Ottomanelli Lisa, Goetz Lance L, Barnett Scott D, Njoh Eni, Dixon Thomas M, Holmes Sally Ann, LePage James P, Ota Doug, Sabharwal Sunil, White Kevin T
Veterans Affairs Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans' Hospital, Tampa, FL; Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL.
Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
Arch Phys Med Rehabil. 2017 Aug;98(8):1567-1575.e1. doi: 10.1016/j.apmr.2016.12.010. Epub 2017 Jan 20.
To determine the effects of a 24-month program of Individual Placement and Support (IPS) supported employment (SE) on employment outcomes for veterans with spinal cord injury (SCI).
Longitudinal, observational multisite study of a single-arm, nonrandomized cohort.
SCI centers in the Veterans Health Administration (n=7).
Veterans with SCI (N=213) enrolled during an episode of either inpatient hospital care (24.4%) or outpatient care (75.6%). More than half the sample (59.2%) had a history of traumatic brain injury (TBI).
IPS SE for 24 months.
Competitive employment.
Over the 24-month period, 92 of 213 IPS participants obtained competitive jobs for an overall employment rate of 43.2%. For the subsample of participants without TBI enrolled as outpatients (n=69), 36 obtained competitive jobs for an overall employment rate of 52.2%. Overall, employed participants averaged 38.2±29.7 weeks of employment, with an average time to first employment of 348.3±220.0 days. Nearly 25% of first jobs occurred within 4 to 6 months of beginning the program. Similar employment characteristics were observed in the subsample without TBI history enrolled as outpatients.
Almost half of the veterans with SCI participating in the 24-month IPS program as part of their ongoing SCI care achieved competitive employment, consistent with their expressed preferences at the start of the study. Among a subsample of veterans without TBI history enrolled as outpatients, employment rates were >50%. Time to first employment was highly variable, but quite long in many instances. These findings support offering continued IPS services as part of ongoing SCI care to achieve positive employment outcomes.
确定一项为期24个月的个人安置与支持（IPS）支持性就业（SE）计划对脊髓损伤（SCI）退伍军人就业结果的影响。
对单臂、非随机队列的纵向观察性多中心研究。
退伍军人健康管理局的SCI中心（n = 7）。
在住院治疗（24.4%）或门诊治疗（75.6%）期间登记的SCI退伍军人（N = 213）。超过一半的样本（59.2%）有创伤性脑损伤（TBI）病史。
为期24个月的IPS SE。
竞争性就业。
在24个月期间，213名IPS参与者中有92人获得了竞争性工作，总体就业率为43.2%。对于作为门诊患者登记的无TBI的参与者子样本（n = 69），36人获得了竞争性工作，总体就业率为52.2%。总体而言，就业参与者的平均就业时间为38.2±29.7周，首次就业的平均时间为348.3±220.0天。近25%的第一份工作在项目开始后的4至6个月内获得。在作为门诊患者登记的无TBI病史的子样本中观察到类似的就业特征。
作为正在进行的SCI护理的一部分，参与为期24个月IPS计划的几乎一半SCI退伍军人实现了竞争性就业，这与他们在研究开始时表达的偏好一致。在作为门诊患者登记的无TBI病史的退伍军人子样本中，就业率超过50%。首次就业时间差异很大，但在许多情况下相当长。这些发现支持将持续的IPS服务作为正在进行的SCI护理的一部分提供，以实现积极的就业结果。
