Job Reintegration Research Articles

Perception of modification of the habituation component in users undergoing rehabilitation programs for drug addiction

Introduction: addiction is classified as a brain disease, causing alterations in neurochemical functioning. It is also considered a chronic and transgenerational disease, with cultural, environmental, and individual predispositions. Psychosocial rehabilitation addresses these factors, creating collaborative spaces with a multidisciplinary team of professionals.Methods: qualitative approach with a hermeneutic phenomenological design. A semi-structured interview was conducted with 5 participants in October, who had started their substance use between the ages of 13 and 22, and were in the first or second stage of rehabilitation.Results: within the trajectory of substance use, it was observed that individuals begin using at an early age due to parental negligence during adolescence. Additionally, the loss of roles and significant relationships due to substance use is described, but they find in the rehabilitation center an opportunity to regain roles and habits. As an emerging theme, personal projections related to job reintegration are valued.Discussion: the positive influence of rehabilitation centers on the recovery of roles and habits in individuals with addictions is highlighted. It is also concluded that the rehabilitative environment within the center is crucial, but its effectiveness depends on factors such as camaraderie and equipment. Furthermore, despite the efforts toward social and job reintegration, participants face obstacles due to social stigmas.

Comfort Care Needs of Allogeneic Stem Cell Transplant Survivors: Lived Experience.

Allogeneic Stem Cell Transplantation (ASCT) and, consequently, the chronicity associated with this life event have a growing prevalence and a significant impact on the life and daily life of each person who experiences it. It is necessary to reflect on the care needs of this group of vulnerable people. Comfort is a concern, and its improvement is a desired outcome of healthcare. To achieve this, it is necessary to know the needs of the people who are the focus of care. This paper aims to understand the needs of comfort care in the lived experience of comfort for survivors of ASCT. Qualitative approach using van Manen's phenomenology of practice. We uncovered the phenomenon through phenomenological interviews, which integrated narratives and illustrative episodes that reflected the lived experience of 20 survivors. Participants in the study were people who had undergone allogeneic hematopoietic progenitor cell transplantation, who were monitored on an outpatient basis and who met the following conditions: (i) were over 18 years old; (ii) had undergone SCT at least 3 months previously; (iii) had no evidence of disease relapse; (iv) were able to express themselves verbally, providing information relevant to the study, as well as expressing emotions and feelings. Descriptions of lived experiences were collected from participants between July 2020 and May 2021. In the phenomenological reflection on the lived descriptions, we followed the "stages" epoché, reduction, and vocative. The following themes emerged from the ASCT survivor's lived experience of comfort related to comfort care needs: continuous follow-up, reference nurse, information, assistance in adapting to the new self, mental health intervention, spiritual support, adaptation to changes in sexuality, physical rehabilitation, and job reintegration. This study reveals the importance of continuous follow-up for ASCT survivors. Survivors experience major changes in their lives in the long term and require a response from health professionals to find comfort in their daily lives.

Comprehensive rehabilitation and job reintegration of people with severe mental illness in a Latin American country: REINTEGRA study protocol

BackgroundDespite the increasing use of comprehensive rehabilitation models for people with severe mental illness (SMI), there are still limitations to their implementation and replicability in a consensual way, particularly in Latin American countries. The REINTEGRA program aims to be a standardized model of comprehensive rehabilitation focused on psychosocial and cognitive improvement through a set of interventions on different areas of people’s functionality, with the goal of reintegrating people with SMI into the labour market. In this paper we summarize the protocol for its subsequent implementation in a mental health institution in Mexico.MethodThe protocol is based on a quasi-experimental, prospective longitudinal study, with a pragmatic or naturalistic control group. It will be carried out in three phases. Phase 1 consists of a series of interventions focused on psychosocial improvement; Phase 2 focuses on cognitive and behavioral improvement treatments; and Phase 3 targets psychosocial recovery through rehabilitation and reintegration into the labour market. The overall procedure will be monitored with standarized evaluations at different stages of the program.DiscussionThis study presents a model of integral rehabilitation of people with SMI. At the moment, one of the obstacles to overcome is the organization and procedural control of the different actors needed for its implementation (nurses, psychologists, doctors, companies, institutions, etc.). REINTEGRA will be the first comprehensive rehabilitation model that includes systematized procedures for job reinsertion for people with SMI in Mexico, which aims to be a standardized tool of easy adaptation and the replicability for other mental health centers and institutions.

