Cognitive remediation for vocational rehabilitation nonresponders
Cognitive remediation for vocational rehabilitation nonresponders
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对职业康复无反应者的认知矫正
DOI：
10.1016/j.schres.2016.04.045
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发表时间：
2016
影响因子：
4.5
通讯作者：
Rosemarie S Wolfe
中科院分区：
文献类型：
--
作者：
S. McGurk;K. Mueser;Haiyi Xie;K. Feldman;Yaniv Shaya;Leslie S Klein;Rosemarie S Wolfe
严重精神疾病（SMI）患者的认知修复会干扰工作，但很少有研究评估它对那些没有从职业服务中受益的人的影响。未从职业康复中受益的重度精神分裂症患者（83%）被随机分配到通过培训职业专家识别认知困难并提供与工作相关的认知应对策略（强化职业康复：E-VR）或类似的强化职业服务和认知补救（思维技能工作：TSW）来加强职业服务。在基线、治疗后（9个月）和随访（18个月）时评估认知和症状，每周跟踪工作3年。54名参与者随机分为E-VR组（N = 26）和TSW组（N = 28）。TSW的参与者在训练后的认知功能上比E-VR的参与者有更高的曝光率（89%），并且在认知功能上的改善比E-VR的参与者更多，在18个月的时候有所衰减。在为期3年的研究中，TSW和E-VR的参与者在竞争性工作（57%对48%）或有偿就业（61%对48%）方面没有显著差异，尽管TSW的参与者更有可能从事任何工作活动，包括有偿或志愿工作（75%对50%，p= 0.057），工作时间更长（23.04对48.82,p= 0.051），临床症状的改善也稍微多一些。在基线时，E-VR参与者的受教育程度明显高于TSW，这可能掩盖了TSW的影响。本研究支持认知补救对未从职业康复中获益的人的可行性和潜在益处。
Cognitive remediation in people with severe mental illnesses (SMI) that interfere with work, but less research has evaluated its effects in those who have not benefitted from vocational services. Participants with SMI (83% schizophrenia) who had not benefitted from vocational rehabilitation were randomized to vocational services enhanced by training vocational specialists in recognizing cognitive difficulties and providing job-relevant cognitive coping strategies (Enhanced Vocational Rehabilitation: E-VR), or similarly enhanced vocational services and cognitive remediation (Thinking Skills Work: TSW). Cognition and symptoms were assessed at baseline, post-treatment (9 months), and follow-up (18 months), with work tracked weekly for 3 years. Fifty-four participants were randomized to E-VR (N = 26) or TSW (N = 28). Participants in TSW had high rates of exposure to the program (89%) and improved more than those in E-VR on cognitive functioning post-training, with attenuation of some gains at the 18-months. Participants in TSW and E-VR did not differ significantly in competitive work (57% vs. 48%) or paid employment (61% vs. 48%) over the 3-year study, although those in TSW were more likely to be engaged in any work activity, including paid or volunteer work (75% vs. 50%,p= 0.057), and had more weeks of work activity (23.04 vs. 48.82,p= 0.051), and improved marginally more on the clinical symptoms. The significantly higher education level of participants in E-VR than TSW at baseline may have obscured the effects of TSW. This study supports the feasibility and potential benefits of cognitive remediation for persons who have not benefited from vocational rehabilitation.
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影响因子：
17.7
作者：
Gold, JM;Goldberg, RW;Lehman, AF
通讯作者：
Lehman, AF
影响因子：
17.7
作者：
McGurk, Susan R.;Mueser, Kim T.;McHugo, Gregory J.
通讯作者：
McHugo, Gregory J.
影响因子：
12.8
作者：
Kurtz, Matthew M.
通讯作者：
Kurtz, Matthew M.
影响因子：
6.6
作者：
Mueser, KT;Salyers, MP;Mueser, PR
通讯作者：
Mueser, PR
DOI：
10.4088/jcp.12m07686
发表时间：
2012-09
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
Twamley EW;Vella L;Burton CZ;Heaton RK;Jeste DV
通讯作者：
Jeste DV