“Placement Budgets” for Supported Employment—Impact on Quality of Life in a Multicenter Randomized Controlled Trial

Frontiers in Psychiatry

Wolfram Kawohl¹  Michael P. Hengartner²  Nicolas Rüsch³  Carlos Nordt⁵  Wulf Rössler⁶  Helene Haker⁷ 

[1] Department for Psychiatry and Psychotherapy, Psychiatric Services Aargau, Brugg, Switzerland;Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland;Department of Psychiatry II, University of Ulm and BKH Günzburg, Günzburg, Germany;Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany;Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland;Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil;Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland;

关键词: psychiatric rehabilitation;    quality of life;    supported employment;    randomized trial;    severe mental disorder;   

DOI  :  10.3389/fpsyt.2018.00462

来源: DOAJ

【 摘 要 】

Background: Employment is an important aspect of psychiatric rehabilitation. The objective of this analysis was to explore how quality of life (QoL) may affect the outcome of supported employment and vice versa.Methods: A total of 116 participants with severe mental disorders were randomly assigned to either 25, 40, or 55 h placement budgets, which comprises job coaches' time resources to support a client in finding a job. The intervention followed the individual placement and support model and lasted up to 36 months. Primary outcome was employment in the first labor market for at least 3 months. QoL was assessed 7 times over the entire 36-months observation period using the WHO QoL Bref, which comprises the dimensions physical health, psychological, social relationships, and environment.Results: The three placement budgets did not differentially relate to QoL, but QoL environment showed a significant increase over time across all three groups. Baseline QoL environment weakly predicted subsequent obtainment of employment (F = 4.08, df = 1, p = 0.046, Cohen's d = 0.39). Controlling for baseline QoL, those participants who obtained a job, as compared to those who did not, showed persistent increases in QoL physical health (b = 0.39, p = 0.002, Cohen's d = 0.50) and QoL psychological (b = 0.40, p < 0.001, Cohen's d = 0.47).Conclusion: Obtaining employment in the first labor market improves patients' QoL. Supported employment is a valuable intervention that may benefit patients with severe mental disorder.

【 授权许可】

Unknown