Vocational Status Research Articles

An analysis of career and vocation status and educational effectiveness after transition from high school into society for students with severe disabilities

An analysis of career and vocation status and educational effectiveness after transition from high school into society for students with severe disabilities

A multi-dimensional measure of vocational identity status

Establishing a worker identity is among the most central aspects of the transition from adolescence to adulthood. Despite its importance, few measures with acceptable psychometric and conceptual characteristics exist to assess vocational identity statuses. This study reports the development and evaluation of the Vocational Identity Status Assessment (VISA), which is derived from established conceptual models and includes career exploration, commitment, and reconsideration dimensions. Results show that the VISA exhibited metric invariance across a high school and university sample. Cluster analyses demonstrated that the VISA consistently resolved six identity statuses across the two samples, supporting the previously established achieved, moratorium, foreclosed, and diffused statuses along with two additional statuses termed searching moratorium and undifferentiated. The identity statuses predicted differences in participants’ work valences and well-being with the achieved and diffused statuses respectively exhibiting the most and least favorable characteristics. Implications, limitations, and suggestions for future research based upon these findings are offered.

P03-368 Use of antipsychotics in patients with schizophrenia and cognitive impairment: A naturalistic survey across four European countries

AimCognitive deficits impair social and vocational rehabilitation in schizophrenic patients but little is known to which extend these symptoms are perceived by psychiatrists and how they influence antipsychotic treatment. Therefore, an online survey was performed in four European countries (Germany, Greece, Italy and Spain).MethodsThe survey involving 744 psychiatrists and assessed demographic characteristics including vocational status, presenting symptomatology, cognitive dysfunction severity, and current antipsychotic treatement. Methodology is described in full detail by Gorwood (2010).ResultsOut of 3,996 patients, 29% were clinically assessed as having mild, 54% moderate and 17% severe cognitive dysfunction. In the mild dysfunction group, mean time since diagnosis was 9.7 years, 12.0 years in the moderate dysfunction group, and 17.0 years in the severe dysfunction group, and majority were outpatients (74.7%, 57.9% and 56.7%, respectively). The respective mean number of previous episodes was 5.1, 6.2 and 7.2 (6.0 for the total sample). Full or part time employment was reported in 32,2%, 19.1% and 11.8% of the patients, respectively. Olanzapine was the most frequently used antipsychotic in the mild group (21.0%) and severe group (24.9%), and risperidone in the moderate group (23.0%). Ziprasidone was used in 10.2%, 0.8% and 7.1% of subjects.ConclusionCognitive dysfunction is frequently perceived by psychiatrist in every day clinical practice and severely interferes with the vocational status. Major associations between specific antipsychotics and the levels of cognitive impairment were not observed. Irrespective of the level of cognitive dysfunction, > 50% of subjects were outpatients.

Higher vocational talents training scheme reform research and practice

this paper briefly introduces the higher vocational talents training scheme research status and research background, and put forward higher vocational talents training scheme reform and practice of research contents, purpose, and to solve the problems in teaching, and gives the research method and procedure and result had anticipated.

Relation of Vocational Identity Statuses to Interest Structure Among Swiss Adolescents

Vocational identity is one core component of identity construction in adolescence. The current study investigated whether vocational interest structure in terms of differentiation, coherence, elevation, and interest–aspiration congruence would differentiate among students in vocational identity achievement, foreclosure, moratorium, and diffusion. Swiss students at the beginning of eighth grade ( N = 341) participated in the study. Groups were created using cluster analysis based on the dimensions of career exploration and career commitment, and group differences were explored with discriminant analysis. Controlling for sociodemographic variables, higher interest differentiation and elevation distinguished students in achievement/moratorium from those in diffusion. More interest elevation differentiated moratorium from foreclosure.

