Journal of Vocational Rehabilitation - Volume 39, issue 2
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Journal of Vocational Rehabilitation will provide a forum for discussion and dissemination of information about the major areas that constitute vocational rehabilitation.
Periodically, there will be topics that are directed either to specific themes such as long-term care or different disability groups such as those with psychiatric impairment. Often a guest editor who is an expert in the given area will provide leadership on a specific topic issue. However, all articles received directly or submitted for a special issue are welcome for peer review. The emphasis will be on publishing rehabilitation articles that have immediate application for helping rehabilitation counselors, psychologists and other professionals in providing direct services to people with disabilities.
Original research articles, review articles, program descriptions, and case studies will be considered for publication. Ideas for special topical issues are welcomed as well.
Abstract: Unemployment is higher among people with multiple sclerosis (MS) than would be expected and vocational rehabilitation efforts to help people with MS retain or regain employment have been marginally successful. To better understand the role workplace accommodations may play in employment, 41 people with MS who had contacted the Kent State Employment Assistance Center between 10 and 15 years ago were telephoned as part of a program evaluation follow-up and asked about their experience with the accommodations and short term and long term employment outcomes. Sixty percent reported they were still working, and subjects reported that low cost, low impact…accommodations were more likely to be provided. Further research was recommended.
Abstract: Caregivers provide assistance for their family member with multiple sclerosis (MS) for an indefinite amount of time. Using Lazarus and Folkman's (1984) stress process theory as a theoretical framework, this study investigated the relationship of gender, current health problems, perceived stress, ways of coping, social support, control of internal states, and family adaptation to develop an adjustment model for caregivers of people with MS. Ninety caregivers participated in this study. Path analysis was used to evaluate the hypothesized relationships. The test of this model showed fit indices that indicated an excellent fit for the model (χ2 = 18.373, p…= 0.366; NFI = 0.892; CFI = 0.99; RMSEA = 0.03). The finding shows that positive coping strategies enhanced caregiver's control of internal states and subsequently led caregivers to seek social support and in turn, caregivers perceived family function positively. control of internal states, positive coping strategies, and social support buffered the negative effect from caregiver's stressors on family adjustment.
Keywords: Multiple sclerosis, caregiver, adjustment, stress processing theory
Abstract: BACKGROUND: Research has clearly demonstrated the relationship between quality of life (QOL) for adults with multiple sclerosis (MS) and selected demographic and illness-related variables. However, this investigation posed a further question: would housing satisfaction variables (e.g., need for accommodations, confidence in ability to live independently and to afford to do so, and level of daily functioning) account for additional variance in the prediction of QOL? OBJECTIVE: The objective of this study was to explore the extent to which housing satisfaction variables add to the prediction of QOL among a large sample of Americans with MS. METHOD: Quantitative analysis for the…study included descriptive statistics such as means and standard deviations along with backward elimination multiple regression analysis, to determine the extent to which the independent variables, including educational level, employment status, MS status variables, and housing variables, contributed to the overall prediction model for the quality of life of adults with MS. RESULTS: Regression results indicated that housing satisfaction variables, in addition to perceived severity of MS, level of cognitive functioning, number of symptoms, and employment status, were retained in a predictive model of QOL. CONCLUSIONS: The findings suggest the need to include housing consultation as an important component of the array of medical, vocational, educational, and cognitive rehabilitation strategies provided to adults with MS.
Keywords: Multiple sclerosis, housing, quality of life, disability and housing
Abstract: BACKGROUND: This article presents the results of a comprehensive national analysis of the specialized and accessible housing situation among Americans with multiple sclerosis (MS). This study represents the first national assessment of specialized housing among Americans with MS. OBJECTIVE: The objective of this study was to comprehensively evaluate the specialized housing situation for US adults with MS, and specifically, to identify the most pressing needs and most frequently identified barriers to achieving safe and accessible housing. METHODS: In order to achieve a representative national survey, a sample of 5082 adults with MS was randomly selected from the membership of the…North American Research Committee on Multiple Sclerosis patient registry and selected chapters of the National Multiple Sclerosis Society in states in which the NARCOMS registry had lower representation. The sample represents approximately 1% of the estimated 400,000 Americans with MS, and includes persons with a wide range of geographic, age, racial/ethnic, income, educational, and residential characteristics. RESULTS: Residential accessibility was limited for almost 20% of the participants. A large percentage of people with MS reported that they do not have accessible bathroom/bathing facilities, an accessible kitchen, or a needed wheelchair accessible exterior entrance or ramp to their entrance. Awareness of specialized housing resources was very limited. Particularly at risk for requiring specialized housing were adults over age 50. CONCLUSION: The specialized housing needs of Americans with MS are diverse and extensive. Additional research, policy, and advocacy attention to the housing needs of this population is needed. Specialized housing should be made a larger professional focus among rehabilitation professionals.
Keywords: Multiple sclerosis, health status, housing, residential mobility, residence characteristics, architectural accessibility, facility design and construction
Abstract: The onset of multiple sclerosis (MS) often occurs during individuals' prime working years. Although the majority of people with MS are employed at the time of diagnosis, premature departure from the workforce is an all too common response to the significant challenges posed by this disease. The purpose of this article is to examine job retention barriers frequently encountered by people with MS and to describe vocational rehabilitation (VR) strategies designed to ameliorate these barriers so that these individuals can continue working. The authors summarize research findings on illness-related, demographic, and work-environmental barriers to job retention and career advancement. The…authors then provide examples of job retention strategies and interventions that can be implemented by VR professionals to improve the employment outcomes of people with MS.
Abstract: BACKGROUND: State vocational rehabilitation (VR) agencies play a significant role in supporting the employment goals of people with disabilities, but delays in the receipt of vocational services could adversely affect employment outcomes of applicants for services. OBJECTIVE: We explore how exogenous variation in the duration to service receipt for VR applicants receiving Social Security Disability Insurance (SSDI) benefits affects their employment outcomes. METHODS: We constructed a data set for an annual cohort of SSDI applicants for VR services and followed them for 48 months after their application month using VR and Social Security Administration (SSA) administrative records. We then estimated…multivariate models to predict employment-related outcomes based on agency order of selection characteristics and a measure of the usual wait time experienced by all SSDI applicants to the same agency in the same month. RESULTS: Having wait lists for services and experiencing longer wait times for services are associated with lower employment outcomes at VR closure and employment outcomes observed through SSA administrative data. CONCLUSIONS: Longer wait times harm the economic well-being of SSDI VR applicants, reduce VR agency revenues, and increase SSA benefit costs. An experimental test of the effect of accelerating the pace of service delivery seems worthwhile.
Keywords: State vocational rehabilitation agencies, social security disability insurance, employment