Supported Employment for Veterans With Traumatic Brain Injury: Provider Perspectives
Supported Employment for Veterans With Traumatic Brain Injury: Provider Perspectives
复制标题
DOI：
10.1016/j.apmr.2017.06.029
复制
发表时间：
2018-02-01
影响因子：
4.3
通讯作者：
Resnick, Sandra G.
中科院分区：
文献类型：
--
作者：
Pogoda, Terri K.;Carlson, Kathleen F.;Resnick, Sandra G.
目的：确定试点和非试点地区在目前(1)向创伤性脑损伤（TBI）退伍军人提供支持就业（SE）方面的差异；(2) SE与多发创伤/TBI团队之间的人员配置和沟通；(3)提供者对提供社会服务的促进因素和障碍的看法，以及改善社会服务的建议。设计：混合方法横断面调查研究。背景：退伍军人健康管理局SE项目。调查对象：调查对象144人，其中SE主管54人，职业康复专家90人。干预措施：不适用。主要结果测量：基于网络的强迫选择调查和开放式项目调查，包括心理服务团队特征、与多发创伤/TBI团队的沟通以及为有TBI病史的退伍军人提供心理服务的经验。结果：为TBI退伍军人提供SE的试验点为100%，非试验点为59.2% （P= 0.09）。然而，试验点的职业康复专家报告说，与非试验点相比，与多发创伤/TBI团队就SE转诊进行沟通的频率更高（P= 0.003）。在开放式项目中，对于改善SE的建议在试点和非试点地点是相似的，包括增加职业康复专家和病例管理的人员配备，加强SE和多重创伤/TBI团队之间的沟通和教育，扩大SE项目的范围，使资格基于就业支持需求，而不是基于诊断。结论：本研究结果可为有就业支持需求的创伤性脑损伤退伍军人的服务提供、资源分配、团队整合工作和外联工作提供证据基础。由爱思唯尔公司代表美国康复医学大会出版
Objective: To identify any pilot and nonpilot site differences regarding current (1) provision of supported employment (SE) to veterans with traumatic brain injury (TBI); (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE.Design: Mixed methods cross-sectional survey study.Setting: Veterans Health Administration SE programs.Participants: Respondents (N=144) included 54 SE supervisors and 90 vocational rehabilitation specialists.Interventions: Not applicable.Main Outcome Measures: Web-based surveys of forced-choice and open-ended items included questions on SE team characteristics, communication with polytrauma/TBI teams, and experiences with providing SE to veterans with TBI history.Results: SE was provided to veterans with TBI at 100% of pilot and 59.2% of nonpilot sites (P=.09). However, vocational rehabilitation specialists at pilot sites reported that communication with the polytrauma/TBI team about SE referrals was more frequent than at nonpilot sites (P=.003). In open-ended items, suggestions for improving SE were similar across pilot and nonpilot sites, and included increasing staffing for vocational rehabilitation specialists and case management, enhancing communication and education between SE and polytrauma/TBI teams, and expanding the scope of the SE program so that eligibility is based on employment support need, rather than diagnosis.Conclusions: These findings may contribute to an evidence base that informs SE research and clinical directions on service provision, resource allocation, team integration efforts, and outreach to veterans with TBI who have employment support needs. Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine