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PubMed1992

Contextual issues for vocational placement coordinators: some preliminary findings.

While vocational placement is seen as an important component of the rehabilitation process, the experience of being a vocational placement officer has not been well documented in New Zealand. In the present study, previously developed and validated measures of occupational stress (defined as responsibility pressure, quality concern, role conflict, and job vs non-job conflict) and general life satisfaction were completed by 16 vocational placement officers employed by the Accident Compensation Corporation. Subjects also completed two open-ended questions assessing significant stresses in their work and strategies whereby stress could be reduced. There were high negative correlations between job stress and life satisfaction, and subjects reported particularly high levels of role conflict in their work. Open-ended stresses identified by subjects included: time pressure/workload problems; difficulties with negative societal and employer attitudes to disability; problems with clients, and; personal motivation problems. Most strategies for stress reduction that were identified were concerned with creating more effective communication and decision making processes in the organizational environment. Problems and limitations of the present study are addressed and future research directions are identified.

Aged↗

PubMed1997

The unemployed sick-listed and their vocational rehabilitation.

The unemployed on long-term sick-leave are many and difficult to rehabilitate. The likelihood that a period of sick leave will result in a temporary disability pension is about three times greater for the unemployed than for those with jobs. The aim of this current study was to examine the vocational rehabilitation process of the unemployed on long-term sick-leave. The study was based on 118 matched cases on long-term sick-leave, 59 employed and 59 unemployed. Data were collected at seven social insurance offices in rural areas of Jämtland, Sweden. Our hypothesis was that the unemployed were disregarded in vocational rehabilitation. The results partly confirm this. Unemployed people's potential need for rehabilitation is not investigated to the same extent as employed people's. Also the unemployed have to wait longer for an investigation. Against our hypothesis, however, no difference exists between the employed and the unemployed in rehabilitation impulse, rehabilitation plan or rehabilitation allowance. Nor do the unemployed, except for those awaiting investigation, wait longer than the employed. The major result of the study is, instead, that vocational rehabilitation in general, regardless of employment status, seems beset with problems. Rehabilitation activities seem far too few and initiated unnecessarily late. Neither the employer nor the social insurance office seem to be fulfilling their statutory duties.

Absenteeism↗

PubMed2001

Effect of early vocational intervention in a rheumatological outpatient clinic--a randomized study.

This study aims to explore the effect of vocational intervention in a rheumatological outpatient clinic. The study is designed as a randomized study with intervention in 108 patients and with 93 patients serving as controls. The study population comprises patients referred for non-inflammatory diseases of the locomotor system who are all active members of the workforce and whose vocational status is threatened by their disease. Intervention consisted of sociomedical examination, multidisciplinary assessment and individual sociomedical rehabilitation plans. The study shows that intervention was an important instrument in the process of clarifying patients' future maintenance situation as assessed 1 year after intervention (relative risk (RR) = 1.2 (CI 1.0-1.5)). The effect was particularly prominent among well-educated women. A non-significant effect was established for vocational status in general (RR = 1.1 (CI 0.8-1.4)). This effect was significant and positive for well-educated patients with a short-term sick leave (maximum 6 months). The verified effect of early sociomedical intervention in the secondary healthcare sector warrants the permanency of routine intervention.

Adolescent↗

PubMed2001

Applying social skills training in the context of vocational rehabilitation for people with schizophrenia.

This paper describes a model for the conceptualization of social skills necessary for the vocational success of people with schizophrenia. Based on this model, a two-part measure was developed and validated to assess social skills necessary for job search and tenure. The measure consists of a 10-item self-administered checklist and a role-play exercise. The self-administered checklist measures clients' perceived competence in handling work-related social situations. The role-play exercise assesses the social skills necessary for job acquisition and maintenance in two simulated situations (participating in a simulated job interview and requesting urgent leave from work). Furthermore, a social skills training module has been designed, which enhances vocational outcome and fills a gap in the existing, commonly used modules. A pilot study shows that the training module together with appropriate professional support afterward is effective in enhancing the social competence and vocational outcomes of persons with schizophrenia. Implications for cross-cultural applications are discussed.

