Ottomanelli Lisa, Barnett Scott D, Goetz Lance L, Toscano Richard
VA HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital , Tampa, Florida ; Department of Rehabilitation and Mental Health Counseling, University of South Florida , Tampa, Florida.
VA HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital , Tampa, Florida ; VA HSR&D Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital , Tampa, Florida.
Top Spinal Cord Inj Rehabil. 2015 Winter;21(1):31-9. doi: 10.1310/sci2101-31.
Designing effective vocational programs for persons with spinal cord injury (SCI) is essential for improving return to work outcome following injury. The relationship between specific vocational services and positive employment outcome has not been empirically studied.
To examine the association of specific vocational service activities as predictors of employment.
Secondary analysis of a randomized, controlled trial of evidence-based supported employment (EBSE) with 12-month follow-up data among 81 Veteran participants with SCI.
Primary activities recorded were vocational counseling (23.9%) and vocational case management (23.8%). As expected, job development and employment supports were the most time-consuming activities per appointment. Though the amount of time spent in weekly appointments did not differ by employment outcome, participants obtaining competitive employment averaged significantly more individual activities per appointment. Further, for these participants, job development or placement and employment follow-along or supports were more likely to occur and vocational counseling was less likely to occur. Community-based employment services, including job development or placement and employment follow-along or supports as part of a supported employment model, were associated with competitive employment outcomes. Office-based vocational counseling services, which are common to general models of vocational rehabilitation, were associated with a lack of employment.
Vocational services that actively engage Veterans with SCI in job seeking and acquisition and that provide on-the-job support are more likely to lead to employment than general vocational counseling that involves only job preparation.
为脊髓损伤（SCI）患者设计有效的职业项目对于改善受伤后的重返工作结果至关重要。特定职业服务与积极就业结果之间的关系尚未得到实证研究。
研究特定职业服务活动作为就业预测因素的关联性。
对一项基于证据的支持性就业（EBSE）随机对照试验进行二次分析，该试验对81名患有SCI的退伍军人参与者进行了为期12个月的随访。
记录的主要活动是职业咨询（23.9%）和职业个案管理（23.8%）。正如预期的那样，每次预约中，职业发展和就业支持是最耗时的活动。虽然每次预约花费的时间在就业结果方面没有差异，但获得竞争性就业的参与者每次预约的个人活动平均显著更多。此外，对于这些参与者来说，职业发展或安置以及就业跟进或支持更有可能发生，而职业咨询则不太可能发生。作为支持性就业模式一部分的社区就业服务，包括职业发展或安置以及就业跟进或支持，与竞争性就业结果相关。职业康复一般模式中常见的基于办公室的职业咨询服务与就业不足相关。
与仅涉及就业准备的一般职业咨询相比，积极让患有SCI的退伍军人参与求职和就业并提供在职支持的职业服务更有可能带来就业。
