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At least 19 recordsLinked to original sources
PubMed1999

Vocational rehabilitation--early versus delayed. The effect of early vocational rehabilitation compared to delayed vocational rehabilitation among employed and unemployed, long-term sick-listed people.

The aim of the present study was to examine whether the wait before vocational rehabilitation affected the outcome for employed and unemployed, long-term sick-listed people. The study is based on sick-leave cases 90 days or longer, which started during 1992-1994 in a rural area in Sweden. The study included all sick-leavers with non-malignant musculoskeletal diagnoses from the neck, shoulder and back regions and who had undergone vocational rehabilitation. Of these, 391 were employed and 78 unemployed. Our hypothesis was that those who undergo early vocational rehabilitation, irrespective of employment status, often get well sooner, have fewer sick days and lower benefit levels after vocational rehabilitation than those who have to wait a long time for their rehabilitation. Our hypothesis was supported only regarding the employed who mainly reported well at 6 and 12 months after vocational rehabilitation. In the longer term (24 months) the effect was however no longer evident. Earlier studies indicate that more factors than an early start to rehabilitation are important for a successful outcome. A more important factor is probably that the right measures have been initiated at the right time, that the measures are of high quality and that the sick-leaver is mentally prepared for the measure. Although early vocational rehabilitation did not prove to be a determining factor for a successful outcome there is still reason to emphasize early involvement in the case to guarantee rehabilitation of high quality.

Absenteeism↗
PubMed2003

[Vocational rehabilitation in German vocational retraining centres and results of Berufsförderungswerk Heidelberg gGmbH].

The article focuses on the results of vocational integration over the last two decades and on actual results from client-surveys as presented by the Arbeitsgemeinschaft Deutscher Berufsförderungswerke (ADB) (working group of the German vocational retraining centres) and the Berufsförderungswerk Heidelberg (BFW Heidelberg, the vocational retraining centre in Heidelberg). Process quality of vocational rehabilitation can be indicated by data like the number of persons dropping out of their training - the ratio to be found in the vocational retraining centres is on a lower level than in other institutions of vocational training. Clients have changed: during the last decade the average age of the clients in the BFW Heidelberg has increased by 3 years, there is a higher proportion of women, but there also are more clients with psychological disorders. A new group of clients is growing - non-handicapped persons who pay for their training themselves. Process quality has improved, with graduates of the BFW Heidelberg saying significantly more often that they can use much or very much of the training courses' contents within their later occupational activities -- the proportion increases with the level of training they had undergone. Additionally the proportion of those is growing who see themselves in an -- according to their training -- adequate occupational situation. These are certainly positive results referring to the indicators of process quality. Concerning outcome quality one has to take the levels of occupational integration into account. Compared with the results of German vocational retraining centres overall, graduates of the Heidelberg centre constantly had a higher level of vocational integration over the last 20 years, one of the reasons being that the vocational training offered in Heidelberg reaches up to the level of degree of a university of applied sciences. The situation on the job market strongly influences occupational integration: it is evident that a high rate of unemployment will extend the time span necessary for placement. But in the long run occupational integration proves to be amazingly high. Variables that influence the results are: level of disability, sex, age and marital status. The level of vocational qualification is a characteristic with high evidence: integration of graduates at the level of "Fachschule" (highly skilled technician or the like) is 10 % higher and that of graduates at the level of "Fachhochschule" (university of applied sciences) another 10 %. Participation in vocational rehabilitation generally is highly estimated -- estimation as given two years after the training increases with the level of qualification. In the Heidelberg centre progress is seen in expanding the proportions of special target groups (which of course is politically aimed at): women now account for some 30 %, there are more elderly clients and for example also more clients with psychological disorders. The vocational integration of these various groups has to be regarded under different aspects. For example, the situation of severely disabled clients is quite ambivalent: their proportion is falling and their rate of occupational integration is relatively low -- yet there are effects that may compensate. So the importance of the disability decreases with a rising level of vocational training. The data presented may permit the conclusion that vocational rehabilitation at the Heidelberg centre has become more successful over the last decade.