Adolescent↗

PubMed2005

Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam.

An important issue for the nursing education system in Taiwan is to reinforce nursing education to enhance competence levels for entry to nursing specialties. Consequently, to meet the prospective demands of technical manpower, not only do nursing students in college and vocational schools pursue further studies, but they also take competitive entrance exams. Using a descriptive cross-sectional design, the study examined the following among nursing students in vocational high schools: (1) perception and sources of entrance exam stress and use of coping behaviors; (2) the effect of difference in entrance exam stress levels on coping behaviors used, and (3) measurement of coping function to determine which coping behavior works best for buffering the impact of stress on psychological health during a preparatory stage of a college and university entrance exam. The subjects were 441 third-year nursing students of vocational high schools in northern Taiwan, recruited by convenience sampling. Three measurements were adopted: Stress perceived scale, Coping behavior inventory, and a Chinese health questionnaire. Results showed that the five main stressors of entrance exam stress, in descending order, were taking tests, the student's own aspirations, learning tasks, teacher's aspirations and parent's aspirations. Students generally used problem-focused coping strategies including optimistic action and social support to deal with the entrance exam stress, but use of emotion-focused coping strategies including avoidance and emotional disturbance was significantly increased as perceived level of stress rose. Two-way analyses of variance (2-way ANOVA) revealed that problem-focused coping had a positive main effect of alleviating psychological distress. A significant interaction was observed between stress perceived and problem-focused coping used for psychological health. Further examination of the interaction effect showed that problem-focused coping behaviors were potentially more adaptive in relation to psychological health at the lower and moderate stress levels (25 - 75%T) than that at the extreme stress level (> 75%T). Conversely, emotion-focused coping had a negative main effect or impairing psychological health. No interaction effect was found between stress perceived and emotion-focused coping used, suggesting that the relationship between emotion-focused coping and psychological distress was consistent across various stress levels.

Adaptation, Psychological↗

PubMed2003

Predictors of condom use among adolescent Thai vocational students.

PURPOSE: To describe the prevalence of premarital sexual behavior and condom use, and to identify predictors of condom use using the expanded health belief model (EHBM) among vocational students in Bangkok, Thailand. METHODS: A cross-sectional correlational design was used with a cluster-based sample of 425 students aged 18 to 22 years from eight randomly selected private vocational schools in Bangkok. Anonymous self-report questionnaires were used to collect the data. Stepwise multiple regression was conducted to identify predictors of condom use. RESULTS: Overall, 49.9% of participants were sexually active, 64.8% of men and 32% of women. Of the sexually active participants, only 6.3% reported using condoms every time when having sex in the beginning of the relationship, and 10.2% during the last few times. Twenty-four percent of sexually active participants had unplanned pregnancies, and 7% had sexually transmitted diseases (STDs). The predictive model of condom use consisted of perceived benefits from using condoms; interactions between intention to use condoms and gender: knowledge of STDs, HIV, AIDS, pregnancy and peer norms; and alcohol use and age. Adjusting for modifying factors, the predictor set explained 27% of the variance in condom use. CONCLUSIONS: Most of this sample of sexually active Thai vocational students practiced unsafe sex, and many had unplanned pregnancies and STDs. The EHBM provided a modest predictive model of condom use.

Adolescent↗

PubMed2007

Work and vocational psychology: theory, research, and applications.

Work is integral to human functioning, and all psychologists need to understand the role of work in people's lives. Understanding factors influencing work choices and helping individuals effectively make career decisions is the focus of vocational psychologists. However, external changes, such as shifts in the economy and labor force, as well as initiatives within the field are challenging the assumptions within vocational psychology. This chapter reviews the empirical work since 1995 in four areas: (a) what factors influence career choices, (b) how people make career decisions, (c) how context influences career choices, and (d) effective interventions for help with the first three questions. The review focuses first on vocational psychology's rich tradition of theoretically driven research, and then discusses research in career development that crosses a number of theoretical approaches, and finally identifies the assumptions in the field and questions for future examination.

