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PubMed1996

Educational performance and vocational participation after spinal cord injury in childhood.

OBJECTIVE: To examine educational achievement and vocational success of children with SCI. DESIGN: Surveys administered to students and teachers, and content analysis of school records. SETTING: Regional pediatric rehabilitation program. PARTICIPANTS: Participants were selected from 144 children with SCI treated from 1979 through 1992; 98 met inclusion criteria of onset of SCI before the age of 18 years, older than 3 years, residual paresis, and no cognitive impairment; 29% were lost to follow-up, and 53 of the 70 contacted were enrolled. MAIN OUTCOME MEASURES: School completion rates, absenteeism, grades, ratings of participation; education and living situations after high school; history of paid employment. RESULTS: The 53 responders were: 33 boys, 20 girls; 25 with paraplegia (47%), 28 with tetraplegia (53%); mean length of disability = 9.4 years; 12 primary students (23%), 19 secondary students (36%), and 22 postsecondary participants (41%). Students and teachers rated student participation and performance as average or above compared to peers; 84% of secondary students planned to attend college after graduation. Only 33% of high school students over age 15 had been employed. Ninety-one percent of postsecondary subjects had graduated from high school. Seven (32%) had graduated from college or a vocational program, 11 (50%) were enrolled in college full- or part-time, and 4 others (18%) were neither in school nor employed. Current employment rates were 71% of college graduates, 36% of those in college, and 0% of those who had never enrolled. Level of SCI was not related to employment. CONCLUSIONS: Students with SCI demonstrate adequate participation and performance in educational settings, but may benefit from more vocational counseling and opportunities for paid employment.

Adolescent↗
PubMedDate not supplied

Vocational and social outcomes of adults with chronic aphasia.

UNLABELLED: Vocational and social outcomes of rehabilitation, such as employment, Social Integration, and life satisfaction, are critical determinants of the usefulness of rehabilitation. The purpose of this study was to describe the employment status, Social Integration, and perceived life satisfaction of adults with chronic aphasia 2 years after discharge from an intensive treatment program. Among the 20 survey respondents, 62% of those who had been working prior to aphasia onset were also working at the time of follow-up. Those who were working before but not after onset had higher Home Integration scores. There was a relatively large perceived change in communication from clinic discharge to the 2-year follow-up. Eighty-five percent of the respondents indicated a positive life satisfaction rating. There was a significant positive relationship between Home Integration and life satisfaction ratings. The results are discussed in relation to other reports of employment and social outcomes for stroke and aphasia. LEARNING OUTCOMES: As a result of this activity, the participant will be able to: (1) identify factors that may contribute to the successful return to work for adults with chronic aphasia; (2) describe the vocational and social outcomes of a select group of adults with chronic aphasia after participation in an intensive treatment program; and (3) discuss future need areas in understanding vocational and social participation for adults with chronic aphasia after intervention.

Adult↗
PubMed1996

Vocationalism: a mirror on the profession.

The introduction of National Vocational Qualifications in Care (Care Sector Consortium 1993) has received considerable attention in the nursing press. This article seeks to explore vocationalism and its effects on nursing. It argues that the very nature of vocational competence acts as a mirror on the profession and should encourage reflection on the nature of nursing and its professional aspirations.

Clinical Competence↗
PubMed1997

Relationships between social competence, psychopathology and work performance and their predictive value for vocational rehabilitation of schizophrenic outpatients.

Earlier studies suggest that social competence has a higher predictive value for vocational outcome than psychopathology. These studies, however, show methodological shortcomings, including the fact that the instruments used for assessing social competence, psychopathology and work performance are strongly interrelated. The present study, involving a population of 34 chronically schizophrenic outpatients enrolled in a vocational rehabilitation program, was conducted in order to determine: (1) how closely the Role Play Test, the Positive and Negative Syndrome Scale and the Work Behavior Assessment Scale are related to each other; and (2) whether social competence is a better predictor of work performance and outcome of vocational rehabilitation than psychopathology. Factor analysis has revealed that the instruments are interrelated, mainly in the dimensions of negative symptoms, social relationships, non-verbal measures of social competence and conceptual disorganization. In backward regression analyses, psychopathological indicators proved to be the best predictors of work performance both cross-sectionally as well as in the longterm course. In the traditional two-syndrome model of schizophrenic psychopathology only negative symptoms were left in the regression model. In a four-dimension model the disorder of relating and the conceptual disorganization dimension were the best predictors. Differences between disorder of relating and social competence, assessed by the Role Play Test, are discussed here as well as the implications of this study for rehabilitation.

