Adaptação transcultural e análise da confiabilidade da versão brasileira do questionário de reabilitação para o trabalho - WORQ / Cross-cultural adaptation and reliability analysis of the Brazilian version of the Work Rehabilitation Questionnaire (WORQ)

Resumo Introdução O Work Rehabilitation Questionnaire (WORQ) é um instrumento internacional baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliar a capacidade funcional em pessoas com deficiência para o trabalho. Objetivo Realizar adaptação transcultural e análise da confiabilidade para a população brasileira. Métodos A adaptação transcultural consistiu em tradução, síntese das traduções, retrotraduções, análise do comitê de juízes, pré-teste e teste piloto. Os resultados foram obtidos pelo cálculo da taxa de concordância para equivalência semântica, idiomática, experiencial e conceitual. A confiabilidade foi testada por análise de estabilidade, equivalência e consistência interna por meio do cálculo de α-Cronbach e Coeficiente de Correlação Intraclasse (ICC). Resultados Participaram da primeira etapa 05 tradutores, 08 juízes e 14 possíveis usuários no pré-teste. A taxa de concordância foi menor que 90% apenas na equivalência idiomática, resultando em ajustes ortográficos sem alterar o construto do instrumento. A confiabilidade foi testada em 34 trabalhadores com deficiência, idade média de 40,3 (±4,2) anos, ambos os sexos, funcionários de uma instituição de ensino de São Paulo inseridos pela lei de cotas (8.213/91). A Consistência Interna apresentou valores superiores a 80% em todos os domínios e foi maior que 90% para o escore total. Após 15 dias da primeira avaliação, foram sorteados 20 desses participantes para reavaliação. O ICC para estabilidade foi 82,5% (p=0,008) e equivalência foi 95,4% (p<0,001). Conclusão O questionário WORQ foi traduzido e adaptado transculturalmente para o português brasileiro e apresentou confiabilidade para responder aos domínios da CIF. A versão brasileira está disponível na home page do WORQ, no endereço eletrônico http://www.myworq.org/questionnaire_en.php.

Abstract Introduction The Work Rehabilitation Questionnaire (WORQ) is an international instrument, based on the International Classification of Functioning, Disability and Health (ICF), used to assess the functional capacity of people with work disabilities. Objective To perform a cross-cultural adaptation and a reliability analysis of this instrument for the Brazilian population. Method The cross-cultural adaptation consisted of translation, synthesis of translations, back translations, analysis by the committee of judges, pre-test, and pilot test. The results were obtained by calculating the agreement rate for semantic, idiomatic, experiential, and conceptual equivalence. Reliability was tested by analysis of stability, equivalence, and internal consistency by calculating Cronbach's Alpha and Intraclass Correlation Coefficient (ICC). Results Five translators, eight judges, and 14 possible users in the pre-test participated in the first stage. The agreement rate was <90% only for idiomatic equivalence, resulting in orthographic adjustments without changing the instrument construct. The reliability was tested on 34 workers with disabilities, with a mean age of 40.3 (±4.2) years, of both sexes, employees of an educational institution in the state of São Paulo, Brazil, hired through the Quotas Law (8,213/91). The internal consistency showed values >80% in all domains and was >90% for the total score. Fifteen days after the first assessment, 20 of these participants were randomly selected for reassessment. The ICC values for stability and equivalence were 82.5% (p=0.008) and 95.4% (p<0.001), respectively. Conclusion The WORQ was translated and cross-culturally adapted to Brazilian Portuguese and reliably responded to the ICF domains. The Brazilian version of the WORQ is available at http://www.myworq.org/questionnaire_en.php.