Percepción sobre las atenciones de terapia ocupacional en modalidad de telerrehabilitación en pacientes atendidos en la sección de Terapia Ocupacional del Hospital del Trabajador, Santiago de Chile

Hospital del Trabajador is part of the biggest workers compensation system in Chile, it provides care for workers who suffered job related accidents or occupational diseases. Occupational Therapy delivers rehabilitation interventions through a comprehensive and functional perspective in order to facilitate personal autonomy, job reintegration and social participation of its users. Prior to this contingency, services were delivered 100% on site, but with the arrival of COVID-19, the mobility of people was limited through the implementation of quarantines, preventing or hindering participation in face-to-face treatment sessions. To guarantee the continuity of the treatments, a care protocol was designed with a tele-rehabilitation system, where each area designed activities that were possible to be replicated at the users' homes. Given how untimely and fast these changes happened, it was considered important to carry out a self-evaluation within the occupational therapy team three months after implementing the system, carrying out a descriptive study that seeks to know the perceived advantages and disadvantages of the system. The main conclusions show that this modality is highly beneficial to maintain the continuity of treatment at home, being even more productive when combined with face-to-face activities, where tele-rehabilitation modality reinforce activities carried out directly. The main disadvantage is the need for the user to have access and use of technology that allows daily connection or, otherwise, to have supportive networks to facilitate the process.

Integration of food waste composting and vegetable gardens in a university campus

Local composting (household, community and small scale applications) is considered a sustainable option for bio-waste recovery and is receiving increasing demand from society. Higher education institutions are no exception, but detailed and comprehensive long-term studies on composting programs on university campuses are lacking. The local composting program of the University of A Coruña (UDC) offers a decentralized service for the treatment of food waste from 11 university canteens using static and dynamic composters located in 9 different composting areas. Considering the three pillars of sustainability, this work describes the characteristics of the different composting technologies used and their investment and operational costs, the routine monitoring process and product quality, the integration of the composting systems as living labs for biotechnology and environmental engineering courses, and the use of compost in the university vegetable gardens. The agents involved in the project are the canteen staff, the university gardening company, external composting operators, university researchers and teachers, sustainability scholarship students and volunteer people. Organic waste is usually delivered directly by canteen staff to composters. The gardening service provides green waste from UDC campus (crushed pruning) that is used as bulking material. The monitoring and maintenance of the composting areas is currently in charge of external staff provided by a local NGO dedicated to cooperation and job reintegration of the unemployed. The service also allows the incorporation of volunteers and scholarship students as operators and process monitoring supervisors. The main result of this project was the prevention of a large amount of waste that did not require collection and transportation, or disposal or incineration. This is being done in an economically sustainable way, as decentralized composting costs have been lower than the average costs of municipal solid waste treatment in the region. The lower investment costs of static composters largely offset the higher labour costs and result in lower overall costs than those of the dynamic composter. The dissemination of composting practice to society was another important outcome of the project.

Psychosocial Intervention in European Addictive Behaviour Recovery Programmes: A Qualitative Study.

Background: The vulnerability of drug users in treatment increases their risk of social exclusion. Psychosocial interventions aim to solve or minimise this risk, increasing social integration for individuals in treatment. In this study, the effectiveness of various European drug recovery programmes was studied by examining psychosocial intervention groups with vulnerable populations. Methods: Research was conducted utilising qualitative methodology in the following manner: bibliographical review (reports and papers) and 18 interviews with key informants (from nine European countries). Results: Treatment programmes were found to be effective for recovery from opiate use, however, social recovery programmes were not found to be effective. For females in treatment and young drug users, the adequacy of programmes received medium-to-low evaluations. Conclusion: It is necessary to increase the effectiveness of psychosocial intervention in recovery-based programmes. In addition, the relevance of these programmes in relation to psychosocial characteristics of the various risk groups (except opioid consumers) should be validated and revisited. Additionally, psychosocial intervention professionals should take a more active role in such programmes, especially in intervention with young people (in health education, prevention, early detection, and intervention) and with women (in regard to the detection and effective intervention for socio-health problems, social and job reintegration, access inequality, and use of services available due to gender).

Reasonable Accommodation at the Workplace for Professionals with Severe Mental Illness: A Qualitative Study of Needs

Background:Professionals with Severe Mental Illness (PwSMI) often face challenges in obtaining and retaining employment. For equal and effective participation, they may require reasonable workplace adjustments. The recently legislated Rights of Persons With Disabilities Act 2016 in India defines such adjustments as reasonable accommodations.Methods:In-depth qualitative interviews were conducted with 15 consenting PwSMI availing psychiatric rehabilitation services at a tertiary mental health institute in India, five mental health professionals, and five employers. The audio-recorded interviews were transcribed and coded manually by two independent investigators. Inductive content analysis approach was used for qualitative analysis.Results:The detected themes included modifications in work schedule, supports to improve work efficiency, modifications in the work environment, modifications in the work-related appraisal, supportive employer policy, and integration of services. The participants described the term “undue burden” to be ambiguous.Conclusions:The reported reasonable accommodations are non-structural and mainly dependent on human assistance. Vocational rehabilitation and job reintegration efforts can focus on guided negotiations between employers and PwSMI. This is dependent on at least some degree of disclosure. Awareness regarding reasonable accommodation and stigma reduction is necessary for successful implementation.

Cardiopulmonary exercise testing for personalized job reintegration after acute cardiovascular attacks: a pilot cross-sectional study.

Background:Cardiovascular diseases (CVD), particularly the ischemic heart disease, are a growing public health issue. In addition, the return to work after an acute cardiovascular attack represents a complex challenge.Objectives:To evaluate utility and safety of cardiopulmonary exercise testing (CPET), particularly performed “on site”, to promote a return to work in line with the residual working capacity.Methods:Fifty-nine workers affected by a major cardiovascular event, aged 18-63 years, have been enrolled between 2015 and 2018. All the patients underwent a CPET in outpatient clinic. Eleven workers also underwent the “on site” CPET, recorded during their working activities.Results:Outpatient clinic CPET outcomes (i.e. normal, mild impairment or moderate/severe impairment of cardiopulmonary function) were associated with the subjective perception of workers’ health status after returning to work. The “on site” CPET was found to be safe and reliable to promote a personalized return to work of patients. In 7 out of 11 patients, the values of O2 consumption (VO2) during the working activity were higher than 40% of VO2 max as obtained from laboratory CPET.Conclusions:This study provides evidence for safety and usefulness of “on site” CPET for a personalized statement of fitness for work. This may facilitate the job retention of patients characterized by a high risk of unnecessary job loss. The use of CPET represents a first step of energy expenditure evaluation associated with specific working tasks.

Diagnosis and Treatment of Breast Cancer in Young Women.

Despite the increase of breast cancer incidence with age, approximately 7 to 10% ofwomen diagnosed with breast cancer are younger than the age 40. This subgroup ofpatients has different risk factors, tumour biology, clinical outcomes, and specific psy- chosocial issues, such as fertility preservation, family planning, and job reintegration. However, age alone should not be the main consideration when choosing the aggressive- ness of the treatment, as other factors must be considered, including the biologic aggressiveness of the tumour, potential long-term toxicities, and the preferences of the patient. Fertility preservation techniques should be discussed with the patient before starting any cancer treatment. Despite the significant percentage of breast cancer patients younger than age 40, fewclinical studies have specifically investigated disease characteristics and outcomes of this population, and most therapies routinely administered to these younger women were tested in older patients. Moreover, young women who have breast cancer are at a greater risk of sexual and psychological distress, and clinicians should address these issues in order to properly support patients during the long diagnostic and therapeutic journey. Consequently, it is essential to follow diagnostic and treatment guidelines specificallyaddressed to young women. Additional specific procedures should be followed to treat pregnant patients with breast cancer.

Return to work after breast cancer: Comprehensive longitudinal analyses of its determinants.

