Bond Gary R, Drake Robert E
Department of Psychology, Indiana University Purdue University Indianapolis, Indiana 46202, USA.
Curr Opin Psychiatry. 2008 Jul;21(4):362-9. doi: 10.1097/YCO.0b013e328300eb0e.
Recently published studies examining predictors of competitive employment for patients with schizophrenia are reviewed.
Researchers continue to examine predictors of employment among three types of variables: patient characteristics, environmental factors, and interventions. Provision of supported employment is the strongest predictor of competitive employment in this population, while patient predictors continue to show modest associations with outcomes. Environmental factors, including societal and cultural influence, local economy, labor laws, disability policies, and governmental regulations, are presumed to have major influences on employment, but these factors have been little studied.
Given the strong and consistent evidence base for the effectiveness of supported employment in helping individuals with schizophrenia achieve competitive employment, mental health planners should make access to this practice a high priority. Barriers to implementation of supported employment, including finance, organization, integration, training, and supervision, need to be systematically addressed. The field currently lacks an adequate understanding of the role of societal, cultural, and regulatory factors in facilitating and hindering employment outcomes; such research is much needed.
对近期发表的关于精神分裂症患者竞争性就业预测因素的研究进行综述。
研究人员继续从三类变量中考察就业的预测因素：患者特征、环境因素和干预措施。提供支持性就业是该人群竞争性就业最强的预测因素，而患者相关预测因素与结果的关联仍较为有限。环境因素，包括社会和文化影响、当地经济、劳动法、残疾政策及政府法规，被认为对就业有重大影响，但这些因素的研究较少。
鉴于支持性就业在帮助精神分裂症患者实现竞争性就业方面有强有力且一致的证据基础，心理健康规划者应将获得这种实践作为高度优先事项。支持性就业实施过程中的障碍，包括资金、组织、整合、培训和监督等，需要系统地加以解决。该领域目前对社会、文化和监管因素在促进和阻碍就业结果方面的作用缺乏充分理解；此类研究非常必要。