Questionário de Reabilitação para o Trabalho (WORQ) aplicado a trabalhadores ativos - evidências de validade de constructo e de confiabilidade / Work Rehabilitation Questionnaire (WORQ) applied to active workers - construct validity and reliability evidence

Resumo Introdução: o Questionário de Reabilitação para o Trabalho (WORQ) foi criado para avaliação da funcionalidade de trabalhadores em reabilitação. Por ser abrangente, supõe-se que sua utilização é útil para avaliar trabalhadores ativos. Objetivo: avaliar a validade de constructo e a confiabilidade da versão autorrespondida do WORQ traduzida para o português brasileiro, para uso com trabalhadores ativos. Métodos: aplicou-se o WORQ em uma amostra aleatória de trabalhadores da Universidade Federal do Acre, no Brasil. Para validação de constructo, foram levantadas hipóteses e feitas correlações entre o WORQ e os instrumentos: WHOQOL-BREF, WHODAS, PHQ-9 e GAD-7. Para confiabilidade, foi utilizada a metodologia teste-reteste em subamostra (n=50) e posterior cálculo do coeficiente de Spearman. Para consistência interna, foi calculado o alfa de Cronbach. Resultados: participaram 241 trabalhadores, 50,2% do sexo feminino. O WORQ apresentou forte correlação com o WHODAS (r=0,782), moderada com o PHQ-9 e com a GAD-7 (r=0,68 e r=0,675) e moderada correlação inversa com o WHOQOL (r=-0,671). Foi obtido alfa de Cronbach de 0,95 e coeficiente de correlação de Spearman de 0,86. Conclusão: O WORQ apresentou evidências sugestivas de validade de constructo e de confiabilidade para uso com trabalhadores ativos, podendo sua utilização ser sugerida na triagem de incapacidades nesses trabalhadores.

Abstract Introduction: the Work Rehabilitation Questionnaire (WORQ) was created to assess the functioning and disability of workers undergoing rehabilitation. Since it is comprehensive, it is assumed that its use for a population of active workers can be useful. Objective: to evaluate the construct validity and the reliability of the self-reported WORQ translation to Brazilian Portuguese, in active workers population. Methods: we applied the WORQ to a random sample of workers from the Federal University of Acre, Brazil. For construct validation, we raised hypotheses and analised correlations between the WORQ and the instruments: WHOQOL-BREF, WHODAS, PHQ-9, and GAD-7. For assess reliability, we used the test-retest methodology in a sub-sample (n=50), followed by the calculation of the Spearman coefficient. For internal consistency, we calculated the Cronbach's alpha. Results: 241 workers participated, 50.2% female. The WORQ showed a strong correlation with WHODAS (r=0.782), moderate with PHQ-9 and GAD-7 (r=0.68 and r=0.675) and a moderate inverse correlation with WHOQOL (r=−0.671). We calculated a Cronbach´s' alpha of 0.95, and a Spearman's correlation coefficient of 0.86. Conclusion: the WORQ presented suggestive evidence of construct validity and reliability for use with active workers. Its use in screening for disabilities in these workers may be suggested.

Barreiras e facilitadores do retorno ao trabalho após traumas ortopédicos agudos em membros superiores: uma revisão integrativa da literatura / Barriers and facilitators to return to work post-acute orthopedic trauma in upper limbs: an integrative literature review

Resumo Introdução As lesões traumáticas de membro superior frequentemente levam ao afastamento do trabalho. Assegurar a manutenção do papel ocupacional de trabalhador compõe os objetivos do terapeuta ocupacional que atua na área de saúde do trabalhador, por meio de ações de prevenção e reabilitação. Nesse sentido, é importante conhecer os fatores que influenciam no retorno ao trabalho. Objetivo Documentar evidências sobre as barreiras e facilitadores para o retorno ao trabalho de pessoas que sofreram traumas agudos em membros superiores. Método Estudo de revisão bibliográfica pelo método de revisão integrativa. A busca foi realizada nas bases de dados da Biblioteca Virtual em Saúde (BVS), Scielo, Lilacs, Periódicos Capes e Pubmed. Foram pesquisados artigos publicados no período entre 2005 e 2015, escritos em português, inglês ou espanhol. Resultados A amostra final é composta de 13 artigos. Após a análise qualitativa, os resultados foram agrupados em quatro categorias temáticas para a verificação das barreiras e facilitadores correspondentes: Paciente, Lesão, Reabilitação e Trabalho. A gravidade da lesão, tempo de hospitalização, número de procedimentos cirúrgicos, inserção em programa de reabilitação, reabilitação voltada ao trabalho, suporte sócio familiar e no local de trabalho foram os principais elementos identificados. Conclusão O programa de reabilitação deve ser integrado e multidisciplinar com ações voltadas ao manejo da dor, recuperação funcional e preparo para o retorno ao trabalho. O suporte sócio familiar e no ambiente de trabalho sempre que possível devem ser considerados dentro do programa de reabilitação profissional para garantir o retorno ao trabalho.