11564 Background: The interplay between breast cancer (BC) late effects, psychosocial and work-related factors in return to work (RTW) is not well understood. Previous reports were retrospective and did not combine all these features. Methods: We used data of a French prospective cohort study (CANTO, NCT01993498) of stage I-III BC patients (pts) including detailed clinical data of 1,874 pts working at diagnosis (dx) and ≥5 years younger than legal retirement age. The outcome was non-RTW 2 years after dx. Multivariable regressions were conducted to identify correlates of non-RTW. First, we examined the independent effect of treatments, toxicities (Common Toxicity Criteria Adverse Events), and patient reported outcomes (EORTC BR23 and FA12; Hospital Anxiety and Depression Scale) collected shortly after end of primary treatment. Then, in a restricted sample of 1,003 pts with working conditions (WC) information available, we fitted models to account for detailed pre-dx WC including type of contract, working hours, strenuous postures, supportive environment, degree of autonomy and perception of work. All models were adjusted for age, stage, marital status, socioeconomic status and comorbidities. Results: Two years after dx, 21% of pts did not work. Adjusted odds of non-RTW were increased among pts treated with combinations of chemotherapy (CT) and trastuzumab (TR) (e.g. OR of CT-TR = 2.20 [95% CI 1.24-3.88] and OR of CT-TR-hormonotherapy (HT) = 1.72 [1.13-2.63] vs. treated only with CT-HT), who had severe arm morbidity (OR = 1.73 [1.27-2.36] vs. no), severe emotional fatigue (OR = 1.55 [1.03-2.32] vs. no), anxiety (OR = 1.51 [1.02-2.23] vs. no), or depression (OR = 2.23 [1.27-3.94] vs no). In addition, we also found that the odds of non-RTW were increased among pts who had shift working hours (OR = 2.23 [1.32-3.76] vs. no), who did not work in a supportive environment before dx (OR = 2.24 [1.44-3.50] vs. supportive) and who perceived their job as boring (OR = 3.57 [1.71-7.46] vs. not boring). Conclusions: More than 1/5 of pts did not RTW 2 years after dx, with treatment (trastuzumab), clinical, psychological and work-related factors being associated with job reintegration. Multidisciplinary strategies are needed to support BC survivors.

Intergenerational management in the group of people subjected to job reintegration as a form of maintaining social security potential in Poland

The aim of this paper is to present a theoretical reflection and results of a pilot study research on intergenerational management in the group of participants of Centrum Integracji Społecznej (later called: Social Integration Centre) in Jeleśnia who underwent job reintegration and can socially improve the social potential of internal security. The concept of national identity and intergenerational awareness in terms of ensuring the social security potential of the country depends in reintegration groups on the broadly understood level of diversity of the team. An important feature of intergenerational management in socially reintegrated groups is situational awareness, mutual respect and a sense of group unity with the leader and vice versa. The mere fact that intergenerational management in relation to security management, the essence of which is to ensure social security potential, is becoming an indispensable issue from a practical point of view (Cf. Ponomarenko & Khudolei, & Prokopenko, & Klisinski, 2018). On the other hand, however, research in the area of management, which is also in the humanities area (Kostera, 2005, 2015), makes it possible to discover new methods and opportunities for the development of social security potential through intergenerational cooperation based on the methods of social education philosophy The article therefore has a quasi-empirical and interdisciplinary nature, as it uses terminology, concepts and thematic scope from the fields of management, security, and elements of upbringing studies.

Which Factors Influence the Success of Supported Employment?

Main goal of this review is to identify predictive factors for the outcome of Individual Placement and Support (IPS) with a focus on Supported Employment (SE) and of pre-vocational training (PVT) of individuals with mental illness. A systematic search of PsychInfo, PubMed, PsychIndex and PsyArticles was conducted. Studies were included if they compared both approaches, SE and PVT, contained predictors to optimize SE or PVT, investigated the effectiveness of SE or examined what constitutes adequate job coaching. 45 articles have been included. 27 articles referred to predictors that influence the outcome of SE or PVT, 9 showed a direct comparison between both approaches, 5 investigated job coaching and 4 examined the effectiveness of SE.In summary motivation, work experience and high fidelity of IPS criteria seem to be the most important predictors for a successful job reintegration using SE. Overall, SE is more effective than PVT. The success of SE can be enhanced by keeping the predictors in mind. However, future research should focus more specifically on predictors.

Psychiatric disorders and health service utilization in unemployed youth

Youth unemployment is associated with increased levels of anxiety, depression, alcohol abuse, reduced self-esteem and satisfaction with life. Up to date data based on standardized psychiatric diagnostic assessments in adolescent or young adult unemployment is very scarce. To our knowledge, this study has, for the first time, assessed both Axis-I (non-personality) and Axis-II (personality) psychiatric disorders and related constructs in a preselected sample of unemployed individuals. Subjects were aged 16–24 and lived in the large urban region of Essen, Germany. They were referred by case managers of the vocational services centre to the on-site psychiatric out-patient unit. SCID-I and II were administered to assess DSM-IV diagnoses. Symptom Checklist 90 R, Beck Depression Inventory and Client Sociodemographic Service Receipt Inventory were used to measure severity of psychopathology and health service utilization. In all, 98% of the unemployed young adults suffered from mental disorders. Mood and anxiety disorders were the most common Axis-I disorders (47.9 and 33.4%). Altogether, 58.2% of probands met diagnostic criteria for a personality disorder; a borderline personality disorder accounted for one half of these disorders. Despite a 49% rate of Axis-I and II comorbidity and severe psychopathology, the majority of subjects were untreated and mental health service utilization in general was low. The diagnosis of a personality disorder was related to a 2.7-fold risk of dropping out of job reintegration programmes. Unemployed young adults referred for a psychiatric assessment have a high rate of both Axis-I and II disorders, which need to be considered upon planning individual-based vocational rehabilitation programs.

