{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:02:05Z","timestamp":1768953725227,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brandenburg Medical School","award":["19630064"],"award-info":[{"award-number":["19630064"]}]},{"name":"German Pension Insurance Berlin-Brandenburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Work-related anxiety can result in prolonged work incapacity and reduce return-to-work probabilities. Despite the prevalence of work-related anxiety in somatic rehabilitation settings, there has been little research examining the experiences of affected patients from a public health perspective. This research project aims to address this gap by providing initial insights into the care provided to patients with somatic complaints and patients with additional work-related anxiety. Methods: A sequential mixed methods approach was employed, beginning with semi-structured interviews (2022, n = 18 orthopedic rehabilitation patients), followed by questionnaire distribution (2023, n = 53). Qualitative analysis distinguished between patients with higher (JA) and lower (nJA) Job Anxiety Scale scores (cut-off 2.5). Results: The findings highlight notable differences between JA and nJA patients. JA patients often report that they face unmet psychological needs, limited work-related treatment focus, financial barriers, and inadequate occupational support, relying more on self-initiative for reliable information. In contrast, nJA patients appear to benefit from stronger social networks, stable financial resources, and improved access to healthcare. Both groups report mixed experiences with workplace support. For professionals the findings underline that JA patients are specifically in need of work-related interventions, even patients themselves remind about this. Conclusions: The findings illustrate significant differences between JA and nJA patients in terms of their experiences, challenges, and support needs within healthcare, workplace, and rehabilitation contexts. While qualitatively insightful, these findings are pilot and explorative and warrant further research. Trial registration: DRKS00029004 (25 May 2022).<\/jats:p>","DOI":"10.3390\/ijerph23010125","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:27:58Z","timestamp":1768908478000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opportunities and Challenges in the Care of Patients with Somatic Complaints and Patients with Additional Work-Related Anxiety\u2014A Mixed Methods Study"],"prefix":"10.3390","volume":"23","author":[{"given":"Lara","family":"Kleist","sequence":"first","affiliation":[{"name":"Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5235-5243","authenticated-orcid":false,"given":"Franziska","family":"Wei\u00dfenstein","sequence":"additional","affiliation":[{"name":"Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5285-6618","authenticated-orcid":false,"given":"Beate","family":"Muschalla","sequence":"additional","affiliation":[{"name":"Psychotherapy and Diagnostics, Technische Universit\u00e4t Braunschweig, 38106 Braunschweig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5988-1194","authenticated-orcid":false,"given":"Lukas","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen","family":"Wengemuth","sequence":"additional","affiliation":[{"name":"Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5533-7450","authenticated-orcid":false,"given":"Kyung-Eun (Anna)","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany"},{"name":"Health Services Research, Research Center Medical Imaging and Artificial Intelligence (MIAAI), Danube Private University (DPU) GmbH, Steiner Landstra\u00dfe 124, 3500 Krems-Stein, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Muschalla, B., and Linden, M. (2013). Arbeitsplatzbezogene \u00c4ngste und Arbeitsplatzphobie: Ph\u00e4nomenologie, Diagnostik, Behandlung, Sozialmedizin [Workplace-related Anxiety and Workplace Phobia: Phenomenology, Diagnostics, Treatment, Social Medicine], W. Kohlhammer.","DOI":"10.17433\/978-3-17-023810-7"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Muschalla, B. (2019). Selbstmanagement bei Arbeits\u00e4ngsten: Manual zum Gruppentraining [Self-Management for Work Anxiety: Manual for Group Training], Verlag W. Kohlhammer. [1st ed.].","DOI":"10.17433\/978-3-17-036017-4"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1055\/s-0042-118578","article-title":"Arbeits\u00e4ngste und ihre Behandlung in der medizinischen Rehabilitation\u2014Handwerkszeug f\u00fcr F\u00e4higkeitentrainings und Psychotherapie [Work-Anxieties and their Treatment in Medical Rehabilitation\u2014Hand Tools for Capacitiy Training and Psychotherapy]","volume":"56","author":"Muschalla","year":"2017","journal-title":"Die Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11800-008-0097-1","article-title":"Der Arbeitsplatz als Quelle von Angst [The Workplace as a Source of Anxiety]","volume":"2","author":"Muschalla","year":"2008","journal-title":"Psychosom Kons."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.apmr.2017.06.017","article-title":"Prevalence and Characteristics of Work-Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study","volume":"99","author":"Muschalla","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s10926-007-9068-1","article-title":"Functional Self-Efficacy Beliefs Influence Functional Capacity Evaluation","volume":"17","author":"Asante","year":"2007","journal-title":"J. Occup. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1037\/apl0000266","article-title":"Understanding the Dark and Bright Sides of Anxiety: A Theory of Workplace Anxiety","volume":"103","author":"Cheng","year":"2018","journal-title":"J. Appl. Psychol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/09546630500482886","article-title":"The Negative Impact of Psoriasis on the Workplace","volume":"17","author":"Pearce","year":"2006","journal-title":"J. Dermatol. Treat."