The accuracy of work evaluator and client predictions of client vocational competency and rehabilitation outcome.
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Based on the aftercare scope of a neurosurgical clinic, the article reports on 147 brain injured patients of different age when the accident occurred. Issues discussed include disability severity and prognosis, problems of secondary abnormal behaviour, and longer-term occupational outcomes. 25% of the adult brain injured patients were working full-time six months after the accident, 34% worked part-time and received a disability pension, and 41% were disability pensioners without part-time job. The share of occupationally reintegrated persons is higher in the younger age group although they had sustained more serious cerebral injuries than older ones.
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The goal of growth hormone therapy in childhood is to increase stature, thereby facilitating normal psychosocial development. To determine the social outcome of patients with growth hormone deficiency (GHD), we interviewed 116 adults with GHD across Canada, including 86 men and 30 women 18 to 38 years of age who were treated with growth hormone during childhood. The education of the 96 patients who had completed their formal education was similar to their siblings and to the general population. Of the patients in the labor force, 35.4% were unemployed; the unemployment rates for those patients less than 25 years of age and those 25 years of age or older were 45% and 23%, respectively, compared with national rates of 21.2% and 9.4% for the same age groups, respectively. Of the 90 patients with GHD who were not attending school, 70 lived with their parents or relatives. Only 15 patients were married; one was divorced. The percentage of patients with GHD who were married was less than 30% of the expected age-adjusted rate. No difference in the rate of employment or marriage was found between the patients with idiopathic isolated GHD and organic hypopituitarism. In summary, the achievements of patients with GHD seem to be normal in the education system, but the rate of employment and marriage are much lower than expected. This poor outcome was unrelated to the response to growth hormone therapy and emphasizes the need to develop strategies that lead to more satisfactory psychosocial integration of patients with GHD in adult life.
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Chronicity in serious mental disorders emanates from deficient ecological resources interacting with vulnerable individuals. Rehabilitation can succeed if an integrated and individualized approach is augmented by appropriate ecological supports.
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