Functional and socioeconomic outcome of inpatient rehabilitation of patients with complex hand injuries

Evaluation of functional outcome and socio-economic results of patients with complex hand injuries after inpatient rehabilitation. In a prospective investigation 36 patients with complex hand injuries received an intensive therapy regime under inpatient conditions. In all patients functional parameters of the hand (total active range of motion, palm to palm distance, spread between thumb and index finger, spread between thumb and little finger) and the score of Buck-Gramcko were registered initially and at the end of inpatient rehabilitation. Socio-economic data (kind of discharge, job reintegration, further treatment) were documented as well. The total active range of motion could be improved from 36% to 69%, spread D1-D5 from 18.5 to 20.7 cm and spread D1-D2 from 13.9 to 15.6 cm. The palp to palm distance of all fingers was reduced from 4.6 cm to 2.3 cm. The Buck-Gramcko score of all injured fingers improved from 4.2 points (poor) at admission, to 11.8 points (good) at discharge, At the end of inpatient rehabilitation 18 patients could return to their job either gradually or on full-time. Even patients with complex hand injuries, good functional results could be achieved by an intensive inpatient rehabilitation characterised by close medical supervision and guidance and tight clinical controls.

Zur Eingliederung von Rehabilitanden in das Erwerbsleben nach Umschulung in Berufsförderungswerken - ein Prognosemodell

Vocational rehabilitation aims at occupational reintegration of the clients. This article focuses on several key results of an evaluation study on rehabilitative vocational training programmes. A central research goal was to identify prognostic factors for successful vocational integration. Three vocational retraining centres (Berufsförderungswerke) participated in this cohort study with five waves of measurement. Data gathering on process and outcome quality of the two-year training programmes was based on client-surveys (questionnaires). A prognostic model for occupational integration one year after the training measure was developed, based on questionnaire data gathered at the beginning of the training courses. One year after completion of their training 55% of the participants had returned to a job (dependent or self-employed). The logistic regression model for prognosis of return to work showed six relevant variables, and occupational integration as well as nonintegration 12 months after training could be predicted in 77%. Regional unemployment rates revealed to be the most important predictive variable for job reintegration. Other significant variables were: control beliefs, educational level, pain, perceived social support, and occupational field. Neither marital status nor level of disability (GdB) proved predictive for return to work. The variables age and gender were significant only in the univariate analysis. A set of variables could be identified as predictive for return to work after a two-year vocational training measure. Some variables, such as control beliefs or perceived social support, may indicate possibilities for specific supportive interventions.

Vocational reintegration following spinal cord injury: expectations, participation and interventions.

Survey. To explore the process of reintegration in paid work following a traumatic spinal cord injury (SCI), including the role of early expectations of individual patients regarding return to work, indicators of success of job reintegration and a description of reintegration interventions and barriers. Dutch rehabilitation centre with special department for patients with spinal cord injuries. Descriptive analysis of data gathered by a mailed questionnaire, which was returned by 57 persons (response 83%) with traumatic SCI, aged 18-60 years, and data of earlier expectations reported by the individual patients during the rehabilitation admission following SCI from 1990 to 1998. Of 49 respondents who were employed at the moment of the SCI, 45% expected to be able to resume work. These positive expectations were associated with a higher educational level. In 67%, return to work was successful. The chance to reintegrate successfully was better if the patient expected to resume work. Logistic regression analysis did not reveal other significant indicators. About one-third of the 49 respondents working preinjury followed vocational retraining, which was successful for most of them so far. In the majority of work situations modifications have been made, such as job adaptations and reduction of working hours. Several unmet needs regarding reintegration interventions were also reported. Positive expectations regarding resumption of work after a SCI are an important indicator of successful reintegration in work. An active role of the rehabilitation team is recommended in drawing up a vocational reintegration plan to prepare the patient, the employer and professionals involved in the reintegration process.

Vocational reintegration after a lower limb amputation: a qualitative study.

