State vocational services and employment in cancer survivors.
BACKGROUND
This study investigated the association of state vocational rehabilitation services in the USA and work outcomes of cancer survivors who were unemployed prior to receipt of services.


METHODS
Administrative data obtained during fiscal year 2005 from the Rehabilitation Services Administration (RSA) database consisting of 1,201 closed cases with the diagnosis of cancer formed the sample of this study. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational service variables were extracted and analyzed in relation to employment outcome data. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics of the participants.


RESULTS
Cancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation program. Of the unemployed cancer survivors who received services, 903 (57%) achieved successful employment while 670 (43%) were not employed following receipt of services. Gender (women; OR = 0.77, 95% CI = 0.61-0.97), lower educational levels (OR = 0.52, 95% CI = 0.33-0.81), provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits; OR = 0.64, 95% CI = 0.50-0.82) were all associated with a greater likelihood of being unemployed at the end of vocational services. Counseling (OR = 1.33, 95% CI = 1.02-1.73), miscellaneous training (OR = 1.61, 95% CI = 1.06-2.44), rehabilitation technology services (OR = 1.22, 95% CI = 0.72-2.08), job placement services (OR = 2.37, 95% CI = 1.72-3.27), job search assistance (OR = 1.43; 95% CI = 1.02-2.01) maintenance services (OR = 1.92, 95% CI = 1.29-2.86), and other services (OR = 1.43, 95% CI = 1.07-1.90) were found to be significantly associated with increased odds for employment.


CONCLUSIONS
Vocational rehabilitation services were found to be associated with employment status. Future studies investigating the specific effects of certain vocational services for unemployed cancer survivors who qualify for these services are warranted.


CONCLUSIONS
Cancer survivors who are seeking employment or experiencing problems maintaining employment who can qualify should be encouraged to pursue services from state vocational rehabilitation agencies. Medical providers should also become familiar with services offered by state vocational rehabilitation agencies and consider the use of these services..
Chan
Fong
F
Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI 53706, USA. chan@education.wisc.edu
Strauser
David
D
da Silva Cardoso
Elizabeth
E
Xi Zheng
Lisa
L
Chan
Jacob Y C
JY
Feuerstein
Michael
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004651:Employment / Q000706:statistics & numerical data; D016832:Employment, Supported / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000191:economics / Q000706:statistics & numerical data; D013219:State Government; D017741:Survivors / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Psychooncology. 2005 Nov;14(11):992-1004
15744780
AAOHN J. 2007 Jul;55(7):290-5
17665826
Cancer. 2004 Oct 15;101(8):1703-11
15386303
Eur J Cancer. 2007 Mar;43(5):914-20
17314041
CA Cancer J Clin. 2005 Sep-Oct;55(5):271-80
16166073
Psychooncology. 2002 May-Jun;11(3):188-98
12112479
Cancer. 2006 Jul 1;107(1):1-11
16718655
J Clin Oncol. 2006 Jan 20;24(3):345-53
16421415
Cancer. 2003 May 15;97(10):2554-64
12733155
Psychooncology. 2002 Mar-Apr;11(2):124-31
11921328
Health Soc Work. 1994 Aug;19(3):227-30
7959406
Acta Oncol. 2007;46(4):446-51
17497311
J Clin Oncol. 2006 Nov 10;24(32):5138-41
17093276
Cancer. 2005 Mar 15;103(6):1292-301
15700265
J Cancer Surviv. 2007 Sep;1(3):185-92
18648969
Cancer. 1991 Jan 1;67(1):206-13
1985719