Employment status, employment functioning, and barriers to employment among VA primary care patients.
Employment status, employment functioning, and barriers to employment among VA primary care patients.
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VA 初级保健患者的就业状况、就业功能和就业障碍。
DOI：
10.1016/j.jad.2015.12.054
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发表时间：
2016
影响因子：
6.6
通讯作者：
Valenstein,Marcia
中科院分区：
文献类型：
--
作者：
Zivin,Kara;Yosef,Matheos;Levine,DebraS;Abraham,KristenM;Miller,ErinM;Henry,Jennifer;Nelson,CBeau;Pfeiffer,PaulN;Sripada,RebeccaK;Harrod,Molly;Valenstein,Marcia
背景先前的研究发现，使用退伍军人管理局的劳动年龄患者的就业率低于非退伍军人或不使用退伍军人的就业率，其中有精神障碍的退伍军人就业率最低。这项研究评估了在初级保健环境中接受治疗的退伍军人管理局患者的就业状况、就业功能和就业障碍，并检验了抑郁和焦虑与这些结果的关联。方法样本包括287名在中西部一家大型退伍军人医学中心接受初级保健治疗的退伍军人管理局患者。结果54%的被调查者有工作，36%的人没有工作，10%的人没有从事经济活动。在调整后的分析中，患有抑郁或焦虑的参与者(43%)不太可能找到工作，求职自我效能感较低，工作表现水平较低，报告的就业障碍更多。抑郁和焦虑与有工作的人失去工作的可能性或未就业的人找工作的可能性无关。限制单一的退伍军人初级保健诊所；横断面研究。讨论在处于工作年龄的退伍军人初级保健患者中，就业率很低，特别是那些有精神健康状况的患者。为患者提供解决心理健康问题、求职自我效能感和工作绩效的初级保健干预措施，对于改善健康、工作和经济结果可能很重要。
BackgroundPrior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes.MethodsThe sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans.Results54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed.LimitationsSingle VA primary care clinic; cross-sectional study.DiscussionEmployment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes.