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Work and employment

Possible problems related to work and employment are initially screened using items from the DASH work module. Supplementary tests are carried out following procedures from the Functional Capacity Evaluation© (FCE).

 Documentation example:

27_work_dash

DASH-Work Module

Screening

Required material: None

The patient responds with a subjective appraisal of their physical ability in relation to their work. Difficulties in the following areas are considered:

  1. Is it possible to work in the usual way?
  2. Given the pain in their shoulder/ arm or hand, is it possible to carry out their usual work?
  3. Can they work as well as they would like?
  4. Can they carry out their work for the previously usual amount of time?

The patient chooses the most appropriate answer from the following options: (1) No difficulty, (2) Mild difficulty, (3) Moderate difficulty, (4) Severe difficulty, (5) Unable.

Tests following the Functional Capacity Evaluation (FCE)

Supplementary testing

Tests following the FCE are carried out by appropriately trained therapists (physiotherapists and occupational therapists).

Required material: Test materials according to the FCE Standards.

Procedure: The therapist will define 1 to 3 tests which correspond to the patient’s occupational demands, briefly documenting the test procedures. The tests are then conducted with the patient, with the therapist assessing the patient’s ability in each procedure (in terms of quality and endurance) according to their following assessment criteria:

The conducted activity is …:

  1. …vigorous, coordinated and can be carried out to the full extent
  2. …possible with the help of compensatory mechanisms
  3. …not possible

The correct activity procedure was achieved…:

  1. …repeatedly without restriction (>15 repetitions)
  2. …with a limited number of repetitions (5-15 repetitions)
  3. …only a few times (<5 repetitions)

Documentation example:

28_work_efl

Specification of occupational strain

Supplementing functioning, an assessment of occupational strain is also captured in the area of work and employment. For this purpose, extracts from the DGUV’s occupational profile (Deutschen Gesetzlichen Unfallversicherung Formtext M2100) along with questions about the maximum occupational loading of the hand and the type of loading are used.

Occupational profile of the German Social Accident Insurance (DGUV)

Patient questionnaire

In the DGUV’s occupational profile, the patient is asked questions regarding their various specific occupations/ activities. In order to create the patient’s occupational profile, the rehab-manager notes the patient’s answers to the questions contained in the occupational profile.

Documentation example:

30_work_profile

Questions on occupational strain

Patient questionnaire

In order to document the severity and type of the patient’s occupational strain, the following additional aspects are captured using a patient questionnaire.

Documentation example:

29_work_belastung

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