Adult↗
PubMed2002

A social psychology approach to measuring vocational rehabilitation intervention effectiveness.

It is rare for rehabilitation researchers to report substantial relationships between functional capacity and vocational rehabilitation achievements. The reason for this is that there are many other factors that also impact on the return-to-work outcomes people achieve. A solution to the problem of having to take into consideration the effects of multiple factors when evaluating intervention effectiveness is to focus more directly on cognitions and behaviors that have been theoretically and empirically linked with a satisfactory return to work. The aim of this paper is to explore and describe a measure of rehabilitation effectiveness based in cognitive-behavioral theory. Rather than the measurement of employment per se, the described measure is focused on the efforts individuals make in relation to achieving their desired outcome. To test the effectiveness, acceptability, and utility of the approach, the measure was trialed with 170 people with a spinal cord injury. This preliminary work has revealed that participants found the measure acceptable and gave detailed responses in regards to: their satisfaction with their vocational status; what it is they would prefer to be doing; and what it is that they are doing to achieve their aims. Study findings suggest that while the approach is likely to require further development, focusing on process variables holds promise as an evaluation approach when assessing the success of vocational rehabilitation intervention effectiveness.

Adult↗
PubMed2004

Vocational function among persons with schizophrenia with and without history of childhood sexual trauma.

This study examined whether history of childhood sexual abuse in schizophrenia is linked with severity of vocational deficits. Work performance was measured using the Work Behavior Inventory and hours of work performed in a vocational rehabilitation program and then compared for 12 participants with schizophrenia or schizoaffective disorder reporting abuse and 18 with schizophrenia with no abuse history. ANOVAs indicated that the sexual abuse group worked fewer hours during the first 4 weeks of the program and demonstrated poorer work performance overall. An interaction was found suggesting that the sexually abused group's performance declined as the nonsexually abused group improved over time. Childhood sexual abuse may be associated with greater vocational deficits in adults with schizophrenia.

Adult↗
PubMed1992

Vocational decision making by sixty spinal cord injury patients.

Sixty persons with spinal cord injury completed the My Vocational Situation (MVS) questionnaire developed by Holland, Daiger and Power. The MVS was designed to identify problems related to vocational decision making, ie lack of vocational identity, lack of occupational information, and the presence of environmental or personal barriers to a chosen occupational goal. As expected, more problems were reported by unemployed persons than by employed persons, and by those who reported lower levels of psychological well being. MVS scores were not mediated by age, time since injury or severity of injury.

Adaptation, Psychological↗
PubMed1997

Experience of undergraduates from three London dental schools and trainers from the south east of England on interviews for vocational training in 1996.

OBJECTIVE: To assess the current perceptions, motivations and expectations of trainers and vocational dental practitioners (VDPs) of vocational training (VT) interviews. DESIGN: Questionnaire based study. SETTING: General practice study carried out in 1996. SUBJECTS: Undergraduates from three London dental schools and vocational trainers from south-east England. MAIN OUTCOME MEASURES: Perceptions, motivation and experiences were assessed by a questionnaire. RESULTS: 111 questionnaires were posted to trainers with 72 (65%) returned. 108 (70%) were returned from the dental schools after 155 were posted. Graduates employed in hospital training posts, armed forces and community dentistry were eliminated from the results. Most trainers (74%) had previous experience of VT and 89% of trainers thought that a CV was important for their choice of VDPs. However, only 11% of trainers sought references before interviewing. 34% of VDPs preferred jobs close to their dental school but 75% considered location to be vital to their choice. 67% of VDPs made 10 or more applications and 57% visited 10 or more practices for interviews. 78% of VDPs considered that either genderism or racism was likely to or possibly influenced the trainers choice. However, the converse was not true, 62% of trainers considered it unlikely that the VDPs were influenced by their gender or race. CONCLUSIONS: Trainers and VDPs have different perceptions concerning the protocol of interviews for VT.

Adult↗
PubMed2004

[Neurocognition, psychosocial outcome and vocational integration].