Abstract Introduction Traumatic upper limb injuries often lead to work disability. Ensuring the maintenance of the worker occupational role is a goal for occupational therapists in occupational health, using prevention and rehabilitation techniques. Therefore, it is important to know the factors that influence return to work. Objective To document evidence of barriers and facilitators elements of return to work after acute upper limb trauma. Method A review study using the integrative review approach. The search included Biblioteca Virtual em Saúde (BVS), Scielo, Lilacs, Periódicos Capes and Pubmed databases. Articles that mentioned a return to work and upper limb trauma in their abstract, published between 2005 and 2015 and written in Portuguese, English or Spanish, were also used. Results The final sample consists of 13 articles, after qualitative analysis the results were grouped into four categories: Patient, Injury, Rehabilitation, and Work. Injury severity, hospitalization time, number of surgical procedures, insertion in a rehabilitation program, work-related rehabilitation, family and workplace support were the main elements identified. Conclusion The rehabilitation program should be integrated and multidisciplinary with actions aimed at pain management, functional recovery, and preparation for a return to work. Support family member and whenever possible work environment should be considered within the vocational rehabilitation program to ensure the return to work.

Vocational Rehabilitation for People with Intellectual Disability: Theoretical Framework, Approaches and Services / 中国康复理论与实践

Objective To establish the theoretical framework and approaches of services provision of vocational rehabilitation (VR) for people with intellectual disability (ID) to promote the decent employment of people with ID.Methods The employment difficulties of people with ID had been analyzed using ICF, and the content and the procedure of VR for people with ID had been explored.Results According to ICF, the employment difficulties of people with ID included functioning, barriers of employment and environmental factors. VR services for people with ID included assessment of employment barriers and vocational capacity, vocational counseling, vocational skill development and training, vocational guidance, support and assistance service, VR and politics development and research. The procedures of VR services for people with ID included assessing employment difficulties and vocational abilities, establishing employment setting and target, planning and implementing individualized VR program, and follow-up services.Conclusion It is necessary to use ICF to develop structured and individualized VR framework and approaches of VR for people with ID.

Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work / 中国康复理论与实践

Objective To apply the Baltimore Therapeutic Equipment (BTE), a kind of vocational training and evaluation system, in rehabilitaion of patients post traumatic upper extremity injury from work, and to observe the effects. Methods Inpatients from September, 2014 to August, 2015 for rehabilitation of traumatic upper extremity injury from work were selected as control group (n=42), and inpatients from September, 2015 to August, 2016 were selected as intervention group (n=36). Both groups received routine rehabilitation, while the control group received con-ventional work simulation training, and the intervention group received work simulation training with BTE, for four weeks. They were measured the standing lifting strength (elbow), squatting lifting strength, dynamic lifting strength (floor to waist), dynamic lifting strength (floor to shoulder), and grip strength of the injured hand and the healthy hand with BTE, before and after rehabilitation; while they were assessed with Disability of Arm Shoul-der and Hand (DASH). The incidence of return to work was investigated at six months of follow-up. Results The standing lifting strength (elbow) (t=4.290, P<0.001), squatting lifting strength (t=2.645, P=0.010), dynamic lifting strength (floor to waist) (t=2.639, P=0.010), dynamic lifting strength (floor to shoulder) (t=5.361, P<0.001), and grip strength of the injured hand (t=2.320, P=0.023) and the healthy hand (t=3.130, P=0.002) im-proved better in the intervention group than in the control group after rehabilitation. However, there was no sig-nificant difference between two groups in score of DASH (t=-0.851, P=0.398), as well as incidence of return to work (χ2=0.05, P=0.944). Conclusion BTE may help to improve the body function in patients post traumatic upper extremity injury from work. However, vocational rehabilitation should focus on the factors other than body function, to improve their return to work.