Adult↗
PubMed1987

[Status and value of vocational education centers in the system of vocational education].

The general framework of vocational rehabilitation has changed since introduction, in 1970, of the federal government's action programme to promote rehabilitation efforts. While the vocational education centres are major providers of vocational rehabilitation services, it has so far been omitted to adjust their mandate to these changed overall conditions. This reassessment is urgently required to be able, among others, to answer the following questions: Will it be necessary for the vocational education centres to offer occupationally qualifying alternatives outside the Vocational Education Act? Will another task accrue to the centres in the framework of the "upgrading offensive", by providing continuing vocational education to jobless disabled people? How could the gap between client functioning levels and occupational demands be eliminated? Which will be the future position of vocational education centres within the overall vocational education system? After setting out the changed overall framework, the present article seeks to outline the perspectives ahead.

Persons with Disabilities↗
PubMed2003

Predicting vocational functioning and outcome in schizophrenia outpatients attending a vocational rehabilitation program.

BACKGROUND: Vocational rehabilitation is a central issue in the rehabilitation of patients with chronic schizophrenia. However, even with the help of comprehensive integration programs, achieving this objective remains a very ambitious and difficult undertaking. Therefore, a profound and up-to-date knowledge of vocational functioning and outcome predictors in patients who have the goal to return into competitive employment is imperative. The objective of the present study was to test the predictors summarized in the recent review of Cook and Razzano, as well as to test those predictors specified in the nine hypotheses put forward by Anthony and Jansen in schizophrenia patients enrolled in a vocational rehabilitation program. METHODS: The predictive value of ten hypotheses centering on vocational functioning and outcome were consecutively tested in a sample of 53 schizophrenia patients. Those predictors identified as significant were then taken into a 'winner take all' regression in order to determine which of them were the best. RESULTS: The overall work performance observed in a workshop proved to be the best predictor of vocational functioning. Contrary to the pivotal claim in Anthony and Jansen's review, in our sample, negative symptoms indeed influenced vocational functioning, outcome and functional skills. Cognitive impairments, social competence and fatalistic control beliefs also had predictive value for vocational functioning and outcome. CONCLUSIONS: These results reflect the accumulated findings of the past decade as summarized by Cook and Razzano. Moreover, they serve to substantiate the necessity of promoting the concept of cognitive remediation and associated programs designed to transform fatalistic beliefs into feelings of hopefulness, thereby enhancing the readiness of schizophrenia patients to enroll in rehabilitation programs.

Adult↗
PubMed1980

The vocational integration of the mentally retarded: a program to develop vocational maturity.

In many countries there are minimum standards for entry into vocational training programs, but until now there has been no instrument for determining whether retarded applicants possess the motor skills required to enter and complete such programs. To construct such an instrument, experts representing most of the skilled vocations in West Germany were consulted about typical skills required during the vocational education in their fields. Based on their responses, a catalog of essential skills was compiled and testing procedures (Handwerklich-Motorischer Eignungstest HAMET) were developed to determine vocationally-oriented motor skills for use in diagnostic and remedial programs for the retarded. A test administered to more than 100 mentally retarded youth showed significant and typical deficiencies in motor skills compared with those of non-retarded individuals. By using a factor analysis of the HAMET-items, it was possible to isolate elementary motor functions which are common to all the skilled vocations. Knowledge of these factors made it possible to start one-year training courses to develop vocational maturity. With selected exercises based on the HAMET-items the courses were very successful. In contrast to traditional programs for the mentally retarded it could also be shown that frequent changes of workshops and of vocational education staff are not necessary and that the entire training program can be carried out in one equipped workshop.

Adolescent↗
PubMed1995

Maximizing vocational outcome after brain injury: integration of medical and vocational hospital-based services.

