[Occupational and social participation disorders in patients in office-practice medical care].
BACKGROUND
Primary care physicians play a crucial role in the assessment of restrictions in of participation, i. e. especially sick leave. In this study we investigated to which degree patients in primary care suffer from disorders of participation and how this is related to problems at the workplace and sick leave.


METHODS
A total of 382 patients, aged 18-65, were investigated in primary care office practices. Self-reported disorders of participation were measured with the IMET, together with sociodemographic and work-related information.


RESULTS
27,4% of 299 patients who were at present working reported to have problems at the workplace. 19% were at present on sick leave. These patients did significantly more often report mobbing at the workplace. No differences were found with respect to quantitative or qualitative overtaxation or with respect to context variables. Restrictions in of participation were strongest related to the workplace but were also reported for the domain of family or social activities. Patients on sick leave also showed more impairment in these private areas than patients at work. The treating physicians saw psychosocial problems as a primary cause for disorders of participation at the workplace.


CONCLUSIONS
Chronic illness does impair occupational as well as general social participation, and such patients are frequently seen in primary care. Physicians in primary health care therefore play an important role in the treatment of restrictions in of participation and especially in early intervention.
Forschungsgruppe Psychosomatische Rehabilitation an der Charité, Universitätsmedizin Berlin, und Abteilung Verhaltenstherapie und Psychosomatik am Rehabilitationszentrum Seehof der Deutschen Rentenversicherung Bund, Teltow/Berlin.
B
B
Muschalla
M
M
Vilain
C
C
Lawall
M
M
Lewerenz
M
M
Linden
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D002983:Clinical Competence; D003284:Contract Services; D004185:Disability Evaluation; D004608:Eligibility Determination; D005260:Female; D005858:Germany; D006801:Humans; D055809:Illness Behavior; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009784:Occupational Diseases / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D011320:Primary Health Care; D012017:Referral and Consultation; D012050:Rehabilitation, Vocational; D018582:Sick Leave; D012917:Social Adjustment; D012943:Social Security; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires