F-3-14-02
PREDICTORS OF EARLY RETIREMENT AND REHABILITATION NEEDS
Sibylle Biefang (University of Ulm, Ulm, Germany), Peter Potthoff (Infratest Epidemiology and Health Research, Munich, Germany), Barbel-Maria Bellach (Robert-Koch Institute, Berlin, Germany), Rolf Buschmann-Steinhage (Federation of the German Pension Insurance Institutions, Frankfurt, Germany)
The German Pension Insurance Institutions grant medical rehabilitation measures to white and blue collar workers with the aim to prevent health-related early retirement. A screening procedure based on predictors of early retirement and use of rehabilitation services gained from longitudinal data may help to detect workers at risk in due time.
For a cohort of workers (n=1.794) who participated in a health survey (including a physical examination) conducted in 1976, we collected information on retirement and rehabilitation status in 1993 and identified those variables from 1976 that were significantly related to both events using uni- and multivariate regression analysis. Significant variables were then transformed into an index and the screening potential of the index for a subgroup of the study subjects (185 cases/270 controls) investigated.
Regression analysis resulted in 26 main predictors for both events, of which l0 were based on clinical findings and 16 on self-reported morbidity, medication, smoking, and working load. Index values (non-weighted sum score) ill the subgroup were significantly higher for cases than controls, especially when values relied on self-reported items alone. The index classified 68% of the cases and controls correctly with a sensitivity of .57 and a specifity of .78.
Predictors based on self-report may be used to preselect workers in need of rehabilitation who subsequently are invited to a medical examination that clarifies this need.
F-3-14-03
BARRIERS TO EMPLOYMENT IN SPINAL CORD INJURY
Irma G. Fiedler (Medical College of Wisconsin, Milwaukee, Wisconsin)
Individuals with severe spinal cord injuries can be gainfully employed. As part of a National Institute of Disability Research and Rehabilitation grant, individuals, with a one-year history of spinal cord injury, are being surveyed to determine the "Perceived Barriers to Employment". Using a set of survey instruments, a trained vocational rehabilitation professional meets with the individual in the privacy of his/her home environment to assess the present status of employment and the attitudes which support the state. One of the survey instruments has been adapted from a self-report document, used for varied disabilities, to a targeted 200 question overview, capable of being used as the basis for establishing a referral network for employment. Early results indicate that the timing of the presentation of information is critical. Although inpatient consultation is vital to stimulate the perception that employment is possible, the grieving period may not allow information to be accurately and relevantly processed. Transportation problems appear to be one of the most significantly noted barriers to employment. Presentation of the survey instrument, examples of successful cases of individuals with severe disabilities, and a videotape expressing employer perspective, will offer directions for overcoming barriers to employment for individuals with spinal cord injuries.