Career Choice↗

PubMed1980

Vocational rehabilitation in dialyzed patients. A cross-sectional study.

The physicians in charge of 15 German hemodialysis units furnished data on 713 dialysis patients. Data relating to the vocational status were examined for 612 patients aged 60 years or below. It was found that the current working status varies with psychological and social factors. The data show that the vocational status is importantly influenced by the premorbid profession, the level of schooling and by the conditions of the local labor market. With the exception of severe complications or secondary diseases, no relation existed between the somatic state and the current working status. As assessed by the physicians in charge, most dialysis patients were able to work part time, but unable to work full time. Lack of facilities for, or financial disincentives against, part time employment are felt to be the single most important obstacle to vocational rehabilitation of dialysis patients.

Cross-Sectional Studies↗

PubMed2002

Cost-effectiveness of two vocational rehabilitation programs for persons with severe mental illness.

OBJECTIVE: This study sought to determine differences in the cost-effectiveness of two vocational programs: individual placement and support (IPS), in which employment specialists within a mental health center help patients obtain competitive jobs and provide them with ongoing support, and enhanced vocational rehabilitation (EVR), in which stepwise services that involve prevocational experiences are delivered by rehabilitation agencies. METHODS: A total of 150 unemployed inner-city patients with severe mental disorders who expressed an interest in competitive employment were randomly assigned to IPS or EVR programs and were followed for 18 months. Wages from all forms of employment and the number of weeks and hours of competitive employment were tracked monthly. Estimates were made of direct mental health costs and vocational costs. Incremental cost-effectiveness ratios (ICERs) were calculated for competitive employment outcomes and total wages. RESULTS: No statistically significant differences were found in the overall costs of IPS and EVR. Participation in the IPS program was associated with significantly more hours and weeks of competitive employment. However, the average combined earnings-earnings from competitive and noncompetitive employment-were virtually the same both programs. The ICER estimates indicated that participants in the IPS program worked in competitive employment settings for an additional week over the 18-month period at a cost of $283 ($13 an hour). CONCLUSIONS: The analyses suggest that IPS participants engaged in competitive employment at a higher cost. When combined earnings were used as the outcome, data from the statistical analyses were insufficient to enable any firm conclusions to be drawn. The findings illustrate the importance of choice of outcomes in evaluations of employment programs.

Cost-Benefit Analysis↗

PubMed2005

Best practice in occupational therapy: program characteristics that influence vocational outcomes for people with serious mental illnesses.

BACKGROUND: Despite the known benefits of work for people with mental illnesses, vocational outcomes of this group remain poor. Attempts at comparing the efficacy of various models of service delivery have met with limited success due to variations across studies. PURPOSE: The purpose of this paper is to provide information about key characteristics related to outcomes in the field of vocational rehabilitation for people with serious mental illnesses. METHOD: A comprehensive review of literature published between 1990 and 2003 was conducted, resulting in 39 articles for analysis. RESULTS: A set of twelve characteristics was identified that appear to influence vocational outcomes across models. These characteristics relate to the types of services offered, the manner in which services are delivered, and the work environment. PRACTICE IMPLICATIONS: The authors suggest these characteristics can be incorporated across models and practice settings. The findings are discussed in terms of implications for best practice in occupational therapy.

Humans↗

PubMed1996

Vocational rehabilitation and special education: partners in transition for individuals with learning disabilities.

A full range of transition services are now available to eligible individuals with learning disabilities through vocational rehabilitation agencies in each state. However, the differences in professional jargon and the academic focus of special education versus the employment outcome emphasis of vocational rehabilitation (VR) have created roadblocks to collaboration between these two agencies. This article describes the purpose of vocational rehabilitation and the service delivery process for individuals with learning disabilities in transition from school to work or postsecondary education settings. Suggestions are also made to prepare families and students with learning disabilities, VR counselors, and special educators to become effective partners in the transition process.

Disability Evaluation↗

PubMed2006

Counselor confounds in evaluations of vocational rehabilitation methods in substance dependency treatment.

Evaluation research on vocational counseling in substance dependency treatment should distinguish between the effects of counselors and counseling methods on clients' employment outcomes. Three experimental designs permit investigation of possible confounds between these types of effects: (a) nested designs (each counselor delivers one counseling method so counselors are nested under methods), (b) crossed designs (each counselor delivers all counseling methods so counselors are crossed with methods), and (c) no-treatment control group designs (experimental group's counselors all deliver the same method). Each design is optimal for one stage of evaluation research. No-treatment control group designs are best for exploratory evaluations of new types of vocational counseling. Nested designs are best for outcome evaluations of different types of interventions. Crossed designs are best for (causal) process evaluations of counseling methods of demonstrated efficacy. Despite the importance of methodological issues and problems, vocational rehabilitation in substance dependency treatment has a greater need for stronger interventions than better evaluation designs.

Analysis of Variance↗

PubMed2005

Vocational perspectives after spinal cord injury.

OBJECTIVE: To give insight into the vocational situation several years after a traumatic spinal cord injury (SCI) and describe the personal experiences and unmet needs; to give an overview of health and functional status per type of SCI and their relationship with employment status. DESIGN: Descriptive analysis of data from a questionnaire. SETTING: Dutch rehabilitation centre with special department for patients with spinal cord injuries. SUBJECTS: Fifty-seven patients with a traumatic SCI, aged 18-60 years, admitted to the rehabilitation centre from 1990 to 1998. MAIN MEASURES: Questionnaire with items related to vocational outcome, job experiences, health and functional status. RESULTS: Of 49 patients who were working at the moment of SCI 60% currently had a paid job. Vocational outcome was related to a higher educational level. A significant relation between the SCI-specific health and functional status and employment was not found. The respondents who changed to a new employer needed more time to resume work, but seemed more satisfied with the job and lost fewer working hours than those who resumed work with the same employer. In spite of reasonable to good satisfaction with the current work situation, several negative experiences and unmet needs were reported. CONCLUSIONS: Despite a high participation in paid work following SCI, the effort of the disabled worker to have and keep a job should not be underestimated.

Activities of Daily Living↗

PubMed2003

General practice vocational training in the UK: what teaching is given in palliative care?

BACKGROUND: Palliative care is an integral part of the general practitioner's role and palliative care teaching and training should be available for GP registrars during vocational training. AIM: This study was carried out to evaluate the content, amount and nature of generic palliative care teaching during vocational training in the UK. METHOD: A postal questionnaire survey of all course organizers enquired as to whether palliative care teaching was included in the core training sessions; professional background of the teachers; teaching methods used; whether the local hospice was used as a resource and whether GP registrars were able to choose a post in a hospice within their training scheme. RESULTS: Three hundred and seventy-seven questionnaires were distributed and 240 were returned completed--a 64% response rate. A total of nine one-year schemes replied that they did not include any teaching in palliative care--the median amount of teaching given for one-year schemes was 4.75 hours and nine hours for the three-year schemes. Statistically significant differences were found in teaching on psychosocial issues and bereavement between one- and three-year schemes. Less than half of all schemes included teaching on financial issues related to palliative care. Several schemes cited difficulties in accessing hospice placements and in accessing hospice medical staff to provide teaching. CONCLUSION: There is wide disparity in both the amount and content of teaching about palliative care within UK vocational training schemes. Difficulty in accessing placements within hospices and in accessing staff from such units to undertake teaching may be a barrier to effective and comprehensive palliative care teaching for doctors working in primary care. We suggest that a national generic curriculum of palliative care within primary care be implemented.