OBJECTIVE: To describe a medical and vocational case-management system that has been implemented at the Mayo Medical Center in Rochester, Minnesota, to decrease the time between onset of brain injury and successful community reintegration. DESIGN: Barriers to employment are identified and targeted as part of a system that integrates medical center- and community-based services. MATERIAL AND METHODS: The success of the project will be determined by several sources, including the Mayo-Portland Adaptability Inventory, a vocational rating scale, and traditional measures of vocational success (for example, level of independent living, job type and setting, rate of pay, and the type and cost of vocational supports being used). Overall study outcomes will be compared against benchmarks derived from the literature on vocational outcome after brain injury. RESULTS: Preliminary data are encouraging that project goals are attainable. The medical case-management system has decreased the amount of time between injury and initiation of vocational and other rehabilitation services. During the first year, 67 persons with brain injury began receiving vocational services through the project, and 34% are in community-based nonsheltered work or training programs. Second-year data will reveal whether the goal of 70% placement within 9 months after admission to the project can be maintained.

Activities of Daily Living↗
PubMed2001

Experiences and perceptions of vocational training reported by the 1999 cohort of vocational dental practitioners and their trainers in England and Wales.

OBJECTIVE: To assess the self-reported confidence of vocational dental practitioners (VDPs) in clinical procedures together with vocational trainers' perceptions of the VDPs confidence in the same procedures, immediately after qualification and towards the end of the vocational training year. DESIGN: A questionnaire-based cohort study. SETTING: A general practice study carried out in 1999. SUBJECTS: Vocational Dental Practitioners and vocational trainers in England and Wales. METHOD: VDPs and trainers were asked on a single occasion to grade the clinical confidence of the VDP at the beginning and near the end of vocational training as high, satisfactory or low. RESULTS: Questionnaires were sent to 531 VDPs and 555 trainers; 82 per cent of VDPs and trainers responded. Approximately half the VDPs were male and 57 per cent were white, whilst 89 per cent of trainers were male and 81 per cent white. A large proportion of both VDPs and trainers reported low confidence in orthodontics, molar endodontics and surgical extractions at the start of the training year. Towards the end of training, both groups reported improved confidence levels in most clinical procedures. However, a higher proportion of trainers reported low confidence than their VDPs in most clinical procedures at both time points (p<0.001). VDPs appeared to gain most from experience and training in administration/management and interpersonal skills. CONCLUSION: Vocational training appears to satisfy its aim to enhance clinical and administrative confidence.

Clinical Competence↗
PubMed2001

[An examination of the relationships among career decision-making self-efficacy, vocational motives, and vocational indecision: a study of women's junior college students].

The purpose of this study was to examine a causal model leading to the tendency of women's junior college students to delay vocational decisions. The model assumes that Career Decision-Making Self-Efficacy (CDMSE) determines vocational motives, which in turn affect the tendency. A questionnaire was administered to 431, 199 first-year and 232 second-year, women's junior college students. CDMSE was measured with self-efficacy for self-appraisal and occupational information-gathering, and vocational motives were self-improvement, interpersonal, and status motives. Results showed that self-efficacy for self-appraisal influenced self-improvement motive for both first-year and second-year students. Self-improvement motive and the self-efficacy then influenced vocational indecision among second-year students. Self-efficacy for information-gathering influenced vocational indecision among first-year students. These findings suggest that college vocational guidance should take self-efficacy and vocational motives into account.

Adolescent↗
PubMed1990

Patterns of vocational interests and work motivation among mentally retarded adults attending vocational rehabilitation centres.

