scholarly journals Occupational Participation of Persons with Schizophrenia: Exploring Issues of Job-Termination in Supported-Employment

2020 ◽  
Vol 1 (1) ◽  
pp. p1
Author(s):  
Cindy Niap ◽  
Abdul Kadir Abu Bakar ◽  
Siew Yim, Loh

Occupational participation in a supported-employment is a rehabilitation strategy to improve both vocational and non-vocational domains of people with psychiatric disabilities, enabling them to access and/or re-enter employment. This study aims to identify the factors associated with unsatisfactory job-termination among the participants of supported-employment to inform future intervention. A cross-sectional survey was conducted on a group (with a diagnosis of schizophrenia) who participated in a supported-employment program in a large psychiatry institution in Malaysia. Within the first week of job termination, interviews were conducted with three subgroups independently - the participants, the employers and the hospital employment specialists, using the Job-Termination Interview. Factors linked to job-termination and job-accommodation were analysed using univariate and multivariate logistic regression.Key reasons for job termination were- poor job performance (n = 32; 47.1%), interpersonal issue (n = 31; 45.6%), medical illnesses (n = 30, 44.1%), incompatibilities between work-schedule and environment (n = 30; 44.1%), and job-dissatisfaction (n = 29, 42.6%). Key factor for sustaining job/ job-accommodation was “higher pay” (n = 4; 33.3%). Overall, an unsatisfactory trend of job terminations was observed where many (n = 53; 77.9%) quit their job without a ready job at hand. Unsatisfactory job-terminations were associated with three factors -(i). Enrolment in the Individual Placement-Support (IPS) (Adj. OR = 10.70, 95% CI 1.32-86.98, p = 0.012), (ii). Unstable medical issues (Adj. OR = 22.51, 95% CI 1.74-291.08, p = 0.003), (iii). Interpersonal issues (OR = 18.26, 95% CI: 2.24-149.15, p < 0.001).Most participants terminated their jobs in an unsatisfactory manner (77.9%). A high 63.2 percent quit their job without another ready-job at hand, while 14.7 percent were fired. Unsatisfactory job-endings were correlated to, poor job-performance, interpersonal problems and medical illnesses. Occupational re-entry intervention program must be tailored to the individual levels and needs, and be fully integrated within the clinical system to ensure job-person-environment fit, in order to improve job-experience and to lower unfavourable job terminations.

2019 ◽  
Author(s):  
Francesco Brigo ◽  
Simona Lattanzi ◽  
Giorgia Giussani ◽  
Laura Tassi ◽  
Nicola Pietrafusa ◽  
...  

BACKGROUND The Internet has become one of the most important sources of health information, accessed daily by an ever-growing number of both patients and physicians, seeking medical advice and clinical guidance. A deeper insight into the current use of the Web as source of information on epilepsy would help in clarifying the individual attitude towards this medium by Internet users. OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to explore factors which explained the influence of information found on the internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8% of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9%) or to confirm a diagnostic or therapeutic decision (37.3%). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95%CI: 1.28-6.76; p=0.011), higher frequency of Internet use (OR: 3.66; 95%CI: 1.56-9.21; p=0.006) and higher confidence in reliability of online information (OR: 2.61; 95%CI: 1.09-6.26; p=0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSIONS Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.


2005 ◽  
Vol 45 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Stuart D M Thomas ◽  
Mairead Dolan ◽  
Jenny Shaw ◽  
Samantha Thomas ◽  
Graham Thornicroft ◽  
...  

Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.


2021 ◽  
Author(s):  
Sara B Mullaney ◽  
Heather Bayko ◽  
Gerald D Moore ◽  
Hannah E Funke ◽  
Matthew J Enroth ◽  
...  

ABSTRACT Introduction U.S. Army Veterinary Corps provides highly skilled and adaptive veterinary professionals to protect and improve the health of people and animals while enhancing readiness throughout the DOD. Army veterinarians must be trained and credentialed for critical tasks within the animal health and food protection missions across all components. The Veterinary Metrics Division in the U.S. Army Public Health Center’s Veterinary Services and Public Health Sanitation Directorate is responsible for tracking readiness metrics of Army veterinarians and maintains a robust online Readiness Metrics Platform. Readiness targets were developed based on trends in readiness platform data, input of senior veterinary subject matter experts, and feedback from the field. To date, no data have been published describing the cases presented to DOD-owned Veterinary Treatment Facilities (VTFs). Without capturing and codifying the types of cases that present to the VTF and comparing to cases typically encountered during deployments, it is difficult to determine whether the VTF serves as an adequate readiness platform. In this study, we compare a representative random sample of non-wellness VTF patient encounters in garrison to cases reported from two different combat zones to determine if the VTF is a suitable clinical readiness platform. Materials and Methods Multiple data sources, including pre-existing published data and new data extracted from multiple sources, were used. The Iraq 2009-2010 dataset includes data collected from a Medical Detachment, Veterinary Service Support (MDVSS) deployed to Iraq from January 5, 2009 through August 23, 2010. The Iraq 2003-2007 dataset originated from a retrospective cross-sectional survey that included database and medical record abstraction. The Afghanistan 2014-2015 dataset includes data collected from the MDVSS deployed to Afghanistan from June 2014 to March 2015. Working dog veterinary encounter data were manually extracted from monthly and daily clinical reports. Data for the Garrison 2016-2018 dataset were extracted from the Remote Online Veterinary Record. A random representative sample of government-owned animal (GOA) and privately owned animal (POA) encounters seen across all DOD-owned VTFs from June 2016 to May 2018 were selected. Results We found that animals present to the VTF for a wide variety of illnesses. Overall, the top 10 encounter categories (90.3%) align with 84.2%, 92.4%, and 85.9% of all the encounter types seen in the three combat zone datasets. Comparing these datasets identifies potential gaps in readiness training relying solely on the VTF, especially in the areas of traumatic and combat-related injuries. Conclusions Ultimately, the success of the DOD Veterinary Services Animal Health mission depends on both the competence and confidence of the individual Army veterinarian. As the MHS transitions and DOD Veterinary Services continues to transform emphasizing readiness through a public health and prevention-based Army medicine approach, Army veterinarians must strike a delicate balance to continue to provide comprehensive health care to GOAs and POAs in the VTFs. Leaders at all levels must recognize the roles VTFs play in overall public health readiness and disease prevention through the proper appropriation and allocation of resources while fostering the development, confidence, and competence of Army veterinarians training within these readiness platforms.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lidia Del Piccolo ◽  
Valeria Donisi ◽  
Ricciarda Raffaelli ◽  
Simone Garzon ◽  
Cinzia Perlini ◽  
...  

Objective: To assess the psychological distress of healthcare providers (HCPs) working in the field of obstetrics during the coronavirus disease 2019 (COVID-19) pandemic and to identify factors associated with psychological distress at the individual, interpersonal, and organizational level.Design: Cross-sectional survey study.Setting: Four University hospitals in Italy.Participants: HCPs working in obstetrics, including gynecologists, residents in gynecology and obstetrics, and midwives.Methods: The 104-item survey Impatto PSIcologico COVID-19 in Ostetricia (IPSICO) was created by a multidisciplinary expert panel and administered to HCPs in obstetrics in May 2020 via a web-based platform.Main Outcome Measures: Psychological distress assessed by the General Health Questionnaire-12 (GHQ-12) included in the IPSICO survey.Results: The response rate to the IPSICO survey was 88.2% (503/570), and that for GHQ-12 was 84.4% (481/570). Just over half (51.1%; 246/481) of the GHQ-12 respondents reported a clinically significant level of psychological distress (GHQ-12 ≥3). Psychological distress was associated with either individual (i.e., female gender, stressful experience related to COVID-19, exhaustion, and the use of dysfunctional coping strategies), interpersonal (i.e., lower family support, limitations in interactions with colleagues), and organizational (i.e., reduced perception of protection by personal protective equipment, perceived delays on updates and gaps in information on the pandemic) factors in dealing with the pandemic.Conclusions: Results confirm the need for monitoring and assessing the psychological distress for HCPs in obstetrics. Interventions at the individual, interpersonal, and organizational level may relieve the psychological distress during the COVID-19 pandemic and foster resilience skills in facing emotional distress.


