Person-related predictors of employment outcomes after participation in psychiatric vocational rehabilitation programmes--a systematic review.
BACKGROUND
There is increasing recognition of the importance of psychiatric vocational rehabilitation (PVR) programmes in helping individuals with severe mental illnesses to find and secure jobs. However, little is known concerning the factors related to PVR outcomes.


OBJECTIVE
This review identifies those person-related factors which most strongly influence employment outcomes after participation in PVR programmes.


METHODS
Medline, Psychinfo, Pubmed and CINAHL were searched for studies using multivariate analysis of longitudinal data, which analysed employment outcomes after at least 6 months of programme participation, and which analysed at least three predictor domains.


RESULTS
Eight studies presented in 16 publications met all the criteria. Better employment outcomes were most strongly related to better work performance measured during PVR participation and to higher work-related self-efficacy. Better social functioning during PVR participation was also significantly related to positive employment outcomes, but this relationship was generally weaker than those of the two aforementioned factors. In most studies, employment outcomes after PVR were not related to past functioning, including work history and diagnosis. Findings on the severity of psychiatric symptoms measured during PVR were mixed. In terms of contribution to outcome, severity of symptoms usually ranked below work performance, when measured concurrently.


CONCLUSIONS
Contrary to previous reviews, this study suggests that the influence of past functioning, including work history, diagnosis and psychiatric history, is outweighed by work performance in PVR. Further prospective and controlled studies are needed to reach more definite conclusions about the individual contributions of person-related factors.
Michon
Harry W C
HW
Research unit of Reintegration Dept. of Cure, Care and Rehabilitation, Trimbos Institute (The Netherlands Institute of Mental Health and Addiction), 725, 3500 AS, Utrecht, The Netherlands. hmichon@trimbos.nl
van Weeghel
Jaap
J
Kroon
Hans
H
Schene
Aart H
AH
D004185:Disability Evaluation; D004650:Employee Performance Appraisal; D004651:Employment; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D012050:Rehabilitation, Vocational; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D020377:Self Efficacy