The present study describes a survey of the vocational interests and work motivation of trainees attending vocational rehabilitation centers for the mentally retarded in Israel. A random sample of 152 subjects was chosen from a total of 1,509 trainees. Two sets of questionnaires were applied: (1) the Illustrated Vocational Inventory (IVI) (Whelan and Reiter, 1980); and (2) a specially designed questionnaire on work motivation based on Herzberg's model (Herzberg et al., 1959). The most significant finding of the study was that several consistent patterns of vocational knowledge, vocational interests and motivational factors emerge with regard to mentally retarded clients attending vocational rehabilitation centers; and this lends strong support to the view that such people can be placed in employment on the open labour market.

Adolescent↗
PubMed1997

Prediction of vocational outcome based on clinical and demographic indicators among vocationally ready clients.

This study examined the clinical and demographic correlates of work skills and vocational outcome for persons with psychiatric disabilities. The same clinical, demographic, work skills, and vocational outcome instruments were administered to 275 persons working toward their vocational goals at three psychosocial rehabilitation centers. Data regarding vocational outcomes were collected quarterly over a period of 3 1/4 years. Using multivariate statistical techniques, clinical and demographic variables that predict work skills and future vocational outcomes were identified. The implications of the findings for program administrators, system planners, and researchers are discussed.

Adult↗
PubMed1981

[Vocational rehabilitation of heart patients. An analysis of "vocational rehabilitation cases" closed by the federal employment institute (author's transl)].

The number of heart/circulatory disease rehabilitation cases closed annually by the Federal Employment Institute has remained almost the same over the 1972-1978 period. In 1978 the national total of closed heart/circulatory disease cases amounted to 6,325, with 945 of the clients having attended vocational rehabilitation measures/courses. Some 25 percent of the cases are classified as "condition following myocardial infarction"; in male clients, this applies to about one third. Compared to the number of male clients, women are strongly under-represented in vocational rehabilitation of heart/circulatory disease patients. In relation to the structure of the gainfully employed population total, the frequency of vocational rehabilitation measures on heart/circulatory disease diagnoses varies strongly among the individual Laender employment office districts. Considerable differences are apparent when the age structure of heart/circulatory disease rehabilitation cases is compared with that of any other disability group. In case of the first, the number of cases increases with age, while the trend is the very opposite in the latter case. This fact shows that vocational rehabilitation measures for heart/circulatory disease patients need come up to special conditions, and that they have to be determined on different criteria. The rate of integrational solutions considered a positive outcome is considerably lower for heart/coronary disease rehabilitees than for the total of rehabilitees. The participation in vocational rehabilitation programmes of 14.9 percent equally is considerably lower than the corresponding percentage of the total number of rehabilitation cases (26.2 percent).

Female↗
PubMed2001

Perceptions of vocational trainees on gender and racial disadvantage within the Thames vocational training programme.

BACKGROUND: A recent report has suggested that vocational trainees within London experienced racial or gender disadvantage during their selection. This exploratory study did not investigate the extent or the nature of this disadvantage. AIM: To undertake a survey using a pre-tested questionnaire with dental vocational trainees on the Thames Scheme. The questionnaire explored perceived and experienced aspects of gender and racial disadvantage during their vocational training programme. RESULTS: 127 trainees completed the questionnaire (response rate 92%). Minority ethnic respondents were more than twice as likely to feel their selection was influenced by gender (odds ratio [OR] 2.25, 95% Confidence Interval [CI] 1.02, 5.10) and more than three times likely to feel selection was influenced by their race when compared with their white colleagues (OR 3.05, 95%; CI 1.01,11.45). The majority of trainees did not perceive any disadvantage whilst on the vocational training course. For example, only five respondents (4%) felt that minority ethnic individuals were treated less favourably during the vocational training course. CONCLUSION: In conclusion, this preliminary study has attempted to explore inter-ethnic differences within the profession on perceived racial disadvantage and possible strategies for change. It is clear that the perception of disadvantage is greater than the reality within the experience of most trainees.

Asia, Western↗
PubMed1999

Neuropsychological impairments, vocational outcomes, and financial costs for individuals with traumatic brain injury receiving state vocational rehabilitation services.

