Bedell Gary
Tufts University, Department of Occupational Therapy, Medford, MA 02155, USA.
Work. 2008;31(2):131-44.
To design and evaluate a pilot intervention to promote self-management skills and work transition for persons with HIV/AIDS. The seven-week group intervention consisted of 1.5-hour bi-weekly sessions focused on goal setting and developing strategies to manage health, work and daily life routines while participating in a job skills training program in New York City.
Six successive groups received the intervention over the course of two years (n = 53). Existing and newly-developed measures were used to examine key outcomes. Differences between pre-intervention and post-intervention scores on outcome measures were examined using paired-tests and effect sizes. Employment outcomes and participant satisfaction were examined post-intervention.
The intervention was feasible to implement and sessions were viewed favorably by the majority of participants. Moderate to large effect sizes were found immediately post-intervention in participants' perceived ability to work and balance health, work and daily life. Fifty two percent of the participants were working part or full time and 41% were actively searching for employment at three to five months follow-up. Small effect sizes demonstrating improved outcomes at follow-up were found in symptom severity, self-advocacy and medication adherence self-efficacy. Small effect sizes demonstrating a potential decrement in outcomes at follow-up were found in participants' need satisfaction and perceived symptom impact on work performance.
The results are promising, but further research is needed due to design limitations and the preliminary nature of the intervention and measures used. The potential decrement in outcomes might reflect a shift in participants' needs or view of how their health affected work performance and suggests that ongoing supports were needed post-intervention.
设计并评估一项试点干预措施，以提高艾滋病毒/艾滋病患者的自我管理技能并促进其工作过渡。为期七周的小组干预包括每两周一次、每次1.5小时的课程，重点是设定目标以及制定在参加纽约市职业技能培训项目期间管理健康、工作和日常生活的策略。
在两年时间里，六个连续的小组接受了干预（n = 53）。使用现有的和新开发的测量方法来检查关键结果。使用配对检验和效应量来检查干预前和干预后结果测量分数之间的差异。干预后检查就业结果和参与者满意度。
该干预措施实施起来可行，大多数参与者对课程评价良好。干预后立即发现参与者在工作以及平衡健康、工作和日常生活方面的感知能力有中等到较大的效应量。在三到五个月的随访中，52%的参与者从事兼职或全职工作，41%的参与者在积极寻找工作。在症状严重程度、自我维权和药物依从性自我效能方面发现随访时有小的效应量表明结果有所改善。在参与者的需求满意度以及感知症状对工作表现的影响方面发现随访时有小的效应量表明结果可能有所下降。
结果很有前景，但由于设计局限性以及所采用干预措施和测量方法的初步性质，还需要进一步研究。结果的潜在下降可能反映了参与者需求的变化或他们对健康如何影响工作表现的看法的转变，这表明干预后需要持续的支持。
