Cotner Bridget A, Ottomanelli Lisa, O'Connor Danielle R, Njoh Eni N, Barnett Scott D, Miech Edward J
VA HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, Tampa, Florida.
Department of Anthropology, University of South Florida, Tampa, Florida.
Top Spinal Cord Inj Rehabil. 2018 Fall;24(4):325-335. doi: 10.1310/sci17-00046. Epub 2018 May 3.
Individual Placement and Support (IPS) is an evidence-based practice that helps persons with mental and/or physical disabilities, including spinal cord injury, find meaningful employment in the community. While employment is associated with positive rehabilitation outcomes, more research is needed on the impact of IPS participation on non-vocational outcomes, particularly quality of life (QOL). : To identity QOL outcomes experienced with (1) IPS participation and (2) IPS participation leading to employment. Using a mixed method design, data on quality of life outcomes were collected from 151 interviews and 213 surveys completed by veterans with SCI participating in IPS. At 12 months, participants who obtained competitive employment (CE) and those who did not (no-CE) showed improvement on most measures. In months 12-24, the CE group showed improvements on all study measures while the no-CE group declined on many indices. Statistically significant changes were observed between participants who obtained CE versus no-CE on several measures. Themes were identified from interview data related to productivity and well-being. Productivity themes were (1) contributing to society, (2) earning an income, and (3) maintaining employment. Themes for well-being were (1) mental health/self-confidence, (2) physical health, and (3) goal setting. Themes were associated with IPS participation irrespective of employment outcomes. IPS participants who were competitively employed report consistent improvement in handicap, health-related QOL, and life satisfaction measures across time. Qualitative findings revealed improved QOL outcomes in productivity and well-being for veterans participating in IPS overall, regardless of employment outcomes.
个体安置与支持(IPS)是一种循证实践,可帮助患有精神和/或身体残疾(包括脊髓损伤)的人在社区中找到有意义的工作。虽然就业与积极的康复结果相关,但关于参与IPS对非职业结果,特别是生活质量(QOL)的影响,仍需要更多研究。目的是确定(1)参与IPS和(2)参与IPS并实现就业所经历的生活质量结果。采用混合方法设计,从151次访谈和213份调查问卷中收集了参与IPS的脊髓损伤退伍军人的生活质量结果数据。在12个月时,获得竞争性就业(CE)的参与者和未获得竞争性就业(无CE)的参与者在大多数指标上都有所改善。在12至24个月期间,CE组在所有研究指标上都有所改善,而无CE组在许多指标上有所下降。在几项指标上,获得CE与未获得CE的参与者之间观察到了具有统计学意义的变化。从与生产力和幸福感相关的访谈数据中确定了主题。生产力主题为:(1)对社会做出贡献;(2)赚取收入;(3)维持就业。幸福感主题为:(1)心理健康/自信;(2)身体健康;(3)目标设定。无论就业结果如何,这些主题都与参与IPS相关。获得竞争性就业的IPS参与者报告称,随着时间的推移,他们在残疾、与健康相关的生活质量和生活满意度指标上持续改善。定性研究结果表明,总体而言,参与IPS的退伍军人在生产力和幸福感方面的生活质量有所改善,无论就业结果如何。