MEANING OF WORK FOR YOUNG ADULTS WITH SCHIZOPHRENIA

为患有精神分裂症的年轻人提供的职业康复和辅助就业服务并没有产生令人鼓舞的就业率。尽管提供康复服务并通过了《美国残疾人法》(1990)，但劳动力参与率一直低于25%。先前的研究表明，药物、心理社会服务、就业政策、家庭和社会支持以及就业史有助于重新就业，但竞争性就业率仍然很低。大样本研究并不能完全帮助理解重返工作的复杂现象；因此，本研究将从一个小的工作中竞争性地分析个别主题。还将分析症状和受试者变量的其他横断面数据，解释什么能使人重返工作场所的因素没有得到很好的定义。这项定性和定量相结合的研究将重点放在职场成功的多个前置因素上，而不是将先前的工作作为重新进入工作岗位的单一预测因素。从个人的角度了解工作领域(即工作动机、内部和外部资源)将有助于了解有关信念、价值观和工作能力、康复服务的贡献以及工作空间支持的利用。定性研究作为研究的主要方法，特别适合回答这一研究问题。20名健康状况稳定的年轻人，他们有一系列病前工作史，目前正在竞争或寻找工作，将在三个一个半小时的会议上接受采访。通过半结构化访谈获得的对工作的叙述性描述将包括一个基于文本的数据库，在其中可以利用扎根的理论原则进行严格的分析，这些原则将证明数据对新兴理论的充分性、可信度和适当性。这项研究的重要影响包括将个人的独特视角与职业康复服务的设计和提供的现有知识联系起来，包括病例管理，这是以前的研究没有涉及到的。新出现的访谈主题集中在动机领域，这一领域甚至没有被先前的研究所捕捉到。紧急访谈的主题集中在动机、病前工作经历、症状对工作功能的影响、内部和外部资源、工作适应、生活质量和工作场所支持等领域，将有助于了解这一人群工作结果的异质性，并指导未来的研究。

Vocational rehabilitation and supported employment services for young adults with schizophrenia have not produced encouraging rates of employment. Labor force participation has been fixed at less than 25% despite rehabilitation services and passage of the Americans with Disabilities Act (1990). Prior studies indicate that medication, psychosocial services, employment policies, family and social support, and employment history contribute to work re-entry but rates of competitive employment still remain low. Large sample studies have not fully aided understanding of the complex phenomenon of return to work; therefore this study will analyze individual themes from a small working competitively. Additional cross-sectional data of symptom and subject variables will also be analyzed Factors that explain what enables return to the workplace are not well defined. Rather than focus on prior employment as a single predictor of work re-entry, this combined qualitative and quantitative study will focus on multiple antecedents of workplace success. Understanding the domains of work (i.e. motivation for work, internal and external resources) from an individual point of view will contribute knowledge about beliefs, values, and capacity for work, contributions of rehabilitation services, and utilization of workspace supports. Qualitative inquiry, as the principal methodology of the study, is uniquely suited to answer this research question. Twenty medically stabilized young adults with a range of pre-morbid work history who are currently working competitively or seeking work will be interviewed over three 1 1/2 hour sessions. The narrative description of work obtained through semi-structured interviews will comprise a text based data bank within which rigorous analysis can occur utilized grounded theory principals which will attest to the adequacy, trustworthiness, and appropriateness of the data to the emerging theory. Important implications for the study include bridging the unique perspective of the individual with the existing knowledge of design and delivery of vocational rehabilitation services, including case management, which have not been captured by prior studies. Emergent interview themes focused on the domains of motivation, which have not even captured by prior studies. Emergent interview themes focused on the domains of motivation, pre-morbid work experience, effects of symptoms on work functioning, internal and external resources, work accommodations, quality of life, and workplace supports will contribute to understanding the heterogeneity of work outcome for this population and guide future research.