OBJECTIVE: To determine the relationship among neuropsychological variables, vocational outcomes, and vocational costs for Missouri Division of Vocational Rehabilitation (MO-DVR) clients with traumatic brain injury (TBI). DESIGN: Clients referred for neuropsychological evaluations were followed until DVR case closure. Subjects were grouped according to the following DVR status at case closure: Successfully Employed, Services Interrupted, and No Services Provided. Spearman correlations with Bonferroni corrections were calculated to determine relationships among variables, and Kruskal-Wallis nonparametric one-way analyses of variance (ANOVAs) were conducted to evaluate differences in DVR group status in terms of neuropsychological variables and DVR costs. SETTING: All evaluations were completed through a Midwestern university neuropsychology laboratory. PATIENTS: 110 consecutively referred DVR clients with nonacute TBI referred for neuropsychological evaluation. MAIN OUTCOME MEASURES: Absolute level (ie, raw/standard scores) of neuropsychological functioning and relative degree of decline in: intelligence (WAIS-R), memory (WMS-R General and Delayed Memory Indices), attention (WMS-R Attention Index), speed of processing (Trails A), and cognitive flexibility (Trails B); DVR costs at closure. RESULTS: 1) Surprisingly, the Successfully Employed group had significantly greater neuropsychological impairments; 2) Greater decline in delayed memory was associated with higher DVR costs (r = -0.30, P <.05); and 3) More indices of relative decline were significantly correlated with vocational outcomes (5/6) than were indices of absolute functioning (3/6). CONCLUSIONS: DVR is effective in providing services to individuals with the most significant neuropsychological deficits; it is important to consider both absolute level of functioning and relative decline in functioning when evaluating TBI.

Adolescent↗
PubMed1993

[Vocational promotion of psychiatrically handicapped patients in a Frankfurt am Main vocational training center].

In 1988, the Frankfort on Main Vocational Retraining Centre had decided in favour of increased, on-going admission of psychiatrically disabled adults, offering opportunities for their vocational education. The centre's objective is to enable psychiatrically disabled rehabilitees to successfully complete formal occupational training in as "normal" a setting as possible. This means: the Centre is a vocational rehabilitation facility, and is not directed at therapy or care. Psychiatrically disabled rehabilitees are accepted for up to 10 percent of available places in the various programme types. The overall objective is formal occupational qualification. A "training centre" open to all training orientations has been established for individualized service provision in the event of crisis situations during programme participation. Special attention is focussed on intensive, continuous further education of staff, inter alia by group supervision.

Combined Modality Therapy↗
PubMed1985

Vocational predictions compared with present vocational status of 60 young adults with cerebral palsy.

A group of 97 cerebral-palsied students between the ages of seven and 16 years were assessed in the 1960s and 1970s, and predictions were made as to their vocational status as adults. In 1983, 60 of the 76 over 18 years of age were contacted. 39 had been employed at some time since leaving high-school, but only 17 were employed at the time of the survey. Of those who had worked, over half had achieved or exceeded their vocational predictions. Those in competitive employment were more likely to be mildly disabled, to have higher IQs and to have been educated in integrated schools. Those who had never been employed were older and less independent in self-care and travel in the community. However, intelligence was not a major factor in distinguishing the employed from the never-employed. Recommendations are made for integrated education and job training in competitive settings, for community-based assessments and for family involvement in all aspects of planning to improve the vocational prospects of cerebral-palsied children.

Adult↗
PubMed2003

Rural/urban differences in vocational outcomes for state vocational rehabilitation clients with TBI.