A lot of progress has been made in the treatment of schizophrenia against hallucinations and delusions. However, Schizophrenia still remains a highly disabling disease causing tremendous deficits in social- and vocational functioning. Cognitive deficits are known since the early 90's as a further core feature of schizophrenia, and it has been shown that social- and vocational dysfunctions are closely related to neurocognitive deficits. Whether those findings bear a potential for therapeutic implications still needs to be shown. In this overview therapeutic interventions with respect to cognitive deficits and their effectiveness and their role for vocational rehabilitation will be summarized.

Antipsychotic Agents↗
PubMed2005

[Vocational performance tests for brain-injured patients: a follow-up study].

Work hardening programmes are suggested for brain-injured patients who were unemployed during the rehabilitation period or could not return to their previous job due to specific impairments. The aim of this vocational intervention is to obtain information about the chance of competitive re-employment and about potential obstacles preventing it. In 1994 the city of Munich has established opportunities to perform work hardening programmes in selected municipal work domains. Between 1994 and 1998, 28 patients from the neuropsychological department of the Munich-Bogenhausen municipal hospital underwent such an intervention. 18 persons could be contacted for structured telephone interviews addressing their work histories after discharge from the rehabilitation unit. Three former patients who had retired immediately after the work hardening intervention did not attempt to resume working. Among the remaining 15 patients, six were able to resume full-time competitive work at follow-up, four persons were still employed but had been forced to limit work demands, and five persons had retired. A positive course of reintegration was seen in three patients who received a special vocational support following the work hardening intervention at the same place of work. A negative outcome resulted in four persons who were recommended to participate in vocational retraining. A poor general life satisfaction was reported particularly by retired persons.

Adult↗
PubMed2006

[Early termination of vocational rehabilitation for the severe mentally ill].

OBJECTIVE: To determine the conditional factors underlying a premature termination of vocational rehabilitation programs. METHODS: 123 rehabilitation participants were assessed prospectively regarding sociodemographic and psychopathological variables, level of functioning, subjective health, intellectual and work capacity. RESULTS: 23 persons terminated rehabilitation prematurely. Drop-outs differed regarding sociodemographic and illness-related variables, in subjective physical health, level of functioning, intelligence and work capacity. Three types of "drop-outs" could be identified: Termination due to exacerbation (of a functional psychosis), due to reluctance to show-up (mainly men with antisocial personality disorders) and a non-specific group. CONCLUSION: Vocational rehabilitation of subjects with severe mental illness should take account of each rehabilitant's individual capacities and abilities as well as individual concepts of the disorder. Moreover, integrated concepts of medical treatment and vocational rehabilitation are needed to ensure rehabilitation success.

Adult↗
PubMed2000

The role of quality management in the European platform for vocational rehabilitation.

PURPOSE: This paper explores the importance of applying the principles of quality management to vocational rehabilitation. METHOD/RESULTS: The role of the European Platform for Vocational Rehabilitation is outlined and a case made for incorporating quality into rehabilitation practice. The goal of this forum is to establish European co-operation in order to improve rehabilitation and vocational training and guidance for individuals with disabilities and social disadvantages. The work of this organization is set within the context of quality management. CONCLUSIONS: In exploring the role of the 'platform' it is suggested that there are benefits for rehabilitation professionals and individuals with disabilities in the European states working together to explore good practice.

Europe↗
PubMedDate not supplied

A synthesis of a vocational assessment system and an information system of technical aids.

PURPOSE: In vocational rehabilitation, the selection and tailoring of the work place is tightly bound with the integration or reintegration of people with disabilities into the work environment. Instruments which ease this task are assessment systems as well as information systems of technical aids. To date, these instruments are separated from one another in practice. They also necessitate a broad transfer capacity between the results of an assessment system and the selection of technical aids for a work place design suited for people with disabilities. METHOD/RESULTS: Therefore, when employing assessment system, immediate access to information concerning technical aids would ease the work of experts in the area of vocational rehabilitation. This information should also provide a commentary concerning which aids have been utilized to date in concrete cases of suitably designing work places for people with disabilities. CONCLUSIONS: This article describes the synthesis of a vocational assessment system with an information system of technical aids from the aspect of frequency of use.

Communication Devices for People with Disabilities↗
PubMed1999

The effect of vocational rehabilitation on later sick leave.