Education, Medical, Graduate↗

PubMed1984

Vocational adjustment patterns of alcohol and drug misusers following treatment.

Vocational adjustment following treatment was studied in 77 men patients (39 alcohol and 38 drug misusers) of a residential treatment program for substance misuse. Significantly more patients were employed at discharge from treatment, and at 1, 3 and 6 months postdischarge than at 1 month pretreatment. Patients employed at discharge experienced a significant decrease in employment level at 1, 3 and 6 months postdischarge. Patients who participated in outpatient treatment following discharge had significantly higher levels of employment at 3 months following discharge. Since there is a significant general decrease in employment level during the first 3 months postdischarge, it is suggested that counselors be aware of this as a vocational crisis period. The third through sixth months postdischarge are more stable. The first 3 months are especially important for younger drug misusers with legal problems. Alcoholics may sometimes need added incentive from vocational counselors because they tend to have fewer legal problems than drug misusers and therefore less outside pressure to gain employment.

Adaptation, Psychological↗

PubMedDate not supplied

The Indianapolis Vocational Intervention Program: a cognitive behavioral approach to addressing rehabilitation issues in schizophrenia.

Despite wishing to return to productive activity, many individuals with schizophrenia enter rehabilitation with severe doubts about their abilities. Negative beliefs in schizophrenia have been linked with poorer employment outcome. Accordingly, in this paper, we describe efforts to synthesize vocational and cognitive behavior therapy interventions into a 6-month manualized program to assist persons with schizophrenia spectrum disorders overcome negative beliefs and meet vocational goals. This program, the Indianapolis Vocational Intervention Program (IVIP), includes weekly group and individual interventions and is intended as an adjunct to work therapy programs. The IVIP was initially developed over a year of working with 20 participants with Structured Clinical Interview for the Diagnostic and Statistical Manual-I (SCID-I) confirmed diagnoses of schizophrenia or schizoaffective disorder who were actively engaged in 20 hours per week of work activity. For this paper, we explain the development of the treatment manual and the group and individual interventions and present case examples that illustrate how persons with severe mental illness might utilize the manualized intervention.

Adult↗

PubMed2006

Listening for recovery: the vocational success of people living with mental illness.

BACKGROUND: Mental health occupational therapists work with some individuals who want employment but who are not successful at finding or keeping a job. PURPOSE: The purpose of this qualitative study was to suggest factors contributing to vocational success. METHOD: The investigators interviewed 8 participants who were recovering from psychosis. The interview texts were coded and analyzed for emerging themes. RESULTS: Three themes emerged that describe how the participants achieved vocational success: self-assessing their mental health regularly, actively working to maintain and improve their mental health, and striving to feel connected to others at work. The results are consistent with previous studies that found that a positive fit between a worker and the workplace is linked to the worker feeling connected to and valued by the workplace. PRACTICE IMPLICATIONS: This study suggests that supporting the ways individuals assess and promote their own mental health and recovery will contribute to their success at work. Occupational therapists are urged to help people find workplaces where they feel encouraged and comfortable as this appears to be an important factor in vocational success.

Adult↗

PubMed1993

Factor analysis of the WAIS-R and Verbal Memory and Visual Memory Indices of the Wechsler Memory Scale--Revised, for a vocational rehabilitation sample.

Few empirical studies have examined factor structures of responses of vocationally impaired persons, and those studies have drawn only on aptitude scores (Wechsler Adult Intelligence Scale--Revised: WAIS--R). Results have been inconclusive as to whether a two- or three-factor solution is more appropriate. The present work examined the factor scores of a vocational rehabilitation sample of 54 adults who had been given the WAIS--R and the Verbal Memory and Visual Memory Indices of the Wechsler Memory Scale--Revised. Analysis indicated that combining data from the two tests yields a viable three-factor solution which may contribute to the refinement of intervention strategies for vocationally vulnerable adults.

Accidents, Occupational↗