieties. Results Patients with different work-anxieties were impaired in different capacity dimensions: Work-related social anxiety went along with clinically relevant impairment in capacity of assertiveness (M = 2.40), anxiety of insufficiency went along with impaired capacity of endurance (M = 2.20), and work-related generalized worrying was accompanied by impairment in the capacity for decision making (M = 1.82). Specific capacity impairment dimensions were related to sick leave duration, while a global work ability prognosis was not. Conclusions The capacity approach is useful to describe work impairment more precisely and beyond symptoms. On this basis, reintegration-focusing interventions such as capacity training (e.g., social interaction training) or work adjustment (e.g., reducing exposure with interactional work tasks) can be initiated.},
  language  = {en}
}