Reabilitação física e reabilitação profissional: uma reflexão sobre a interface clínica e intersetorial no tratamento terapêutico ocupacional de uma trabalhadora / Physical and vocational rehabilitation: a reflection on the clinical and intersectoral interface in occupational therapy of a worker

Introdução: Observa-se que, nas sociedades tecnológicas, bem como no mundo do trabalho, ocorre uma paulatina desvinculação entre o fazer e o saber humano, sendo que tal fenômeno expõe o trabalhador a riscos de acidentes/adoecimento pelo trabalho, que, uma vez ocorridos, acarretam danos físicos, psíquicos e sociais. Nesse sentido, a reabilitação do trabalhador vítima de acidente/adoecimento pelo trabalho, no que concerne à reinserção no trabalho, é de competência do Sistema Único Saúde, ao passo que a reabilitação profissional é de competência do Instituto Nacional de Seguridade Social. Objetivo: Relatar uma experiência sobre o contexto da reabilitação física em terapia ocupacional com interface clínica e intersetorial no processo de reabilitação profissional de uma paciente sobre o contexto da reabilitação física. Método: O artigo apresenta um Relato de Experiência cujo cenário dos atendimentos é o Ambulatório de Reabilitação Física em Terapia Ocupacional que constitui o Campo de Estágio da Área Física do Departamento de Terapia Ocupacional da Universidade Federal do Espírito Santo. Resultados: Os resultados demonstram que o processo de reabilitação profissional conduzido pelo INSS apresenta um caráter protocolar e de generalizações, bem como não dialoga com os outros setores envolvidos nesse processo, comprometendo sua eficácia junto ao beneficiário. Conclusão: Conclui-se que o contexto de reabilitação física em terapia ocupacional apresenta-se como um importante espaço de acolhimento das demandas relativas ao referido processo. Uma vez que proporciona tecnologias e dispositivos de escuta qualificada que corroboram com a superação das sequelas físicas, emocionais e sociais ocasionadas pelo acidente de trabalho.

Introduction: Technological societies, as well as the occupational field present a gradual disconnection between the doing and the human knowledge, and this phenomenon exposes the worker to the risk of occupational accidents/illness, which, once occurred, lead to physical, psychological and social damages. In this sense, the rehabilitation of the worker who is the victim of an occupational accident/illness, regarding reinsertion at work, is the responsibility of the Unified Health System, while professional rehabilitation falls within the competence of the National Institute of Social Security. Objective: To report an experience about the context of physical rehabilitation in occupational therapy with clinical and intersectoral interface in the process of professional rehabilitation of a patient on the context of physical rehabilitation. Method: The article shows an Experiential Report, whose attendance scenario is the Physical Rehabilitation Ambulatory in Occupational Therapy, which constitutes the Physical Area Training Field of the Occupational Therapy Department of the Federal University of Espírito Santo. Results: We show that the professional rehabilitation process conducted by INSS has a protocolary and generalized nature, as well as a lack of communication with the other sectors involved in this process, which compromises its effectiveness with the beneficiary. Conclusion: We conclude that the context of physical rehabilitation in occupational therapy presents itself as an important space of reception of the demands related to this process. It provides technologies and devices of qualified listening that corroborate with the overcoming of physical, emotional and social sequels caused by the occupational accident.

Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea / 정신신체의학

OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

Percepção dos usuários a respeito de um serviço de reabilitação profissional / Users' perception of a professional rehabilitation service

Resumo Introdução: a Reabilitação Profissional (RP) é um programa de intervenção estruturado para desenvolver atividades terapêuticas e de profissionalização, buscando a recuperação do potencial laborativo. Objetivo: identificar a percepção e os sentimentos de trabalhadores reabilitados ou em reabilitação a respeito do processo de RP, bem como descrever o perfil de saúde e afastamento desses trabalhadores. Métodos: estudo qualitativo, descritivo, realizado em uma autarquia municipal de saneamento básico com os funcionários participantes do Programa de Reabilitação Profissional (PRP). Foram realizadas onze entrevistas utilizando um instrumento semiestruturado. Para o tratamento dos dados utilizou-se a técnica de análise temática ou categorial. Resultados: identificaram-se nas entrevistas núcleos de sentido que, ao serem agrupados por suas similaridades, permitiram a formação de quatro categorias de análise: Impacto da doença e do afastamento do trabalho; Inefetividade do Programa de Reabilitação Profissional; Percepção quanto ao retorno ao trabalho; e Relacionamento com chefias e colegas. Conclusão: na perspectiva dos participantes, o processo de reabilitação evidencia os impactos da doença e do afastamento do trabalho, e revela a inefetividade do PRP. As dificuldades no retorno ao trabalho e no relacionamento com chefias e colegas foram apontados como fatores que influenciam a readaptação laboral.

