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Unemployment can negatively impact quality of life among patients with schizophrenia. Employment status depends on ability, opportunity, education, and cultural influences. A clinician-rated scale of work readiness, independent of current work status, can be a valuable assessment tool. A series of studies were conducted to create and validate a Work Readiness Questionnaire (WoRQ) for clinicians to assess patient ability to engage in socially useful activity, independent of work availability.
Content validity, test–retest and inter-rater reliability, and construct validity were evaluated in three separate studies.
Content validity was supported. Cronbach’s α was 0.91, in the excellent range. Clinicians endorsed WoRQ concepts, including treatment adherence, physical appearance, social competence, and symptom control. The final readiness decision showed good test–retest reliability and moderate inter-rater reliability. Work readiness was associated with higher function and lower levels of negative symptoms. Low positive and high negative predictive values confirmed the concept validity.
The WoRQ has suitable psychometric properties for use in a clinical trial for patients with a broad range of symptom severity. The scale may be applicable to assess therapeutic interventions. It is not intended to assess eligibility for supported work interventions.
The WoRQ is suitable for use in schizophrenia clinical trials to assess patient work functional potential.
A survey of industrial accident commissioners in California showed that compared with reports by other physicians, psychiatrists' reports were seen as weaker, less understandable, more subjective, more complicated, and more unscientific. It is essential for forensic psychiatrists to express ideas clearly and succinctly in written reports. The key to writing an effective report is to focus from the beginning on the legal question. The stages of report writing are planning, writing, and editing. As with any endeavor, effective planning is critical to success. The planning stage can be subdivided into gathering data, considering the audience, organizing, and outlining. The four principles of good writing are clarity, simplicity, brevity, and humanity. The authors offer specific suggestions to apply these principles to forensic psychiatric report writing. The editing phase can be challenging because it requires one to take a critical look at one's own work.
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