2021 ◽  
Vol 4 (1) ◽  
pp. 46-63
Author(s):  
Fred Wamimbi ◽  
Muhammadi Bisaso

The study examined the effect of performance appraisal practices on teachers’ job performance, and sought to investigate the effect of 1) target setting 2) performance monitoring and 3) employee feedback on teachers’ job performance. A cross-sectional survey design with a mixed-method approach was adopted. The target population of the study was composed of 211 respondents spread across four private universal secondary schools; 207 teachers and four head teachers; and a sample size of 189 respondents with 185 teachers and four head teachers selected using a simple random sampling approach coupled with a fish-bowl technique, while census inquiry was adopted to select head teachers. A self-designed closed-ended questionnaire was administered to collect data from teachers while an interview guide was adopted to collect data from head teachers. The CVI obtained for the instrument was .90 and a reliability index of 931 Cronbach alpha co-efficient. Data was analyzed using frequencies, percentages, and simple regression. Findings indicate that target setting (β = 0.375, p< 0.05), performance monitoring (β = 0.435, p< 0.05) and employee feedback (β = 0.375, p< 0.05) had very strong significant effect on teachers’ job performance. The study concludes that performance appraisal practices can significantly aid teachers’ job performance in private USE schools if well handled in terms of comprehensiveness, clarity and timeliness. It recommends that target setting should involve teachers and their individual differences be reflected; academic meetings should be held monthly and performance support should be extended to teachers; whilst feedback given to teachers ought to be timely, comprehensive and interactive.


1986 ◽  
Vol 28 (6) ◽  
pp. 389-394 ◽  
Author(s):  
Maria Fernanda Furtado de Lima e Costa ◽  
R. S. Bocha ◽  
Naftale Katz

A cross: sectional survey on schistosomiasis was done in Comercinho (Minas Gerais State, Brazil), a town with 1474 inhabitants. Stool (Kato-Katz method) and physical examinations were done on 90% of the population and on 84% of the individuals over 2 years of age, respectively. The ecological and individual (case-control) analysis were used to investigate the relation between splenomegaly and S. mansoni egg counts in different age groups. In the ecological analysis there was a clearly correspondence between higher geometric mean of eggs and higher percentage of splenomegaly in the age groups 5-9 and 10-12 years. In the individual analysis it was found that only in the youngest individuals (5-8 or 5-9 years old) the splenomegaly was related with higher mean egg counts in the feces, having been a tendency to the decrease of excretion of eggs in patients with splenomegaly as the age increased. These results strongly suggest that the ecological data are' better indicator of the severity of schistosomiasis in endemic areas, as the decrease of the egg excretion in patients with splenomegaly may be a confounding variable for the individual analysis.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S130-S130
Author(s):  
Lauren B Nosanov ◽  
Kathleen S Romanowski

