Reker T, Eikelmann B, Schonauer K, Folkerts H
Klinik für Psychiatrie, Universität Münster.
Psychiatr Prax. 1998 Mar;25(2):76-82.
Vocational rehabilitation of mentally ill patients is now focused outside the psychiatric hospital. Three types of programmes play a major role: outpatient work therapy programmes at psychiatric hospitals, jobs in (partly) sheltered employment facilities as in companies specially adapted for employing mentally ill persons, and workshops for the mentally disabled. In the north-western German region of Westphalia-Lippe (population: 9 million) we carried out a three-year prospective study on a regionally representative sample from such rehabilitation institutions to assess the course and outcome of vocational rehabilitation. The sample comprised 295 men and 176 women with a mean age of 36.1 year (+/- 9.6). The majority were chronically ill patients with a history of frequent long-term hospitalisation. 61% of all probands were suffering from schizophrenic disorders. The outcome of vocational rehabilitation differs substantially among the three programme types, primarily due to varying baseline conditions, subjective expectations or goals, and courses of illness. The programmes are not alternatives but should be seen as supplementary components of a care system which has to meet a wide range of patient requirements. Vocational integration into the open labour market is a desirable and realistic objective for only some of those concerned.
精神病患者的职业康复目前集中在精神病院之外。有三种类型的项目发挥着主要作用：精神病院的门诊工作治疗项目、（部分）庇护性就业设施中的工作，如在专门为雇佣精神病患者而改造的公司里工作，以及为精神残疾者设立的工坊。在德国西北部的北莱茵-威斯特法伦州利珀地区（人口：900万），我们对这些康复机构中具有区域代表性的样本进行了一项为期三年的前瞻性研究，以评估职业康复的过程和结果。样本包括295名男性和176名女性，平均年龄为36.1岁（±9.6岁）。大多数是慢性病患者，有频繁长期住院的病史。所有被调查者中有61%患有精神分裂症。职业康复的结果在这三种项目类型中差异很大，主要是由于基线条件、主观期望或目标以及病程各不相同。这些项目并非相互替代，而应被视为一个护理系统的补充组成部分，该系统必须满足患者的广泛需求。对于部分相关人员来说，融入公开劳动力市场是一个理想且现实的目标。
