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A medical/vocational case coordination system for persons with brain injury
MALEC JF; BUFFINGTON ALH; MOESSNER AM
ARCH PHYS MED REHABIL , 2000, vol. 81, n° 8, p. 1007-1015 Doc n°: 97047 Localisation : Documentation IRR Descripteurs : JK2 - READAPTATION PROFESSIONNELLE - HANDICAP, AF3 - TRAUMATISME CRANIEN
Article consultable sur : http://www.archives-pmr.org
Objective: To evaluate initial placement and 1-year employment outcomes of a Medical/Vocational Case Coordination System (MVCCS) for persons with brain injury (BI) that provides: (1) early case identification and coordination, (2) appropriate medical and vocational rehabilitation interventions, (3) work trials, and (4) supported employment interventions including job coaching. Participants: One hundred fourteen Minnesota residents, ages 18 to 65 years, with acquired BI. Main Outcome Measures: Outcome: Five levels of Vocational Independence Scale (VIS). Predictor: Preinjury employment status (VIS) and years of education, severity of initial injury, time since injury, current impairment/disability as measured by the Rasch-analyzed Staff Mayo-Portland Adaptability Inventory (MPAI), and impaired self-awareness measured by staff rating and the difference between Staff MPAI and Survivor MPAI. Results: At placement, 46% in independent work; 25% in transitional placements; 9% in long-term supported employment; 10% in sheltered work; and 10% not placed. At 1-year follow-up (n = 101); 53% in independent work; 19% in transitional placement; 9% in supported work; 6% in sheltered work; and 13% unemployed. Regression analyses showed time since injury and Rasch Staff MPAI predicted VIS at placement; only VIS at placement independently predicted VIS at 1-year follow-up; Rasch Staff MPAI and preinjury education level predicted time to placement. Conclusions: The MVCCS optimized vocational outcome after BI. Time since injury and impairment/disability best predicted vocational placement. Level of initial placement best predicted employment status at follow-up. Persons with greater disability required more extended time and more extensive rehabilitation services before placement. Langue : ANGLAIS Identifiant basis : 2000212972 |
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