Abstract Introduction: Vocational Rehabilitation (VR) is an intervention program structured to develop therapeutic and professionalization activities aiming at recoverying work ability. Objective: to identify the perceptions and feelings of rehabilitated or in rehabilitation workers about the VR process, as well as to describe their health and sick leave profiles. Methods: qualitative and descriptive study carried out with workers of a municipal basic sanitation public service, who had taken part in the Vocational Rehabilitation Program (VRP). Eleven interviews were conducted using a semi-structured instrument. The thematic or categorical analysis technique was used for data treatment. Results: we identified 4 categories of analysis: Disease and sick leave impact; Ineffectiveness of the Vocational Rehabilitation Program; Workers' perception regarding return to work; Relationship with heads and co-workers. Conclusion: in the participants' perspective, the rehabilitation process highlights the disease and sick leave impacts, and disclose the VRP ineffectiveness. Difficulties in returning to work and in the relationship with heads and co-workers were pointed out as factors that influence work rehabilitation.

A reabilitação profissional no INSS: caminhos da terapia ocupacional / Vocational rehabilitation at the National Social Security Institute: paths of occupational therapy

Este texto traz dados de uma pesquisa que objetivou identificar e compreender práticas e concepções delineadas pela terapia ocupacional no Serviço de Reabilitação Profissional no Instituto Nacional do Seguro Social (INSS), no estado de São Paulo. Compreende-se que a reabilitação profissional, que visa a proporcionar aos segurados os meios para reingresso no mercado de trabalho e que é atribuída oficialmente ao Ministério da Previdência Social, dialoga com a saúde, com a educação e com as políticas e ações de trabalho e emprego. Os dados foram coletados por meio de um questionário encaminhado às terapeutas ocupacionais do INSS no referido estado, bem como por entrevistas realizadas com parte delas, abordando temáticas que foram categorizadas para a análise do que relatam acerca de suas práticas e concepções, enfatizando pontos reflexivos sobre limites, possibilidades e desafios nessa atuação e ampliando a discussão para a estrutura do Serviço. É apontada uma série de fatores que implicariam uma avaliação mais negativa que positiva de sua atuação no Instituto, os quais estariam mais vinculados a questões estruturais do Serviço. Creem, todavia, na melhoria dessa estrutura, indicando a necessidade do incremento das possibilidades oferecidas, de uma maior participação e responsabilização por parte das empresas, da construção de um trabalho articulado com os demais setores governamentais e da sociedade civil, além da ampliação e da reformulação da legislação que trata da reabilitação profissional no Brasil.

This article presents data from a research that aimed to identify and understand the practices and concepts of occupational therapy in the Vocational Rehabilitation Program of the National Social Security Institute (INSS), in the state of São Paulo. Vocational rehabilitation aspires to provide means for workers to reenter the job market, being associated with health, education, and labor and employment. Data were collected through a questionnaire sent to occupational therapists, as well as through interviews with some of them. We discussed themes that were categorized to analyze their practices and concepts and highlighted topics that allowed us to reflect on the limits, possibilities and challenges faced by these workers, examining the structure of the program as well. A number of factors imply that their performance at the INSS is more negative than positive, which could be related to structural issues of the program. However, the therapists believe in improving its structure and point out the need to increase the possibilities offered, allowing for a greater participation and responsibility of companies, for more combined efforts with other government sectors and the civil society and for the expansion and reformulation of the Brazilian legislation on vocational rehabilitation.