Abstract Introduction Over the duration of firefighters’ careers there exists a high probability of sustaining burn injuries necessitating medical evaluation and treatment. While many are minor and do not significantly affect the ability to work in full capacity, there exists risk for both short and long-term incapacitation. It is not uncommon for firefighters to push for earlier return to work than is medically advisable. However, there are additional external factors which drive premature return to duty. Methods An online cross-sectional survey was sent to firefighters who were members of a statewide Professional Firefighters’ Union. A multiple-choice format was used to assess demographics, injury details, medical care received and return to work. Free text format allowed for elaboration regarding factors influencing decisions to return to work. Results The survey was sent to 30,000 firefighters, with 413 (1.4%) responses received. Excluding those with incomplete data, 354 remained for analysis. Of these, 132 (37.3%) reported a burn injury which required medical evaluation. The majority were sustained during active duty, with 90.7% using protective gear at the time. Most burns were small and affected the head (50.8%) and upper extremities (48.3%). The majority were not treated at a Burn Center. While 12 (16.2%) reported returning to work prematurely themselves, nearly half indicated that they knew a colleague whom they felt had returned to work too soon. Factors cited include firefighter culture, finances, limitations of workman’s compensation, pressure from peers and employers, dislike of light duty and a driving desire to get back to work. Conclusions While many cite love of the job and a culture of pride and camaraderie that is “in our DNA”, firefighters’ decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed at both the individual and organizational level, which may best be facilitated by evaluation and treatment at a Burn Center. Applicability of Research to Practice Improved understanding of factors driving firefighters’ views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.


2021 ◽  
Author(s):  
Gemma Simons ◽  
Raymond Effah ◽  
David Baldwin

Objectives To find out how, why and when medical students think wellbeing should be measured. Design A mixed methods study comprising a cross-sectional online survey (November 2020-March 2021) and semi-structured on-line interviews. Views on the frequency of availability for measurement, the format, type and purpose of measurement, and with whom wellbeing should be discussed were measured. When an outcome was scored 7-9 on a 9-point Likert scale of agreement by ≥75% of participants it was considered critical, in line with COMET and GRADE processes for rating recommendations. Inductive thematic analysis was undertaken on the interview transcripts by two independent researchers. Setting All Medicine programmes at University of Southampton. Participants Medical students from all years took part in the survey (n=118) and interviews (n=16). Results Participant demographics were similar to national medical student demographics. Most participants (94%) felt able to give 5 minutes to measure their wellbeing at least once a month. No single format of measurement was rated critical. Research, governance and individual feedback all reached the 75% threshold for the purpose being considered critically important. Only subjective assessments undertaken by the individual in real-time were rated as critically important (78.1%) measurement tools. Students selected that they would discuss their wellbeing with other medical students (n=87) nearly as often as they selected a member of the Faculty (n=104). Top determinants of wellbeing picked by medical students were energy, ability to do activities of daily living, and negative feelings. Five interview themes further explained these findings. Conclusions Five recommendations about self-care teaching, quality-assured pastoral and peer support, proactive wellbeing check-ins and demographic data are discussed in light of these findings. Methods to achieve them are suggested, which are medical student-centred, and which make use of existing resources.


2021 ◽  
Vol 12 (2(S)) ◽  
pp. 1-19
Author(s):  
Gbemisola A. Daramola ◽  
Olawumi Dele Awolusi

The physician is traditionally the head of the medical team. To be an effective and efficient team leader is not innate but requires acquiring some competencies. The medical school curriculum was deficient in this regard hence the need for acquisition of these skills through training. Consequently, the present study aims to assess the influence of leadership competencies and Development Needs on the job performance of Physician Mangers. A cross-sectional survey was distributed among Physician Managers in various hospital types that were purposefully selected. Ten Physician Managers were also interviewed for in-depth information of skills they require to perform well. Descriptive and inferential statistics were used to summarize the items of the questionnaire at 5% level of significance and to determine if a significant difference existed between groups of Physician managers. Results show that possessing the competencies; communication and relationship management, leadership and business skills and knowledge do influence the job performance of Physician Mangers. There was a significant difference between physicians that had formal training in management and those that had none in the communication and professionalism domains. Seven Physician Managers from different types of hospitals were interviewed, two of them females. They had been in managerial positions from 6months to 34 years. They all emphasised communication and leadership skills as important competencies for every physician manager. They all also suggested that management training must be introduced either during undergraduate or postgraduate training and that physician as head of the medical team require regular management update training.


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