Therapeutic relationships in vocational rehabilitation: Predicting good relationships for people with psychosis

Therapeutic relationships between clients and vocational rehabilitation workers have been shown to predict entering competitive employment. We aimed to determine predictors of good relationships, using data from an international randomized controlled trial of supported employment (n=312). Baseline predictors of early therapeutic relationships with vocational workers were assessed, along with the impact of vocational status and changing clinical and social functioning variables on relationship ratings over time. Associations between client and professional relationship ratings were also explored. Better early client-rated therapeutic relationship was predicted by better baseline relationship with the clinical keyworker, being in the Individual Placement and Support (IPS) service, the absence of work history and a greater proportion of care needs being met, whereas over time it was predicted by being in the IPS service. Professional-rated early relationship was predicted by social disability and remission, while over time it was predicted by being the same sex as the client, duration of the relationship and the client's increasing anxiety. Client and professional ratings were positively associated but clients' ratings were higher than professionals', particularly in the IPS service. Relationships were better where clients may have been more motivated to engage, including by their prior experience of a good therapeutic relationship with the clinical keyworker.

Predicting loss of employment over three years in multiple sclerosis: clinically meaningful cognitive decline

Cognitive dysfunction is common in multiple sclerosis (MS), yet the magnitude of change on objective neuropsychological (NP) tests that is clinically meaningful is unclear. We endeavored to determine NP markers of the transition from employment to work disability in MS, as indicated by degree of decline on individual tests. Participants were 97 employed MS patients followed over 41.3 ± 17.6 months with a NP battery covering six domains of cognitive function. Deterioration at follow-up was designated as documented and paid disability benefits (conservative definition) or a reduction in hours/work responsibilities (liberal definition). Using the conservative definition, 28.9% reported deteriorated employment status and for the liberal definition, 45.4%. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test, Total Learning (CVLT2-TL) measures distinguished employed and disabled patients at follow-up. Controlling for demographic and MS characteristics, the odds ratio of a deterioration based on a change of 2.0 on the CVLT2-TL was 3.7 (95% CI 1.2–11.4 and SDMT by 4.0 was 4.2 (95% CI 1.2–14.8), accounting for 86.7% of the area under the ROC curve. We conclude that decline on NP testing over time is predictive of deterioration in vocational status, establishing a magnitude of decline on NP tests that is clinically meaningful.

Employment among spinal cord injured patients living in Turkey: a cross-sectional study

The aim of this study was to determine the rate of employment and to establish the factors affecting vocational status in spinal cord injured patients living in Turkey. One hundred and fifty-two traumatic spinal cord injured patients older than 18 years with injury duration of at least 1 year and living in the community were included in the study; homemakers were not taken into consideration. The demographic and clinical data were retrieved from the medical records. The patients were interviewed with a structured questionnaire about the employment status at the time of the injury and after the injury, seeking a job after the injury, possible causes for unemployment, educational activities after the injury, and being a member of a social association. Descriptive statistics, Mann-Whitney U test and Pearson's χ test were used to analyze the results. The rate of employment was 21% among this group of spinal cord injured patients. Female sex, young age at the time of the injury, longer time since injury, higher educational level, being educated after injury, and being a member of a social association have positive effects on vocational outcome; age at the time of the study and severity and level of the lesion did not affect employment. According to the results of this study, the employment rates after spinal cord injury are low in Turkey. There is a need to maximize the employment capacity. Social and educational activities after injury should be encouraged during rehabilitation.

A 2-year follow-up of mentalization-oriented group therapy following day hospital treatment for patients with personality disorders

