[Future occupational plans of patients after orthopedic rehabilitation: how are they expressed? What influences them?].

Perceptions about one's occupational future are regarded as the initial phase in an ongoing process of occupational resettlement towards achieving gainful activity. Actual gainful activity, however, tends to be increasingly dependent on a number of labour market variables. At the end of an orthopaedic rehabilitation measure, 341 patients with pain syndromes of the locomotor system were interviewed concerning their vocational perspectives and notions, and the data obtained were studied in association with anamnestic and psychosocial factors. It is assumed that both plain expectations (such as returning, or not returning, to work) and multi-layered statements alike (such as the dual message of returning and of not returning to work, at first glance incompatible) will frequently be masked in the interview. Distinct, differing patterns were nevertheless found for the various patient groups regarding pain description, pain course, subjective disablement by pain, subjective job burden, subjective well-being, rehab expectations, and judgement of therapy outcome. Similar differences were stated for the social situation, indicated inter alia by (in)capacity for work, or application for benefit award (severely disabled person status, invalidity pension). Pain drawings, pain severity scaling, differentiated description of various pain qualities, the Pain Disability Index, all emerged as useful and practical additional tools in elucidating these patterns.