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美国脑瘫成年人的职业康复服务和就业结果。

Vocational rehabilitation services and employment outcomes for adults with cerebral palsy in the United States.

机构信息

Graduate Institute of Rehabilitation Counseling, National Changhua University of Education, Changhua City, Taiwan.

出版信息

Dev Med Child Neurol. 2013 Nov;55(11):1000-8. doi: 10.1111/dmcn.12224. Epub 2013 Aug 8.

Abstract

AIM

The aim of this study was to examine the relationship between vocational rehabilitation services provided and work outcomes among people with cerebral palsy (CP), taking in to account demographic characteristics.

METHOD

From the US Department of Education Rehabilitation Service Administration Case Service Report (RSA-911) database, data from 3162 individuals with CP (1820 males [57.6%] and 1342 females [42.4% age range 16-54 y) whose cases were closed in 2009, were used in this study. A total of 1567 cases (49.6%) were closed with clients being categorized as 'successful employment' and 1595 cases (50.4%) were closed with clients being classified as unemployed.

RESULTS

Multivariate logistic regression was used to examine the relationship between services provided and work outcomes with regard to demographic characteristics. Males aged between 26 and 54 years old with higher education attainment were more likely to be employed. Individuals receiving disability benefits were less likely to be employed. After controlling for the effect of demographic and work disincentive variables, five vocational rehabilitation services significantly predicted employment outcomes (p<0.05), including (1) on-the-job training; (2) job placement assistance; (3) on-the-job support; (4) maintenance services; and (5) rehabilitation technology.

INTERPRETATION

Medical and health professionals need to be aware of vocational rehabilitation agencies as a resource for providing medical, psychological, educational, and vocational interventions for adults with CP to help them maximize their employability, to address their much needed work adjustment skills, to establish independent living, and to eventually reach their full potential in participation in society.

摘要

目的

本研究旨在考察为脑瘫患者(CP)提供的职业康复服务与工作结果之间的关系,同时考虑到人口统计学特征。

方法

本研究使用了美国教育部康复服务管理局案例服务报告(RSA-911)数据库中的数据,该数据库包含了 2009 年结案的 3162 名 CP 患者(1820 名男性[57.6%]和 1342 名女性[42.4%],年龄在 16-54 岁之间)的数据。共有 1567 例(49.6%)以客户“成功就业”为分类结案,1595 例(50.4%)以客户“失业”为分类结案。

结果

采用多变量逻辑回归分析,根据人口统计学特征,考察了服务提供与工作结果之间的关系。年龄在 26-54 岁之间、受教育程度较高的男性更有可能就业。领取残疾津贴的人就业的可能性较低。在控制了人口统计学和工作抑制变量的影响后,有五项职业康复服务显著预测了就业结果(p<0.05),包括(1)在职培训;(2)工作安置协助;(3)在职支持;(4)维持服务;和(5)康复技术。

结论

医疗保健专业人员需要意识到职业康复机构是一个资源,可以为 CP 成年人提供医疗、心理、教育和职业干预,帮助他们最大限度地提高就业能力,解决他们急需的工作调整技能,建立独立生活,并最终充分发挥他们在参与社会中的潜力。

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