Reliability and Validity of the Lam Assessment of Employment Readiness for Injured Workers / 中国康复理论与实践

@#Objective To measure the reliability and validity of the Lam Assessment of Stages of Employment Readiness (LASER) Putonghua version for injured workers, and observe the confidence of return to work on different preparation stages. Methods 85 injured workers with limb fractures were included. The data was obtained through face-to-face structured interview. The test-retest reliability and internal consistency were measured. Factor analysis was used to examine construct validity of the Putonghua version LASER. Results Principle component analysis extracted four factors, which was consistent with the original version of LASER. Intra- class correlation coefficient (ICC) of test-retest ranged 0.27~0.89, whereas the internal consistence among these 4 stages ranged 0.691~0.796. There were significantly differences in confident scores in different stages among 3 different confidence groups. Conclusion The structure validity of Putonghua version of LASER is useful for reflecting the readiness of injured workers' return to work. However, the reliability coefficient is rather low in some of the items, which could be resulted in incorrect judgment of readiness of return to work of injured workers. The further study on items correction and development is apparent.

Economia solidária e reabilitação vocacional no campo da drogadição: possibilidades e limites das práticas atuais / Cooperative work and vocational rehabilitation in the drug addiction treatment: opportunities and limitations of current practices

Este artigo visa a contribuir ao debate sobre as potencialidades do trabalho no processo de recuperação de dependentes químicos. Consideramos nesta análise os princípios subjacentes à reabilitação vocacional praticada no contexto internacional, seguido da descrição das diretrizes brasileiras para a inclusão social de dependentes químicos por meio do trabalho. Por fim, procedemos a uma análise comparativa das matrizes conceituais, dos conceitos de saúde subjacentes e do potencial emancipatório em ambas as perspectivas. O material consultado foi levantado por meio de revisão bibliográfica em bases de dados da área da saúde. Já as informações sobre as diretrizes brasileiras foram coletadas nas publicações oficiais disponibilizadas on-line pelo Ministério da Saúde e Ministério do Trabalho e do Emprego do Brasil. A análise do material permitiu-nos verificar que a reabilitação vocacional praticada em países da América do Norte e da Europa destina-se a usuários de serviços de saúde mental, procedendo à inclusão pelo viés da doença. Enfatiza a recolocação no mercado formal de trabalho, por meio de programas voltados ao treinamento de habilidades para obter e manter um posto de trabalho conquistado. Já as diretrizes do governo brasileiro estão pautadas nos princípios do cooperativismo e da economia solidária. Privilegia o ser humano como sujeito e finalidade maior da atividade econômica, focalizando as potencialidades e recursos do trabalho, em detrimento das limitações impostas pela doença ou pela condição socioeconômica que tenha gerado a situação de exclusão.

Effects of supported employment on vocational rehabilitation for schizophrenia patients:a randomized controlled study / 中华行为医学与脑科学杂志

Objective To investigate the effects of supported employment(SE) on the vocational rehabilitation for schizophrenic rehabilitants.Methods 108 schizophrenic rehabilitants with stable conditions were recruited and randomly allocated into the control group and experimental group.Fifty-four cases in the control group received the general outpatient service and follow-up service with drug maintenance therapy and 54 cases in the experimental group received SE with drug maintenance therapy.At the baseline and the end of the sixth month,all of the 108 cases were assessed by the Positive and Negative Syndrome Scale (PANSS) and Work-related Social Skills Scale (WSSS) respectively.The competitive employment rate and average working days of the two groups were evaluated at the end of the sixth month.Results There was no significant difference in the total score of WSSS,and the total score of PANSS and its sub-scores on the Positive Scale,Negative Scale and General Psychopathological Scale betweeu the two groups at the baseline(P＞ 0.05).At the cnd of the sixth months,significant differences (P＜0.01 ～ 0.05) were found in the total score of WSSS,the sub-score of the Negative Scale,the competitive employment rate and the average working days((35.11 ± 12.71) d vs(20.15 ± 8.04) d) between the experimental and control groups.Conclusion SE can increase the employment rate of schizophrenic rehabilitants,improve their abilities to acquire and maintain competitive employment,and meanwhile relieve their negative symptoms.

Factors Affecting Turnover Intention of People with Mentally Disabilities Working in Manufacturing Industry / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify turnover intentions in workers with mentally disabilities working in manufacturing industry. METHODS: Participants were 147 workers with mentally disabled living in B-city and Y-city. The data were collected from September 1st to November 30th, 2011 using self-report questionnaires including measurements of turnover intentions, family support, work volition, working environment, job satisfaction and internalized stigma. Data analysis was done using the SPSS/WIN 18.0 program. RESULTS: The average score for turnover intention was 2.9+/-0.7. Turnover intention was related to job satisfaction, working environment, family support and internalized stigma. The predicting factors for turnover intention were job satisfaction, internalized stigma and gender. Those factors accounted for 41.9% of turnover intention. CONCLUSION: The results imply that workers with mentally disabled need to reduce internalized stigma as well as to increase job satisfaction in order to decrease turnover intention.