The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study had a retrospective design with semi-structured interviews. The authors used a qualitative methodology to obtain detailed information on the reintegration process. Thirty-two (32) subjects participated with a mean age of 42.6 years. The mean time between amputation and return to work was nearly one year (11.5 months). The most common reasons for delay in return to work were stump problems and problems in wound healing. Fifty percent (50%) of the amputees got different work tasks or another job than before amputation, mainly because of physical restrictions caused by the amputation. The most important motives of the amputees for job reintegration were work as a form of day spending (69%) and social contacts at the workplace (66%). Bad support of the implementing body which takes care of job reintegration and employer (34%) were the most mentioned obstacle to job reintegration. Vocational workers should be regular members in the rehabilitation teams for amputees.

Job satisfaction and health experience of people with a lower-limb amputation in comparison with healthy colleagues

Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH. Job satisfaction and health experience of people with a lower-limb amputation in comparison with healthy colleagues. Arch Phys Med Rehabil 2002;83:628-34. Objectives: To describe indicators of job dissatisfaction among amputee employees and to compare job satisfaction and health experience of working amputee employees with that of control subjects. Design: A cross-sectional study, mailed questionnaire. Setting: Patients were recruited by the orthopedic workshops of the Netherlands. Participants: One hundred forty-four patients who had an acquired unilateral major amputation of the lower limb at least 2 years before, were aged 18 to 60 years (mean age, 43y), and were living and working in the Netherlands. One hundred forty-four control subjects matched for age, gender, and type of job. Interventions: Not applicable. Main Outcome Measures: Statistical analysis of responses to a questionnaire regarding patient characteristics and amputation-related factors, amputee patients' opinions about their work and the social atmosphere at work, and their general health (RAND 36-Item Health Survey [RAND-36]). Results: People with an amputation had greater job satisfaction (70%) than did the able-bodied control group (54%). The wish for (better) modifications in the workplace and the presence of comorbidity were significantly related to job dissatisfaction in people with limb loss. Amputee employees were less often hindered by the failures of others and by fluctuations in temperature. People with limb loss showed a worse physical health experience than controls on the RAND-36. Conclusions: The vocational satisfaction of people with limb loss may be improved by better workplace modifications, depending on the functional capabilities of the person and the functional demands of the job; improvement may also be achieved by vocational rehabilitation programs, especially for those with an amputation in combination with other morbidity. Despite experiencing more health problems, the amputee group expressed greater job satisfaction than the able-bodied group, reflecting a great appreciation of job reintegration by people with a lower-limb amputation. © 2002 by the American Congrees of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Factors related to successful job reintegration of people with a lower limb amputation

Schoppen T, Boonstra A, Groothoff JW, van Sonderen E, Göeken LN, Eisma WH. Factors related to successful job reintegration of people with a lower limb amputation. Arch Phys Med Rehabil 2001;82:1425-31. Objective:To study demographically, amputation-, and employment-related factors that show a relationship to successful job reintegration of patients after lower limb amputation. Design: Cross-sectional study. Setting: University hospital. Patients: Subjects had an acquired unilateral major amputation of the lower limb at least 2 years before, were aged 18 to 60 years (mean, 46yr), and were living in the Netherlands. All 322 patients were working at the time of amputation and were recruited from orthopedic workshops. Intervention: Questionnaires sent to subjects to self-report (1) demographic and amputation information and (2) job characteristics and readjustment postamputation. Questionnaire sent to rehabilitation specialists to assess physical work load. Main Outcome Measures: Demographically related (age, gender); amputation-related (comorbidity; reason and level; problems with stump, pain, prosthesis use and problems, mobility, rehabilitation); and employment-related (education, physical workload) information about the success of job reintegration. Results: Job reintegration was successful in 79% and unsuccessful in 21% of the amputees. Age at the time of amputation, wearing comfort of the prosthesis, and education level were significant indicators of successful job reintegration. Subjects with physically demanding jobs who changed type of job before and after the amputation more often successfully returned to work than subjects who tried to stay at the same type of job. Conclusions: Older patients with a low education level and problems with the wearing comfort of the prosthesis are a population at risk who require special attention during the rehabilitation process in order to return to work. Lowering the physical workload by changing to another type of work enhances the chance of successful reintegration. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Job Preparation and Reintegration of Psychotic Patients into Nonurban Areas of Piedmont

(1994). Job Preparation and Reintegration of Psychotic Patients into Nonurban Areas of Piedmont. International Journal of Mental Health: Vol. 23, Jobs and Psychosocial Rehabilitation, pp. 23-29.