Objective To analyse the effectiveness of mentalization-oriented outpatient group therapy following 5-month day hospital treatment. Methods Twenty-two patients with personality disorders participated. All were consecutively referred and diagnosed according to standardized criteria and had completed a 5-month long psychotherapeutic day hospital treatment. Intervention consisted of once a week mentalization-oriented group therapy for up to 3 years. Outcome on acute symptoms included hospitalizations and suicide attempts, the more enduring social and interpersonal problems were assessed by standardized questionnaires regarding symptoms, interpersonal problems, social functioning and vocational status. Outcome measures were analysed within the framework of generalized estimating equations at the beginning and at the end of treatment, and at 2 years follow-up. Results Average treatment length was 2 years. There was no dropout from treatment. Significant improvements were observed on the Symptom Checklist SCL-90-R, Personality Severity Index Score, Inventory of Interpersonal Problems-Circumplex version, Clark's Personal and Social Adjustment Scale, Global Assessment of Functioning, hospitalizations and vocational status. At follow-up, these results further improved significantly. Conclusion Long-term mentalization-oriented outpatient group therapy was associated with a reduction in both acute symptoms and the more long-lasting social and interpersonal problems in this patient group. At follow-up, results further improved, were paralleled by a level of hospitalizations which dropped to almost none, a marked decrease in the use of psychological treatment, and a clearly improved vocational status. Copyright © 2010 John Wiley & Sons, Ltd.

An interdisciplinary pain rehabilitation programme: description and evaluation of outcomes.

The purpose of this archival report is to describe the essential elements of an intensive 8-week interdisciplinary pain rehabilitation programme (IPRP) with a cognitive-behavioural emphasis and the results that can be expected in treating patients with chronic pain conditions. This report describes a private outpatient program providing treatment services to patients with long-term disabling pain arising from work- or accident-related musculoskeletal injuries. The cohort consists of 338 consecutive patients who completed the program over a 3-year period (patients discharged between January 1, 2005, and December 31, 2007). Improvements in vocational status were noted in 75% of patients with chronic pain. Patients were also able to reduce their pain levels by approximately 16% and to reduce their levels of anxiety and depression by 13% and 17% respectively. At the same time, 61% of patients were able to reduce or eliminate their pain medications. Outcomes are consistent with evidence-based clinical practice guidelines for the management of chronic pain conditions. The published literature supports the efficacy of this interdisciplinary approach in highly disabled patients for whom effective treatment has been delayed. Early intervention in the subacute phase is recommended for prevention of long-term disability in patients with chronic pain.

Declarative and nondeclarative memory in schizophrenia: What is impaired? What is spared?

The study's aim was to assess a broad range of declarative and nondeclarative memory functions in schizophrenia to identify areas of impairment versus relative preservation. Participants included 40 schizophrenia outpatients and 30 demographically comparable community residents. All participants were administered a battery assessing declarative memory (verbal learning, working memory, semantic memory, remote memory, verbal retention) and nondeclarative memory (procedural learning, priming). To control for order effects, the battery was divided into three parts of approximately equal length with order of administration counterbalanced across study participants. The results showed persons with schizophrenia to be significantly impaired relative to community residents in verbal learning, working memory, semantic memory, remote memory, and priming. In contrast, the two groups were comparable in verbal retention and procedural learning. In the schizophrenia group, priming ability best discriminated past year's vocational status. In sum, the findings indicate a specific pattern of impairment and preservation of memory functioning in schizophrenia. Skill (procedural) learning and retention of learned, declarative verbal information across a delay appear intact, while all other areas measured appear impaired.

Factors associated with functional recovery in bipolar disorder patients

Among bipolar disorder (BPD) patients, functional recovery, defined as regaining individual premorbid residential and vocational status, is far less common than symptomatic recovery. As several factors have tentatively been implicated in outcomes in BPD, we investigated predictors of functional recovery among BPD patients, including demographic, clinical, and neurocognitive factors. We assessed functional recovery status with standardized residential and occupational indices, assessed neurocognitive functioning with performance-based neuropsychological tests, and collected demographic and clinical information for 65 euthymic or residually depressed Structured Clinical Interview for DSM-IV-defined type I or II BPD patients. We examined predictors of functional recovery with multiple logistic regression modeling. More education (p = 0.006), fewer years of illness (p = 0.037), and being married (p = 0.045) were associated independently with functional recovery, even after controlling for residual depressive symptoms, diagnostic type (I versus II), and psychiatric comorbidity. Functionally unrecovered BPD patients performed less well than recovered patients on verbal fluency (effect size = 0.54, p = 0.03), a measure of executive functioning, but this difference was not significant when adjusted for residual mood symptoms and education. Among euthymic or mildly depressed BPD patients, functional recovery was associated with more education, being married, and fewer years of illness.

