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[Public vocational integration: a new method for integrating psychiatrically handicapped patients into occupational life?].

Suitable conditions of employment represent a central factor in the rehabilitation of mentally ill people. In this case both the normality of the job--as felt by the individual--and adequate instrumental and social working conditions are determining factors. According to the ideas of the Workshop for the Handicapped (Werkstatt für Behinderte) and the movement for the Self-help Firms, the integration of the mentally ill into normal jobs is an important step in the right direction. Appropriate preparations (i.e. assessment of patients' working capabilities and the drawing up of expectation profiles, work-preparation measures) and well-organized follow-up care are required to achieve this. Statutes which make access easier must be created in the fields of both labour and social law in order to make integration into the labour market possible. In this respect the non profit-making provision of employees (Gemeinnützige Arbeitnehmerüberlassung) represents a model. The procedure has been described and first experiences with its realization have been reported upon.

Activities of Daily Living↗

[Individual rehabilitation planning in the vocational rehabilitation of mentally ill young people].

For many young people, their aspiration for an environmentally compatible, and societally meaningful, field of activity is very marked and reflects the values they hold. Vocational rehabilitation should be oriented accordingly, and take up the motivational potential implied. The more accurate the knowledge of previous vocational experience, motivations, attitudes toward work, and of the subjective difficulties in coping with work-related requirements, the more detailed can vocational rehabilitation planning be devised. The potential is increased by a concept that is guided by insights from the psychology of work and emphasizes individual rehabilitation planning as well as follow-along developmental counselling. Assessment of 52 individual service instances for mentally ill youths and young adults, of Berlin-Kreuzberg, revealed an appropriate placement quota of 67%. The developmental course taken in the individual cases shows that satisfactory long-term outcomes can be achieved through careful entry diagnostics, individual rehabilitation planning, ongoing developmental counselling, selective educational intervention, industrial try-outs, as well as stabilizing aftercare.

Adaptation, Psychological↗

Launch your nursing career.

The nursing departments of three hospitals and a community college in southern Maryland collaborated to develop a solution to the area's nursing shortage. "Launch Your Nursing Career" (LYNC) brings high school students into contact with working nurses during a 2-year period. Participants attend summer classes at the college and work with nurse preceptors in the community hospitals. In addition, nurses in administrative or teaching positions establish mentor relationships with the participants.

Career Choice↗

[Prognosis in ankylosing spondylitis].

Based on the literature we describe the prognosis and natural history of ankylosing spondylitis. The data on mortality are controversial and it seems that only a small group of patient show a decreased survival. It is a chronic disease with most prominent features of pain and increasing stiffness during the first decade. After a course of 40 years 90% of patients have none or only mild disability. Generally quality of life is slightly reduced. Most patients remain engaged in full-time employment, but job adaptations are often unavoidable and vocational counseling seems to be worthwhile.

Activities of Daily Living↗

[Vocational preparation and education of adolescent patients with epilepsy].

Often young epileptics cannot begin a regular apprenticeship immediately after leaving school. Many cases show some somatic and psychointellectual retardation and delayed social development and maturation. Impairment of learning and concentration due to drug-side effects aggravates gaps in basic knowledge which result from frequent school absences due to epileptic illness. Attendance of a vocational training scheme for one year ensures that educational and social deficiencies can be reduced and the practice of daily work can be obtained. The epileptologist should pay particular attention to good compliance. The large variety of psycho-social and behavioural problems can be improved by event-orientated group psychotherapy. A vocational testing period can follow. Time and type of seizures have to be respected in vocational counselling. The vocational training centre for handicapped adolescents offers a comprehensive education by vocational instructors, epileptologists and psychologists.

Adolescent↗

[Relation of vocational orientation/vocational education and illness status].

A cross-sectional analysis was carried out to examine factors exercising an effect on the sickness rate among trainees. The study comprised 389 boys and 217 girls in their first or second years of apprenticeship. The sickness rate was found to be lower among young people with a high level of motivation and achievement than among those achieving less well. An appropriate practical vocational training helps to decrease the number of apprentices absent due to illness.

Absenteeism↗

[Preventive vocational measures for adolescents with asthma and allergies--a model project].

The difficulties encountered by asthmatic and allergic youngsters faced with choosing a career represent a problem that is gaining in relevance. The general prohibition of certain trades is, for many of those involved, both unsatisfactory and lacing in future prospects. In a model project supported by the Federal Institute of Labour is intended to help young people with asthma and allergies. By means of an interdisciplinary programme involving psychologists, teachers, instructors and physicians, the youngsters are given advice on how to chose a career/profession on the basis of their personal interests, abilities, job suitability and health situation. Between September 1987 and March 1989, 50 persons, including 43 asthmatics participated in this programme. In contrast to the poor level of schooling, the intelligence test revealed a normal distribution. The psychological stress tolerance was reduced in two-thirds of the subjects. In 7 cases, workplace-associated changes in pulmonary function were established; in 11 cases workplace-related dermatological problems were seen. Only one-third of the youngsters were considered suitable for careers in industry; the majority were advised to take advantage of the training or rehabilitation possibilities offered by the Federal Institute of Labour.

Adolescent↗