PURPOSE: The aim of this study was to examine the effect of vocational rehabilitation on later sick leave for employed and unemployed people on long-term sick leave. METHOD: The study was based on long-term sick-leave cases initiated during 1992-1994 in Stockholm, Sweden. Of 1704 cases, 383 (321 employed and 62 unemployed) underwent vocational rehabilitation. These were individually matched with sick-leave cases not undergoing rehabilitation, using the variables age, sex, diagnoses and employment status. RESULTS: The hypotheses were (1) that people who underwent rehabilitation, both employed and unemployed, would have less later sick leave than those who did not, and (2) that rehabilitation would affect employed people more than unemployed people. These hypotheses were only partly supported. CONCLUSIONS: The results indicate that vocational rehabilitation has a positive effect regarding later sick leave only for unemployed men. For unemployed women the effect is negative and for those employed, both men and women, rehabilitation has no demonstrable effect.

Adult↗
PubMed2004

Efficacy of the customized employment supports (CES) model of vocational rehabilitation for unemployed methadone patients: preliminary results.

This article presents initial efficacy data for an innovative vocational rehabilitation model designed for methadone-maintained patients--the Customized Employment Supports (CES) model. In this model, a CES counselor works intensively with a small caseload of patients in order to overcome the vocational as well as nonvocational barriers that hinder their employment, with the goal of attaining rapid placement in competitive employment. The CES model was implemented at two Manhattan methadone treatment programs as part of a randomized clinical trial comparing the model's employment outcomes with those of standard vocational counseling. The study tested the hypothesis that patients in the experimental group will have better employment outcomes than those in the comparison group. The data were collected from May 2001 through September 2003. The sample consisted of the first 121 patients who had completed their 6-month follow-up interviews. The preliminary results supported the hypothesis for two indices of paid employment, i.e., the CES group was more likely to obtain both competitive employment and informal paid employment. The clinical trial is continuing.

Adult↗
PubMed2004

Effectiveness of vocational problem-solving skills on motivation and job-seeking action steps.

Most research on employment interventions focuses on job acquisition as the sole outcome measure, despite the fact that there are many intermediate steps to obtaining work. This article examines the impact of a vocational problem solving skills (VPSS) intervention to increase motivation and action step activities that lead to employment. Over a 1-year period between 1995 and 1996, a sample of 109 methadone maintained treatment clients were randomly assigned to either a 10-session vocational problem solving intervention (N= 62) or a time and attention control condition (N=47). The Addiction Severity Index (ASI) and a Vocational Motivational Assessment Checklist (VMAC) were administered upon enrollment in the study and at 6 months postbaseline. The VMAC was completed on a biweekly basis over the 12-week intervention period. The VMAC measures both the behavioral actions to obtain employment (e.g., reading want ads, completing job applications) and client perceived motivation to obtain a job. There were no differences by condition in the level of motivation to secure employment and the number of job seeking activities during the intervention period. However, motivation to work and number of action steps did predict obtaining employment for the sample as a whole at the 6-month follow-up. Although the intervention did not increase motivation and job seeking activities, information regarding reasonable outcomes for this population of chronically unemployed persons was identified. Also, practical and methodological implications are discussed.

Adult↗
PubMed1981

Vocational disability and rehabilitation in multiple sclerosis.

Multiple sclerosis represents a significant cause of vocational disability among young and middle age adults. As a group, M.S. patients are frequently well educated, highly trained and possess intact families but have had to leave their former occupations. While many unemployed M.S. patients are willing and able to work, they are not now receiving the vocational rehabilitation services they need to reenter the work force. Physicians frequently see M.S. patients, but they do not often refer those patients for vocational rehabilitation services. Unemployment associated with multiple sclerosis is a significant social complication of the disease. While the physician cannot cure or halt the progress of the disease, he or she can assist the M.S. patient in obtaining the specialized help necessary to re-enter the job market.

Adolescent↗
PubMed1985

Motivation, vocational interests and job satisfaction of mentally retarded adults.

The relationship between vocational interests of 83 mildly to moderately retarded adults in a residential facility in Israel, their actual work and the factors which they perceived as the most important motivators for them at work and job satisfaction were investigated. Two questionnaires were used: the Illustrated Vocational Inventory (Whelan & Reiter, 1980) and a specially designed questionnaire on motivation to work based on Herzberg, Mausner, and Snyderman's (1959). The results demonstrate the importance of taking into consideration mentally retarded persons' vocational interests when assignig them to different jobs. It further demonstrates the importance of the environment in influencing mentally retarded individuals to seek instrinsic or extrinsic rewards and satisfaction from work.

Adult↗