Do Self-efficacy Expectation and Spirituality Provide a Buffer Against Stress-Associated Impairment of Health? A Comprehensive Analysis of the German Pastoral Ministry Study.

We aimed to analyse stress perception, psychosomatic health and life satisfaction in pastoral professionals, paying particular attention to their individual and shared resources. Enrolling 8574 German pastoral professionals (48% priests, 22% parish expert workers, 18% pastoral assistants, 12% deacons), we found that pastoral professionals' stress perception is associated with psychosomatic health impairment. General self-efficacy was a beneficial resource to protect against stress perceptions, while perception of the transcendent had a further yet weakly positive influence for stress-related impairment of health. External stressors (i.e. team size, duration of work per week and size of pastoral unit) were only of marginal independent relevance.

[Vocational therapy in schizophrenia: effects only with some patients and with which patients?]. / Arbeitstherapie bei schizophrenen Patienten: keine oder doch differenzielle Effekte?

OBJECTIVES: In a previous study the effectiveness of vocational therapy was evaluated using the Osnabrück Profile of Working Abilities (O-AFP). No or only minor effects were detected. The goal of this reanalysis is to identify distinct responder groups. METHODS: Hierarchical cluster analysis of O-AFP-scores before and after treatment, anovas, t-statistics as well as regression and discriminant analyses were applied to specify the clusters. RESULTS: For each of the O-AFP-scales (Learning Ability, Social Communication Ability, Adaptation) three subgroups different in level and slope of abilities could be identified. Improvements with medium to high effect sizes were detected for Social Communication Ability (34 %) and Learning Ability (14 % of the patients), deterioration was found in 30 % of the patients for Adaptation. Subgroups could be described with the help of symptomatology. Further variables and subgroup membership could be predicted above chance by discriminant and regression analysis. CONCLUSION: Targeted and more appropriate design of vocational therapy seems necessary.

[Legislation for inpatient treatment in psychiatry and psychotherapy and its demarcation from rehabilitation. Decision of the German Supreme Court for Social Legislation of February 16, 2005]. / Sozialrechtliche Grundlagen der Krankenhausbehandlung in der Psychiatrie und Psychotherapie in Abgrenzung von der Rehabilitation. Urteil des Bundessozialgerichtes vom 16.02.2005.

Changes in the supply of psychiatric services since the reforms in the 1970s resulted in demarcation problems between treatment (especially for inpatients), rehabilitation, and other forms of care (including nursing and methods of reintegration). As the methods used in psychiatry and psychotherapy in different phases of care are almost identical, other criteria are needed for demarcation. Social legislation does not recognize any time limit for inpatient hospital treatment. In Germany, basic principles for these decisions are laid down in the Personalverordnung Psychiatrie (Psych PV) and the Practice Guidelines of the German Psychiatric Association. Important for the acceptance of inpatient hospital treatment are the objectives and necessities resulting from disease course as well as employment of a multiprofessional team under the guidance of a psychiatric consultant. Alternative methods of care can be suggested only if they are really at the patients' disposal and documentation is not too demanding. These principles were strengthened by the decision of the German Federal Supreme Court for Social Legislation of February 16, 2005.

[The work personality profile: an instrument for the assessment of the work competence of psychiatric patients]. / Das Arbeitsfähigkeitenprofil (AFP): Ein Instrument zur Erfassung der Arbeitsfähigkeiten psychiatrischer Patienten.

The "Work Personality Profile", which assesses via supervisor ratings the basic work competences of psychiatric patients on eleven scales, was translated and adapted for use in German psychiatric institutions. Test analysis of data of 58 patients, most of whom were schizophrenic, yielded good statistical indicators for most of the scales. Factor analyses indicated a structure of two to three components: Learning ability, social and interactional competence, and social adaptation and motivation. Test analyses yielded good coefficience for most of the scales. Further clinical application of the instrument thus seems to be promising. Recommendations for use of a short version are given.