The Factors Influence upon Job Maintenance of the Mentally Disabled with Job Experience / 한국직업건강간호학회지

PURPOSE: This study tried to explore factors influencing on job maintenance of the mentally disabled who employed before. The subjects of this study were the mentally disabled who participated in community mental health center and social rehabilitation center, there had experienced a job in the past. METHODS: The number of community centers were 27 places, there were located in different region. The number of participants were 221 persons agreed to this study. Data was analyzed by Mean, SD and logistic regression analyzation using SPSS/WIN 14.0. RESULTS: General character such as age was significant factor. Monthly pay and working a day in the midst of job related factors were significant. Moreover, job rehabilitation program satisfaction rate and social support revealed significant factors. CONCLUSION: On the basis of results, Job rehabilitation programs for job maintenance of the mentally disabled should be development and establish mediate strategies to improve social support to them.

Associated Factors of Job Satisfaction on Part-time Work of the Mentally Disabled / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the degree of satisfaction of part-time work of the mentally disabled and the factors affecting their job satisfaction. METHODS: The subjects of this study were 106 part-time workers with mental illness in the city of B and Y. The data were collected from February 1, 2012 to May 30, 2012 using self-report questionnaires including the measurement scales of job satisfaction, family support, work volition and the degree of satisfaction with work environment. The data were analyzed using t-test, ANOVA, Pearson correlation coefficients, multiple regression with the SPSS/WIN 18.0 program. RESULTS: The mean of score for job satisfaction was 61.8+/-13.84. Job satisfaction was highly related to family support, work environment and work volition. The associated factor of the subjects job satisfaction were family support, work environment, work volition, and the period of employment. The combination of these four factors showed an explanation for job satisfaction at the rate of 80.2%. CONCLUSION: The results imply that job satisfaction needs to be increased for the job continuity of employees with mental illness. In addition to this, work environment, work volition and family support should first be improved for the increase of job satisfaction.

Vida ocupacional de pacientes sobreviventes ao transplante de medula óssea: estudo exploratório / Occupational life of patients surviving a bone marrow transplantation: Exploratory study / Vida ocupacional de pacientes sobrevivientes a un transplante de médula ósea: Estudio exploratorio

O objetivo deste estudo prospectivo foi descrever a situação ocupacional de pacientes sobreviventes ao Transplante de Medula Óssea (TMO), comparando três grupos: G1 (até 18 meses após o TMO), G2 (de 19 a 48 meses após) e G3 (49 a 120 meses após). A amostra foi composta por 62 pacientes. Para a coleta de dados foram utilizados dois instrumentos: Questionário de Caracterização Sóciodemográfica e Clínica, e Questionário de Recuperação Pós-TMO. Os dados foram submetidos à análise de conteúdo temática. Os resultados mostram que os pacientes recém-transplantados (G1) enfrentaram mais dificuldades na retomada da vida produtiva, gerando tempo ocioso, déficit orçamentário e prejuízos no funcionamento social. Decorridos mais de quatro anos, apresentavam menos dificuldades na retomada do trabalho (G3). Constatou-se que muitos pacientes conseguiram se ajustar à nova realidade, formulando novos projetos ocupacionais. Os achados contribuem para embasamento da prática em reabilitação vocacional.

The aim of this prospective study was to describe the changes in the occupational status of 62 Bone Marrow Transplantation (BMT) survivors, comparing three groups: G1 (up to 18 months after the BMT), G2 (from 19 to 48 months after the BMT) and G3 (from 49 to 120 months after the BMT). To collect data we used two instruments: a Socio-demographic and Clinical Characteristics Survey and a Post-BMT Recovery Questionnaire. The data were submitted to thematic content analysis. The results showed that newly transplanted patients faced more difficulties reassuming productive lives, causing downtime, budget deficits and impairments in social functioning. Four years after BMT, they had less difficulties in reassuming work (G3). Nevertheless, it appears that many patients managed to adapt to their new reality, being able to design new occupational projects. The findings contribute to underpinning the practice in Vocational Rehabilitation in the field of Occupational Therapy.

