Table 2 Content requirements – categories and exemplary quotes

Information for OPs

Disease-related information

O1: What is important for me is some kind of description of the resilience: Is he even resilient yet? And where does he have potential deficits? Because this is something I can include in the work profile and I could also say: Okay, he can’t do that yet or at least not to that extent or we can just leave this work step out. Please find him another task. (OP, FG2)

O2: And I also want to know about his medication, for example. Does he have any concomitant medication over the next half year that might restrict him in doing shift work, for example? […] Or wheresoever. Or in the power of concentration. (OP, FG2)

O3: I’m also concerned about concrete diagnoses, which I have to find out from psychotherapists, because for us, it’s also important to know […] why the occupational physician contacts us. Because sometimes, the employer has the option to commission a report from [an organization], if it’s about occupational suitability, and then, it really matters if someone has a psychosis or an addiction, which is why we need to know about concrete diagnoses as well. (OP, FG1)

O4: It’s especially difficult with bipolarity, because it has to do with quick mood changes that doesn’t always seem to be plausible. […] But it’s only possible to develop a good management if the occupational physician knows who to contact, especially when there are quick changes of mood, phase changes. So that you can even talk about warning signals. But that really requires a trustful collaboration. But if that works, the prognosis for people with bipolarity often improves significantly. (Psych, FG2)

O5: It might be a good idea to separate underlying problems of the current situation; you could separate them in private-related and work-related problems. Then you would already have some sort of sounding, you would get such feedback. Because, well, we can’t do much about private-related problems as occupational physicians. […] But we can actively tackle work-related issues. (OP, FG5)

Treatment-related information

O6: I would really appreciate getting more information on, let’s say, estimated duration of therapy, you know? So that I roughly know when an employee can be expected to return to work; or maybe when the end of therapy can be expected so that I might be able to plan further measures like rehabilitation. (OP, FG4)

Work-related information

O7: And like I said before, it would be nice to have some kind of prognosis, as to whether certain continuing restrictions concerning specific work areas can be expected or whether there will be some straining situations. (OP, FG4)

O8: Yes, questions are often related to the ability to do shift work, so whether day shifts are the only option or whether alternate and night shifts are also possible. (OP, FG4)

O9: Then, working under time pressure, deadline pressure, conflicting activities, such information is also requested there and it’s also helpful for the assessment or the evaluation, to know if someone can still continue corresponding tasks, in full shift or even part-time. (OP, FG4)

O10: But I would need to have a given reintegration proposal plan including all the points mentioned: How many working hours, duration of the measure, shift work, concentration, (approximately the ideal) resilience, medication, special conflict situation? (Psych, FG2)

O11: So, performance capacity, and prognoses about whether working under time pressure or under deadline pressure is possible. (OP, FG4)

O12: That I receive a written report [any report by the psychotherapist] […] that leads to further questions, specific questions, depending on the kind of action. (OP, FG4)

O13: Therefore, I think that an exchange between attending physicians and occupational physicians is extremely important. And I’d like to do it electronically, as well. And then, we can perform an adequate assessment of the work ability, for the CIM team for example. (OP, FG2)

O14: We mustn’t overload psychotherapists with what kind of information they can provide. Right? If they don’t know the operational processes, it’s not really useful to write down: no shift work, for example. You know? And they don’t know whether that’s an exclusion criterion and if the employee might not be able to work anymore at all then, because he is doing shift work and there’s no other option. (OP, FG2)

O16: I think people’s expectations on what would be of help might be useful, like physician 2 also said. And also, what do I interpret into my patients, how is their perception of the workplace? How do they perceive it? Do they feel somehow restricted or pressured? What is really necessary in terms of operational concerns that can’t be changed? Und that’s why they don’t say anything at all, or they say something and feel like they’re running into a wall. For example, when it comes to shift schedules or things like that. (Psych, FG 5)

Information for CIM members

C1: I think that such an electronic patient file, this exchange of information, must stay between physicians. So, between external occupational physicians, yes. Involving the internal CIM team, for example we have members of the works council in the CIM team. We have people in there who have been called in by the employer. If you provide them with information covered by medical confidentiality, if you include them in this circle, then/ There are so many concerns about individual data in a company, which information is known to whom, that the options of who can be included in the CIM team by the company are very limited. (CIM, FG2)

Work ability

C2: How does a problem-compatible workplace look like? And what are our options as employers to enable such a workplace? And is it (even) possible to enable it within the scope of our possibilities? (CIM, FG2)

C3: How can that person be deployed, for example firefighters after having PTSD or else, how can we make this work, how can we lead someone back to work, and I would really like to see more support from attending psychotherapists, because works council consists of occupational physicians, and from a nonmedical, unprofessional point of view, I can say that this is certainly one facet, but the therapeutical aspect would be incredibly important. (CIM, FG1)

C4: I think a detailed description would be very important, too: What is feasible for the employee? And what’s not? You shouldn’t neglect one of the two aspects, always explain both: What is not feasible? It’s often said, no shift work. But what does that mean? Is it early shift, late shift or night shift? We don’t have night shifts at all, we only have late shifts. But what exactly does that mean? (CIM, FG2)

C5: What is also important is that concrete causes and diagnoses shouldn’t be mentioned to the employer right away. Instead, we want to focus on restrictions. So there can be many causes or diagnoses, but they always lead to the same restriction. (CIM, FG3)

Support opportunities

C6: And when talking about concrete options of adjustments, one question often arises, because this is usually associated with immense costs. Is it possible to receive some support? Something like integration offices, like special services on integration elsewhere. Could we get an attendant for the employee? (CIM, FG2)

Information for psychotherapists

Description of the workplace situation

P1: Occupational physicians could provide concrete information about the workplace and all requirements, for example is it shiftwork or cycle-related work. This could be really important for psychotherapists. (OP, FG1)

P2: I think it would be very important to know about how things are handled in the company or how the corporate culture is. (Psych, FG1)

P3: It’s important for us to be aware of stress factors at work, and these are not only environmental aspects like chemicals that can affect the psyche as previously mentioned, but also structural aspects, how is the team structured, how do people work together there. (Psych, FG1)

P4: Let’s say bullying for example or stress at work that has nothing to do with the private environment. You would probably need to have some background information from the occupational physician. (OP, FG5)

Expected chance of reintegration

P6: For example, we have a cooperation where a CIM member sends patients to us, and he also coordinates implementations if necessary, and if he says that we can no longer employ the employee anymore, that all options are exhausted, it’s a completely different frame for me as a therapist and that’s really helpful for my work. (Psych, FG1)

P7: We were talking about his reintegration, and I said that it might be exhausting for him to start full-time because his sick leave lasted for quite a long time. And he explained to me that he preferred not to do that as long as he didn’t get more money. Luckily, he agreed that I can talk to his resident psychotherapist, whom I also knew. And she herself also said, yes, she thinks that she has to discuss that with him, too. (OP, FG2)

Workplace adjustments

P8: Sometimes, we also have some more questions, for example which adjustments might be possible at the workplace. (Psych, FG4)