Vocational Rehabilitation Improves Job Retention for People with Rheumatic Diseases

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Vocational Rehabilitation Improves Job Retention for People with

Rheumatic Diseases

http://www.niams.nih.gov/ne/highlights/spotlight/2004/voc_rehab.htm

Vocational rehabilitation improves job retention for patients with

rheumatic diseases who are at risk for job loss, according to a team of

scientists from Boston University School of Medicine.

The researchers, led by Saralynn Allaire, Sc.D., and supported by a

grant from the National Institute of Arthritis and Musculoskeletal and

Skin Diseases, found that job loss was delayed and reduced in overall

incidence for individuals receiving vocational rehabilitation. Job loss

was reduced 49 percent for individuals receiving intervention compared

with those receiving no intervention. These results, viewed in the

context of government spending for disability versus rehabilitation

services, point to the potential for rehabilitation to reduce the

societal and personal costs of rheumatic diseases.

Health care providers, say the authors, should refer patients with

health-related employment problems to public vocational rehabilitation

programs. They also recommend evaluating the cost effectiveness of

short-term vocational rehabilitation delivered within the community.

Government spending for disability income support programs, say the

scientists, is over 25 times that for vocational rehabilitation. In

addition, the portion of the U.S. job force aged 55 and over is

increasing, and the incidence of many rheumatic diseases rises

substantially for people over age 50. Previous studies have found that

health professionals do not usually recommend vocational counseling.

When they do, however, patients are more likely to have a successful

outcome.

For this four-year study, 242 patients with rheumatic diseases, who had

self-identified as " at risk for job loss, " were randomly assigned to one

of two groups. The experimental group received three hours of vocational

rehabilitation services that focused on job accommodation, vocational

counseling, education and self-advocacy. The control group received no

counseling, but received print materials about disability employment

issues and resources through the mail. Telephone interviews throughout

the study tracked each participant's employment status.

Health-related job loss is associated with loss of self-esteem, life

satisfaction and perceived health status. In patients with rheumatic

diseases, job loss is also associated with higher levels of depression

and pain.

The National Institute of Arthritis and Musculoskeletal and Skin

Diseases (NIAMS) is part of the U.S. Department of Health and Human

Services' National Institutes of Health, the leading Federal agency in

biomedical and behavioral research. The mission of NIAMS is to support

research into the causes, treatment, and prevention of arthritis and

musculoskeletal and skin diseases, the training of basic and clinical

scientists to carry out this research, and the dissemination of

information on research progress in these diseases. For more information

about NIAMS, call the information clearinghouse at (301) 495-4484 or

(877) 22-NIAMS (free call) or visit the NIAMS Web site at www.niams.nih.gov.

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Allaire S, Li W, LaValley M. Reduction of job loss in persons with

rheumatic diseases receiving vocational rehabilitation. Arthritis and

Rheumatism, 2003;48(11):3212-3218.