OBJECTIVE: To evaluate differences in demographics, injury severity, and vocational outcomes for persons with TBI based on rural vs. urban residency. PARTICIPANTS: 78 individuals with TBI (28 from rural counties, 50 from urban counties) who requested services from the Missouri Division of Vocational Rehabilitation (VR) over a two year period. MEASURES: Demographics (i.e., age, race, education), injury severity (i.e., loss of consciousness, post traumatic amnesia, length of hospitalization, neuropsychological test scores), VR services provided (e.g., transportation, maintenance, on-the-job training, etc.), and VR outcomes (successfully vs. unsuccessfully employed; cost per case). PROCEDURE: All participants completed a standard neuropsychological evaluation and completed VR services (i.e., were followed from enrollment to case closure). Rural and urban residency was determined using U.S Office of Management and Budget definitions of metropolitan and non-metropolitan areas. ANALYSIS: Chi-squares, Fisher's Exact tests, Wilcoxon Rank Sums test, and MANOVAs. RESULTS: Few if any differences were found between the groups in demographics (i.e., more African Americans in urban areas), injury severity (i.e., more rural residents with multiple TBIs), or neuropsychological test scores. However, individuals from urban areas received significantly more maintenance funds (46% vs. 21%), transportation services (36% vs. 11%), and on-the-job training (28% vs. 7%), and had more spent on them ($1,816 vs $1,242). Although statistically non-significant (p < 0.15), 24% of individuals from urban areas were successfully employed at VR case closure, compared to only 7% of individuals from rural areas. CONCLUSIONS: Individuals with TBI from rural and urban settings have generally similar demographic, injury severity, and neuropsychological abilities, although they appear to differ in terms of vocational outcomes and number of VR services received, possibly related to limited availability of resources in rural areas.

Adult↗
PubMed1997

[The future of vocational rehabilitation--vocational rehabilitation for the future. An explanation with the federal government's austerity measures].

Under the law on enhancing growth and employment (Wachstums- und Beschäftigungsförderungsgesetz-WFG), the legal entitlement to vocational rehabilitation hitherto stipulated in the employment promotion act (Arbeitsförderungsgesetz-AFG), has been restricted to a narrowly defined population; and pension insurance scheme spending in the entire rehabilitation field been "capped" to the 1993 level minus some 600 million DM. Moreover, the transitional allowance applicable for pension insurance rehabilitees will be lowered. In addition, economies amounting to some 500 million DM have been imposed on the federal employment service Bundesanstalt für Arbeit. These measures are placing persons with disability at a disadvantage, accept exclusion of entire groups of disabled persons, and endanger the very existence of numerous rehabilitation facilities previously established with significant amounts of public funding. A blind eye is being turned on the high level of demand for qualification measures, on the overall economic benefits of rehabilitation measures, and on the fact that measures of this kind are disabled persons' only chance to hold their own in the face of labour market competitiveness. Also, poor awareness seems to exist of the fact that, in the longer run, meaningful contributions to greater economy will more likely be generated by structural adjustment, increased effectiveness, and greater flexibility. The future of vocational rehabilitation is being placed at risk--notwithstanding that vocational rehabilitation for the future is imperative.

Cost Control↗
PubMed2001

[Vocational rehabilitation of the mentally ill - an evaluation of the Vocational Rehabilitation Center in Zurich, Switzerland].

OBJECTIVE: The aim of the Vocational Rehabilitation Center in Zurich (VRC) is to reintegrate mentally ill persons into the primary labour market, mainly by prevocational training followed by continuous professional support for employed individuals. The present study evaluated the impact of the VRC. METHODS: The job and financial situation of 68 trained persons was assessed up to two years after the training. Additionally, their vocational history and sociodemographic data were analysed. RESULTS: Before the training, only 9 % had a job, while two years after the course 42 % were employed in competitive jobs. On the other hand, using an ordinal scale, two years after the training, 78 % of the patients were found in a better job situation than before the course. Likewise, the financial situation of 52 % of the clients has improved within those two years. The strongest correlation with success was the intensity of support after the training. CONCLUSIONS: The VCR is effective in training mentally ill patients for the primary job market. Continuous professional support is vital for ongoing success.

Adult↗