TY - JOUR A1 - Linden, Michael A1 - Bernert, Sebastian A1 - Funke, Ariane A1 - Dreinhöfer, Karsten E. A1 - Jöbges, Michael A1 - von Kardorff, Ernst A1 - Riedel-Heller, Steffi G. A1 - Spyra, Karla A1 - Völler, Heinz A1 - Warschburger, Petra A1 - Wippert, Pia-Maria T1 - Medizinische Rehabilitation unter einer Lifespan-Perspektive T1 - Medical rehabilitation from a lifespan perspective JF - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - Die Lifespan-Forschung untersucht die Entwicklung von Individuen über den gesamten Lebenslauf. Die medizinische Rehabilitation hat nach geltendem Sozialrecht die Aufgabe, chronische Krankheiten abzuwenden, zu beseitigen, zu mindern, auszugleichen, eine Verschlimmerung zu verhüten und Negativfolgen für die Lebensführung zu reduzieren. Dies erfordert in wissenschaftlicher wie in praxisbezogener Hinsicht die Entwicklung einer Lebensspannenperspektive als Voraussetzung für die Klassifikation und Diagnostik chronischer Erkrankungen, die Beschreibung von verlaufsbeeinflussenden Faktoren, kritischen Lebensphasen und Critical Incidents (kritische Verlaufszeitpunkte), die Durchführung von prophylaktischen Maßnahmen, die Entwicklung von Assessmentverfahren zur Erfassung und Bewertung von Verläufen oder Vorbehandlungen, die Auswahl und Priorisierung von Interventionen, eine Behandlungs- und Behandlerkoordination auf der Zeitachse, die Präzisierung der Aufgabenstellung für spezialisierte Rehabilitationsmaßnahmen, wie beispielsweise Rehabilitationskliniken, und als Grundlage für die Sozialmedizin. Aufgrund der Vielfalt der individuellen Risikokonstellationen, Krankheitsverläufe und Behandlungssituationen über die Lebensspanne hinweg, bedarf es in der medizinischen Rehabilitation in besonderer Weise einer personalisierten Medizin, die zugleich rehabilitationsförderliche und -behindernde Umweltfaktoren im Rehabilitationsverlauf berücksichtigt. N2 - Lifespan research investigates the development of individuals over the course of life. As medical rehabilitation deals with primary and secondary prophylaxis, treatment, and compensation of chronic illnesses, a lifespan perspective is needed for the classification and diagnosis of chronic disorders, the assessment of course modifying factors, the identification of vulnerable life periods and critical incidents, the implementation of preventive measures, the development of methods for the evaluation of prior treatments, the selection and prioritization of interventions, including specialized inpatient rehabilitation, the coordination of therapies and therapists, and for evaluations in social and forensic medicine. Due to the variety of individual risk constellations, illness courses and treatment situations across the lifespan, personalized medicine is especially important in the context of medical rehabilitation, which takes into consideration hindering and fostering factors alike. KW - Medical rehabilitation KW - Lifespan KW - Chronic illness KW - Personalized medicine KW - Prevention KW - Medizinische Rehabilitation KW - Lebensspanne KW - Chronische Krankheit KW - Personalisierte Medizin KW - Prävention Y1 - 2017 U6 - https://doi.org/10.1007/s00103-017-2520-2 SN - 1436-9990 SN - 1437-1588 VL - 60 SP - 445 EP - 452 PB - Springer CY - New York ER - TY - JOUR A1 - Muschalla, Beate A1 - Linden, Michael A1 - Joebges, Michael T1 - Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting JF - Journal of occupational and environmental medicine N2 - Objective: The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Methods: Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior-therapy anxiety-management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). Results: No differences were found between WAG and RG for work-anxiety and subjective work ability. When looking at patients who were suffering only from work-anxiety, and no additional mental disorder, the duration of sickness absence until 6 months follow-up was shorter in the WAG (WAG: 11 weeks, RG: 16 weeks, P = 0.050). Conclusion: A shortterm WAG may help return to work in patients with work-anxieties, as long as there is no comorbid mental disorder. Y1 - 2016 U6 - https://doi.org/10.1097/JOM.0000000000000678 SN - 1076-2752 SN - 1536-5948 VL - 58 SP - 398 EP - 406 PB - American Institute of Physics CY - Philadelphia ER - TY - JOUR A1 - Muschalla, Beate A1 - Poguntke, Kim Joy A1 - Linden, Michael T1 - Assessment of Capacity Impairment in Patients with Mental Disorders by Routine Clinical Assessment and by Structured Assessment with the Mini-ICF-APP JF - Psychopathology N2 - 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. KW - Mini-ICF-APP KW - Capacity KW - Disability KW - General practice KW - Mental disorder KW - Clinical judgment KW - Work ability Y1 - 2019 U6 - https://doi.org/10.1159/000502123 SN - 0254-4962 SN - 1423-033X VL - 52 IS - 4 SP - 248 EP - 255 PB - Karger CY - Basel ER - TY - JOUR A1 - Linden, Michael A1 - Muschalla, Beate A1 - Hansmeier, Thomas A1 - Sandner, Gabriele T1 - Reduction of sickness absence by an occupational health care management program focusing on self-efficacy and self-management JF - Work : a journal of prevention, assessment & rehabilitation N2 - BACKGROUND: The aim of occupational health care management programs (OHMP) is to improve the health status of employees, increase work ability and reduce absence time. This includes better coping abilities, work-related self-efficacy and self-management which are important abilities that should be trained within OHMPs. OBJECTIVES: To study the effectiveness of an OHMP including special interventions to enhance self-efficacy and self-management. PARTICIPANTS: Employees from the German Federal Pension Agency. METHODS: Effects of an OHMP on sickness absence was studied by comparing an intervention group (N = 159) and two control groups (N = 450). A core feature of the OHMP were group sessions with all members of working teams, focussing on self-efficacy and self management of the individual participant as well as the team as a group (focus groups). Participants in the OHMP were asked for their subjective evaluation of the focus groups. Rates of sickness absence were taken from the routine data of the employer. RESULTS: Participants of the OHMP indicated that they had learned better ways of coping and communication and that they had generated intentions to make changes in their working situation. The rate of sickness absence in the intervention group decreased from 9.26% in the year before the OHMP to 7.93% in the year after the program, while there was in the same time an increase of 7.9% and 10.7% in the two control groups. CONCLUSIONS: The data suggest that OHMP with focus on self-efficacy and self management of individuals and teams are helpful in reducing work absenteeism. KW - Focus group KW - team training KW - prevention KW - health status KW - sickness absence Y1 - 2014 U6 - https://doi.org/10.3233/WOR-131616 SN - 1051-9815 SN - 1875-9270 VL - 47 IS - 4 SP - 485 EP - 489 PB - IOS Press CY - Amsterdam ER - TY - JOUR A1 - Muschalla, Beate A1 - Linden, Michael T1 - Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders JF - Journal of the American Board of Family Medicine N2 - Purpose: Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia. Methods: A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed. Results: Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life. Conclusions: Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints. KW - Anxiety KW - Mental Health KW - Sick Leave KW - Workplace Y1 - 2014 U6 - https://doi.org/10.3122/jabfm.2014.04.130308 SN - 1557-2625 SN - 1558-7118 VL - 27 IS - 4 SP - 486 EP - 494 PB - American Board of Family Medicine CY - Lexington ER -