Kukla Marina, Bond Gary R, Xie Haiyi
HSR&D Center of Excellence on Implementing Evidence-Based Practice, Richard L.Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
J Nerv Ment Dis. 2012 Mar;200(3):214-22. doi: 10.1097/NMD.0b013e318247cb29.
This study assessed the impact of steady competitive or noncompetitive employment on nonvocational outcomes for clients with severe mental illness receiving employment services. We conducted a secondary analysis of 2-year data for 187 clients participating in a randomized controlled trial comparing two employment programs. Participants were classified according to 2-year employment outcomes into four groups: steady competitive work, steady noncompetitive work, minimal work, and no work. We compared these groups on 2-year outcomes including symptoms, hospitalizations, quality of life, and social networks. During follow-up, working clients had fewer days of hospitalization than the no-work group. The steady competitive group had greater reduction in negative symptoms than did the no-work group. The steady noncompetitive group showed greater improvement in social networks compared with the other groups. Extended periods of work are associated with improvements in nonvocational outcomes. Beneficial effects may vary according to the type of employment.
本研究评估了稳定的竞争性或非竞争性就业对接受就业服务的重度精神疾病患者非职业结局的影响。我们对参与一项比较两种就业项目的随机对照试验的187名患者的两年数据进行了二次分析。根据两年的就业结局，参与者被分为四组：稳定的竞争性工作、稳定的非竞争性工作、极少工作和无工作。我们比较了这些组在两年结局方面的差异，包括症状、住院情况、生活质量和社交网络。在随访期间，有工作的患者住院天数少于无工作组。稳定的竞争性工作组的阴性症状减轻程度大于无工作组。与其他组相比，稳定的非竞争性工作组在社交网络方面有更大改善。较长时间的工作与非职业结局的改善相关。有益效果可能因就业类型而异。
