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Assessing work capacity – reviewing the what and how of physicians’ clinical practice

机译：评估工作能力 - 审查医生的临床实践的原因和如何

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Although a main task in the sickness certification process, physicians’ clinical practice when assessing work capacity has not been thoroughly described. Increased knowledge on the matter is needed to better understand and support the certification process. In this review, we aimed to synthesise existing qualitative evidence to provide a clearer description of the assessment of work capacity as practiced by physicians. Seven electronic databases were searched systematically for qualitative studies examining what and how physicians do when they assess work capacity. Data was analysed and integrated using thematic synthesis. Twelve articles were included. Results show that physicians seek to form a knowledge base including understanding the condition, the patient and the patient’s workplace. They consider both medical and non-medical aspects to affect work capacity. To acquire and process the information they use various skills, methods and resources. Medical competence is an important basis, but not enough. Time, trust, intuition and reasoning are also used to assess the patient’s claims and to translate the findings into a final assessment. The depth and focus of the information seeking and processing vary depending on several factors. The assessment of work capacity is a complex task where physicians rely on their non-medical skills to a higher degree than in ordinary clinical work. These skills are highly relevant but need to be complemented with access to appropriate resources such as understanding of the associations between health, work and social security, enough time in daily work for the assessment and ways to better understand the patient’s work place. Also, the notion of an “objective” evaluation is questioned, calling for a greater appreciation of the complexity of the assessment and the role of professional judgement.
机译：虽然疾病认证过程中的主要任务，但医生在评估工作能力时的临床实践尚未彻底描述。需要增加关于此事的知识，以更好地理解并支持认证过程。在本综述中，我们旨在综合现有的定性证据，以便更清楚地描述医生练习的工作能力评估。系统地搜索七种电子数据库，以便在评估工作能力时检查医生如何做些什么和定性研究。使用主题合成分析和整合数据。包括十二篇文章。结果表明，医生寻求形成一个知识库，包括理解病情，患者和患者的工作场所。他们认为医疗和非医疗方面都会影响工作能力。获取和处理他们使用各种技能，方法和资源的信息。医疗能力是一个重要的基础，但还不够。时间，信任，直觉和推理也用于评估患者的索赔并将调查结果转化为最终评估。信息寻求和处理的深度和焦点因若干因素而异。工作能力的评估是一项复杂的任务，医生依赖他们的非医疗技能比普通临床工作更高。这些技能是高度相关的，但需要补充获得适当的资源，例如了解健康，工作和社会保障之间的协会，每日工作足够的时间，以便评估和更好地理解患者的工作场所。此外，“客观”评估的概念受到质疑，呼吁对评估的复杂性和专业判决的作用升值升值。

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