Insertion sociale et professionnelle des jeunes adultes IMC. Intérêt de facteurs prédictifs dès l’enfance pour ajuster leur projet de vie

Introduction The aim of this study was to compare the real vocational and social outcome of a young adult CP population that was treated for 2 years at the Kerpape rehabilitation unit, with a retrospective insertion prognosis, taken from the analysis of their clinic record. Material and method Investigators first evaluated functional independence, social autonomy, years of education, and vocational status through a phone survey. A second group of investigators (independent from the first one), studied the medical clinic record assessment in order to determine the clinical type of cerebral palsy (CP). The prediction was based on their clinical judgment, using information about the diagnosis, type of involvement, functional status. Out of 120 selected patients, 43 were eventually included in this study. Results Type of CP: 36; 4% quadriplegia; 24.2, diplegia, 9.1% hemiplegia, 30.3% dyskinesia. Walking ability: 45.5 walking, 54.5% wheelchair. Complete independence: 36.4% for personal care, 18.2% for domestic life. Vocational assessment: 6.1% competitive employment, 6.1% sheltered, 78.8% unemployed, 3% studying. Social autonomy and vocational prediction was right in 72.7% of the cases. Discussion The Intellectual Quotient is the most reliable predictive factor for social and vocational outcomes. On the other hand, the functional independence and walking ability are less predictive for social autonomy prediction. Thus, a greater number of CP adults who are dependent in their everyday life could reach social autonomy. A shortfall in social ability darkens social insertion prognostic, and reduces their quality of life. For CP children, it should be useful to develop specific programs to improve their social ability, in addition to motor rehabilitation, and specific education.

Outcome analysis of occupational therapy programme for persons with early psychosis

This study examined the vocational outcomes of young persons with early psychosis after their participation in an occupational therapy program, and identified clinical or process variables that are linked to the vocational outcomes. A total of 147 clients, aged between 15 and 25, with early psychosis or schizophrenia participated in this study. A retrospective review of case management plans and outcomes was conducted. A survey form was designed to record demographic and clinical variables, and a follow-up telephone interview was conducted to monitor the vocational status of clients during the first three months after discharge. Although none of the clients had been engaged in work prior to participation in the programme, 53.7% could maintain a productive role in work (27.2%) or training/education (16.3%) in the three-month follow-up. Better mental condition and insight, stronger motivation for joining treatment, better social support, longer work history, and a shorter period of idleness before joining the programme, were significantly related to more favourable vocational outcomes. Older clients and those with more years of education were more likely to maintain a worker role. Parents were much more conservative about the future work plan than the clients themselves. Symptom management, work habit training, enrichment of the work experience, building social support and cultivation of insight into illness were important strategies related to the successful adoption of a productive role.

An Exploration of Social Cognitive Mechanisms, Gender, and Vocational Identity Among Eighth Graders

The authors conducted a multiple group path analysis examining gender differences in relations among career decision-making self-efficacy (CDMSE), career decision-making outcome expectations (CDMOE), and career decision-making intentions-goals (CDMIG), as well as linkages between these three sociocognitive variables and vocational identity status in a sample of 820 eighth graders. Overall, gender differences in mean levels of the sociocognitive variables were found, with girls scoring significantly higher on each variable. Results revealed model parameters varied across the groups, with stronger paths for boys than girls. Outcome expectations partially mediated the relation between CDMSE and CDMIG. Overall, CDMSE and CDMOE accounted for 30% and 45% of the variance in CDMIG for girls and boys, respectively. Moreover, linear combinations of sociocognitive variables explained differences among identity status groups. Participants with high CDMSE and CDMOE scores were more likely to have made a tentative career choice, whereas those with lower scores had not yet committed. Suggestions are provided for counseling younger adolescents as they begin to develop vocational identities.