},{"key":"ref_9","first-page":"16","article-title":"Arbeitsangst und Arbeitsf\u00e4higkeitsbeeintr\u00e4chtigung\u2014(Wie) kann F\u00fchrung vorbeugen? [Work Anxiety and Incapacity to Work\u2014(How) can Management Prevent it?]","volume":"2","author":"Muschalla","year":"2018","journal-title":"Pers. Q."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1037\/apl0000044","article-title":"Are Anxious Workers Less Productive Workers? It Depends on the Quality of Social Exchange","volume":"101","author":"McCarthy","year":"2016","journal-title":"J. Appl. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s11577-017-0454-1","article-title":"How to Construct a Mixed Methods Research Design","volume":"69","author":"Schoonenboom","year":"2017","journal-title":"KZfSS K\u00f6lner Z. F\u00fcr Soziologie Sozialpsychologie"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.janxdis.2010.02.001","article-title":"The Relationship Between Job-Anxiety and Trait-Anxiety\u2014A Differential Diagnostic In-vestigation with the Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory","volume":"24","author":"Muschalla","year":"2010","journal-title":"J. Anxiety Disord."},{"key":"ref_13","unstructured":"Kuckartz, U. (2018). Qualitative Inhaltsanalyse: Methoden, Praxis, Computerunterst\u00fctzung [Qualitative Content Analysis: Methods, Practice, Computer Support], Beltz Juventa. [4th ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.zefq.2016.12.008","article-title":"Measuring Attributes of Health Literate Health Care Organizations from the Patients\u2019 Perspective: Development and Validation of a Questionnaire to Assess Health Literacy-Sensitive Commu-nication (HL-COM)","volume":"121","author":"Ernstmann","year":"2017","journal-title":"Z. Evid. Fortbild. Qual. Gesundhwes."},{"key":"ref_15","unstructured":"Muschalla, B., and Linden, M. (2025, March 31). Job-Angst-Skala (JAS) Deutsche Version und Kurz-Manual [Job Anxiety Scale (JAS) German Version and Short Manual]. Available online: https:\/\/www.researchgate.net\/profile\/Beate-Muschalla\/publication\/321796844_Job-Angst-Skala_JAS_Deutsche_Version_und_Kurz-Manual\/links\/5a324110aca2727144a475e1\/Job-Angst-Skala-JAS-Deutsche-Version-und-Kurz-Manual.pdf?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InB1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9uIn19."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1097\/JOM.0000000000000678","article-title":"Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting","volume":"58","author":"Muschalla","year":"2016","journal-title":"J. Occup. Environ. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/NCM.0b013e3181f50919","article-title":"Dealing with Anxiety Disorders in the Workplace: Importance of Early Intervention when Anxiety Leads to Absence from Work","volume":"16","year":"2011","journal-title":"Prof. Case Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s10926-012-9399-4","article-title":"Obstacles to and Facilitators of Return to Work after Work-Disabling Back Pain: The Workers\u2019 Perspective","volume":"23","author":"Dionne","year":"2013","journal-title":"J. Occup. Rehabil."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"S\u00f8rensen, K., van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., and Brand, H. (2012). Health Literacy and Public Health: A Sys-tematic Review and Integration of Definitions and Models. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-80"},{"key":"ref_20","unstructured":"Schaeffer, D., Hurrelmann, K., Bauer, U., and Kolpatzik, K. (2020). Nationaler Aktionsplan Gesundheitskompetenz: Die Gesundheitskompetenz in Deutschland St\u00e4rken [National Action Plan for Health Literacy: Strengthening Health Literacy in Germany], KomPart. [1st ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Farmanova, E., Bonneville, L., and Bouchard, L. (2018). Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Im-plementation Issues. Inquiry, 55.","DOI":"10.1177\/0046958018757848"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/HCM.0b013e3182078bf8","article-title":"Leader Communication Styles and Organizational Health","volume":"30","author":"Hicks","year":"2011","journal-title":"Health Care Manag."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lindert, L., Choi, K.-E.A., Pfaff, H., and Zeike, S. (2023). Health Literacy at Work\u2014Individual and Organizational Health Literacy, Health Supporting Leadership and Employee Wellbeing. BMC Health Serv. Res., 23.","DOI":"10.1186\/s12913-023-09766-0"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1007\/s10926-012-9409-6","article-title":"Leadership Effectiveness: A Supervisor\u2019s Approach to Manage Return to Work","volume":"23","author":"Schreuder","year":"2013","journal-title":"J. Occup. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s10926-017-9695-0","article-title":"Evaluating Mental Health Literacy in the Workplace: Development and Psychometric Properties of a Vignette-Based Tool","volume":"27","author":"Moll","year":"2017","journal-title":"J. Occup. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ehmann, A.T., \u00d6g, E., Rieger, M.A., and Siegel, A. (2021). Work-Related Health Literacy: A Scoping Review to Clarify the Concept. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18199945"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Baur, N., and Blasius, J. (2014). Stichprobenziehung in der Qualitativen Sozialforschung [Sampling in Qualitative Social Research]. Handbuch Methoden der Empirischen Sozialforschung, Springer VS.","DOI":"10.1007\/978-3-531-18939-0"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/1\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:33:04Z","timestamp":1768908784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/1\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["ijerph23010125"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23010125","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]}}}