El objetivo de este estudio prospectivo es el de describir la situación ocupacional de pacientes sobrevivientes al Transplante de Médula Ósea (TMO), comparando tres grupos: G1 (hasta 18 meses después del TMO), G2 (de 19 a 48 meses después) y G3 (49 a 120 meses después). La muestra se compuso de 62 pacientes. Para la recolección de datos se utilizaron dos instrumentos: Cuestionario de Caracterización Sociodemográfica y Clínica, y Cuestionario de Recuperación Pos-TMO. Los datos se sometieron al análisis de contenido temático. Los resultados muestran que los pacientes recién transplantados (G1) enfrentaron más dificultades para retomar la vida productiva, generando tiempo ocioso, déficit presupuestario y perjuicios en el funcionamiento social. Transcurridos más de cuatro años, presentaban menos dificultades al retomar el trabajo (G3). Se constató que muchos pacientes consiguieron ajustarse a la nueva realidad, formulando nuevos proyectos ocupacionales. Los hallazgos contribuyen al basamento de la práctica en Rehabilitación Vocacional en el dominio Terapia Ocupacional.

Experience of People Living with HIV Working as Caregivers for AIDS Patients / 정신간호학회지

PURPOSE: The purpose of this study was to investigate in-depth and to understand the experience of people living with HIV who work as caregivers for patients with AIDS. METHODS: Data were collected from December 2010 to April 2011 through focus group and in-depth interviews. Ten people with HIV who work as caregivers for patients with AIDS participated in the research. Data were analyzed using Colaizzi's method (1978). RESULTS: The results showed the important themes to be 'feelings of sympathy', 'burden of caregiving', 'identifying one's own self-worth' and 'hoping for a meaningful future'. People with HIV experienced deep empathy with patients with AIDS, and, even though they suffered physical and emotional distress from the caregiving process, they felt a sense of self-worth and found their existence connected with the world. Furthermore, they were taking more active care of themselves and hoping for a meaningful future. CONCLUSION: For successful social adaptation of people with HIV currently in job-seeking activities, various vocational rehabilitation services are necessary. The results of this study could be used in developing effective social support services for people living with HIV attempting workforce re-entry.

Effect of Vocational Rehabilitation and Related Factors in Adult Mental Retarded Persons in Beijing / 中国康复理论与实践

@#Objective To investigate the effect of vocational rehabilitation and related factors in adult mental retarded persons in Beijing.Methods 152 mental retarded adult persons were investigated with Scale of Vocational Rehabilitation Effective for Adult with Mental Retarda⁃ tion. Results 59 (38.82%) persons improved their vocational ability after rehabilitation. The related factors of vocational rehabilitation included the causes of mental retardation and maladaptive behavior. Conclusion It is important for the vacational rehabilitation that the consultants deal with the maladaptive behavior appropriately.

U.S. Rehabilitation Act： Its Enlightenment for China / 中国康复理论与实践

@#U.S. Rehabilitation Act is a important law for rehabilitation and employment with disability in USA. The development of the Act was elaborated, the characteristics and how to implement the Rehabilitation Act were analyzed to give some revelation in rehabilitation legislation in China.

Comparision on Work Fatigue between the Disabled and the Healthy / 中国康复理论与实践

@#Objective To investigate the status of work fatigue of the disabled and the healthy so that we get to know their employment quality and compressive strength, and then provide the theory basis for the national policy formulation and vocational rehabilitation. Methods We randomly investigated 280 employees (220 disabled, 60 healthy people) in 3 companies from 3 provinces with Fatigue Impact Scale (FIS). Results There was no statistically significant difference between disabled and healthy people about work fatigue, and also that of 3 domains including psycho-social, cognitive and physical activity. After comparison of 40 items on FIS，the disabled had higher fatigue than that of the healthy in 4 items which belonged to psycho-social domain (P<0.05). Conclusion Disabled people are no less than healthy people in compression capability and working capability. They should believe in themselves, and their family and the employees should have more confidence about their work capability than before. Government should provide some support with them on job retention.