Functional Outcome of Multiligamentous Knee Injuries Treated Arthroscopically in Active Duty Soldiers

To evaluate variables unique to our military population to determine whether we can be better predict functional outcome and return to duty of active duty military soldiers with multiligament knee disruption following arthroscopically assisted reconstruction. Twenty-four active duty Army personnel who underwent arthroscopically assisted reconstruction of multiple ligament disruption by the same surgeon were enrolled in this study. Postoperatively, a standardized knee joint questionnaire was administered and current vocational and recreational status was evaluated. Demographic data as well as military-specific factors to include rank, military occupation specialty, associated injuries, and retention on active duty were reviewed for these patients to determine their correlation with outcome. Overall, 13 (54%) remained on active duty following surgical reconstruction of their knee. There was a positive correlation between military rank and return to military duty. We were unable to correlate physical job demand to postinjury duty status. The Cincinnati Knee Ligament Rating Scale indicated that most soldiers were able to perform sports at "half speed", with "some limits" in daily living function scores. Arthroscopically assisted multiligament knee reconstruction enabled only a slight majority of active duty soldiers to return to duty following reconstruction and rehabilitation of this devastating injury.

Neuropsychological functioning as a predictor of employment activity in a longitudinal study of HIV-infected adults contemplating workforce reentry

Cognitive deficits are associated with HIV disease, and HIV-related cognitive deficits have been associated with declines in everyday functioning and vocational status. We administered a baseline neuropsychological (NP) test battery designed to assess estimated full-scale IQ, achievement, attention/concentration, executive function, language, mental speed, motor function, nonverbal memory, verbal memory, and visual-spatial function to a sample of 174 disabled, HIV-positive individuals enrolled in a randomized, controlled trial of a vocational-rehabilitation program. We then used these NP scores to predict employment at the end of participants' study participation, using both hierarchical multiple regression and ordinal logistic regression models. The hierarchical multiple regression analyses did not predict participants' employment activities at the end of study participation. In the ordinal logistic regression model, executive functioning weakly predicted employment status at the end of study participation and inspection of the predicted classifications revealed that 63% of the participants were incorrectly classified using this model. These results suggest that although predicting workforce reentry from NP testing may be statistically significant, NP testing may be of limited clinical value for informing the workforce reentry of disabled people with HIV who are interested in returning to work.

G.P.17.10 The educational and vocational status of muscular dystrophy patients

G.P.17.10 The educational and vocational status of muscular dystrophy patients

CE FEATURE: The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens

This paper reports on long term follow-up data-12 months post intervention-from a clinical trial of an intervention designed to enhance teen resilience by supporting the development of social skills needed to make positive connections and overcome the influence of negative environmental influences. Sixteen adolescents aged 12 to 16 (10 boys and 6 girls) attending an inner city urban secondary school participated in a 32 week intervention study. Subjects were randomly assigned within sex to Teen Club plus Positive Adolescent Life Skills (PALS) or Teen Club intervention groups. The Problem Oriented Screening Instrument for Teenagers (POSIT) was used to measure the dependent variables (problems related to substance use, health, mental health, family relations, peer relations, education status, vocational status, social skills, leisure and recreation, and aggression). The small sample size limited the ability to determine statistical differences between the POSIT subscale scores for PALS plus Teen Club or Teen Club only interventions. Descriptive data suggest mixed results for both interventions and sex groups. Most important were reductions in mental health problems for all boys in both groups and only slightly increased numbers of problems in substance use for PALS boys and girls over time. Other trends by group and sex are reported.

Income differentials on regional labour markets in Southwest Germany

The aim of our paper is to identify explanatory variables for income disparities between women and men across different regional types. Using data from the BA Employment Panel (BEP) descriptive statistics show that the gender pay gap grows wider from core regions to periphery. The main explanatory variables for the income differentials are vocational education in the men's case and size of enterprise in the women's case. Whereas in the case of women the importance of vocational status increases and the importance of size of enterprise decreases from rural areas to urban areas.