一个提高重度脑损伤后重返工作的职业干预:一个务实的试验试验
Grahame K Simpson1, Philippa McRae2, Thomas M Gates3
1Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia; Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW, Australia.
与标准护理相比,职业干预计划 (VIP) 显著改善了严重脑损伤患者返回工作的情况. 这种伙伴关系模式显示出增强职业康复服务的前景.
科学领域:
- 神经康复疗法 神经康复疗法
- 职业康复 职业康复 职业康复
- 公共卫生 公共卫生
背景情况:
- 严重获得性脑损伤 (ABI) 与低回归工作率有关.
- 职业干预计划 (VIP) 是为了支持ABI后的竞争性就业而制定的.
- VIP是澳大利亚新南威尔士州社区康复中心和外部职业教育提供商之间的合作伙伴关系.
研究的目的:
- 评估VIP合作伙伴模式的有效性.
- 将VIP结果与基于健康的职业康复中心 (H-VR) 和通常的治疗 (TAU) 进行比较.
主要方法:
- 一个三臂,非随机的受控试验,涉及12个成人康复中心.
- 干预武器:VIP (社区中心+外部提供者),H-VR和TAU.
- 收集的数据:竞争性就业地位,残疾和参与度评级,干预前,干预后和3个月后续.
- 分析:多层次模型,以评估治疗手臂随时间的变化.
主要成果:
- 有148名患有严重ABI的人参与了这项研究 (VIP:75,H-VR:33,TAU:40).
- 与TAU相比,VIP和H-VR从干预前到干预后的返回工作率显著更高 (P=0.0002).
- 在VIP和H-VR手臂与TAU (P<0.05) 中观察到更好的工作参与和独立生活技能,在随访时保持.
结论:
- 该VIP模型有效地改善了对竞争性就业的回报,与专业H-VR.相比.
- 更广泛地采用VIP模式可以显著提高重度ABI患者的职业康复服务.
- 贵宾模式提供了一个可扩展的解决方案,以改善脑损伤后的就业结果.
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