Zusammenfassung
Anliegen: Selbst mithilfe umfassender Wiedereingliederungsprogramme bleibt die berufliche Rehabilitation
von Patienten mit chronischer Schizophrenie ein sehr hoch gestecktes Ziel. Ein vertieftes
und dem heutigen Stand entsprechendes Wissen über die prädiktiven Faktoren einer erfolgreichen
Wiedereingliederung ist deshalb unabdingbar. Anliegen der vorliegenden Untersuchung
war es, unter Minimierung des Einflusses der verwendeten Instrumente, Faktoren zu
ermitteln, die den Wiedereingliederungserfolg am besten voraussagen können. Methode: In einer Stichprobe von 76 Patienten mit chronischer Schizophrenie wurden mittels
einer Faktorenanalyse aus 32 Variablen 10 für das Funktionieren am Arbeitsplatz relevante
Faktoren ermittelt. In einem zweiten Schritt wurde der prädiktive Wert dieser Faktoren
für den Wiedereingliederungserfolg mittels logistischer Regression ermittelt. Ergebnisse: Erfolgreich waren diejenigen Teilnehmenden, die vor und während der zweiwöchigen
Abklärungsphase ein gutes Arbeitsverhalten zeigten, keine Defizite im Sozialverhalten
und keine depressiv-resignativen Bewältigungsstrategien aufwiesen. Krankheitssymptome
und neurokognitive Defizite waren dagegen von untergeordneter Bedeutung. Schlussfolgerungen: Die Resultate unseres faktoranalytischen Ansatzes bestätigen frühere Ergebnisse,
dass das Arbeitsverhalten in einem geschützten Rahmen sowie soziale Kompetenz die
besten Prädiktoren einer erfolgreichen beruflichen Wiedereingliederung sind. Zudem
bekräftigen sie die Notwendigkeit, Therapieprogramme zu entwickeln, die Zuversicht
und Selbstvertrauen der Patienten fördern.
Abstract
Objective: Vocational re-integration of patients with chronic schizophrenia remains even with
the help of comprehensive integration programs a very ambitious aim. Therefore, a
profound and up-to-date knowledge of vocational outcome predictors is imperative.
The objective of the present study was, while minimizing the influence of the instruments
used, to generate factors, which predict best the re-integration outcome. Method: In a sample of 76 chronic schizophrenia patients ten relevant factors were derived
from a factor analysis including 32 variables. In a second step the predictive value
of these ten factors centering on vocational outcome were tested by logistic regression
analysis. Results: Participants who had a successful outcome showed a good vocational capacity before
and during the two-week assessment phase, had no social deficits and no depressive-resignative
coping strategies. Schizophrenia symptoms and cognitive deficits, however, were of
minor relevance. Conclusions: The results of our factor-analytic approach confirm earlier findings that vocational
functioning observed in a sheltered setting and social competence are the best predictors
for successful vocational rehabilitation. Moreover, they serve to substantiate the
necessity of developing therapeutic programs that enhance patients' hopefulness and
self-confidence.
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PD Dr. med. Holger Hoffmann
Abteilung Sektorisierte Gemeindepsychiatrie · Universitätsklinik für Sozial- und Gemeindepsychiatrie
Bern
Laupenstraße 49
Postfach 52
3000 Bern 10 · Schweiz
Email: hoffmann@spk.unibe.ch
