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首页> 外文期刊>Psychiatric rehabilitation journal >Rural and Urban Supported Employment Programs in the Veterans Health Administration: Comparison of Barriers and Facilitators to Vocational Achievement for Veterans Experiencing Mental Illnesses
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Rural and Urban Supported Employment Programs in the Veterans Health Administration: Comparison of Barriers and Facilitators to Vocational Achievement for Veterans Experiencing Mental Illnesses

机译：退伍军人卫生管理局中的城乡支持就业计划：患有精神疾病的退伍军人的职业成就障碍和促进者比较

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Objective: The purpose of this mixed-methods study was to compare urban and rural supported employment programs on barriers and facilitators with employment for veterans experiencing mental illnesses. Method: A national sample of 114 supported employment staff, supervisors, and upper level managers employed by the Veteran's Health Administration were recruited. Participants completed an online survey of work barriers and facilitators, including open-ended questions regarding additional factors that impact the work success of veterans. Survey responses were compared between participants from rural (n = 28) and urban (n = 86) programs using independent groups t tests. Open-ended questions were analyzed using content analysis. Results: Supported employment personnel from rural programs perceived significantly more barriers to work success compared with urban personnel, particularly in the areas of access to services and a range of job-related factors, including job match and interpersonal relationships at the work site. In contrast, participants from urban programs reported greater facilitators in the domain of mental health services. Qualitative findings add depth to the quantitative findings and highlight challenges in rural supported employment programs impacting job development and job fit. Both urban and rural programs experienced unique barriers related to geography and transportation. Conclusions and Implications for Practice: Findings from this nationwide mixed-methods survey provide a comprehensive picture of the obstacles to employment success for veterans living with mental illnesses and receiving supported employment services in rural areas. Suggestions for changes in policy related to services and resource allocation are presented to address these unique barriers, particularly in rural areas.
机译：目的：这项混合方法研究的目的是比较城市和农村支持的障碍和促进者就业计划与有精神疾病的退伍军人的就业。方法：收集了由114名受过退伍军人卫生管理局聘用的受支持的就业人员，主管和高层管理人员组成的国家样本。参与者完成了对工作障碍和促进者的在线调查，包括有关影响退伍军人工作成功的其他因素的开放式问题。使用独立小组t检验比较了农村（n = 28）和城市（n = 86）项目参与者的调查回答。使用内容分析来分析开放式问题。结果：与城市工作人员相比，来自农村计划的受支持的就业人员认为，工作成功的障碍要大得多，特别是在获得服务和与工作相关的一系列因素方面，包括工作地点的匹配和工作场所的人际关系。相反，城市计划的参与者报告说，在精神卫生服务领域有更多的促进者。定性调查结果增加了定量调查结果的深度，并突显了农村支持的就业计划中影响工作发展和工作适应性的挑战。城市和乡村计划都遇到了与地理和交通有关的独特障碍。结论和实践意义：这项全国范围的混合方法调查的结果提供了有关患有精神疾病并在农村地区获得支持的就业服务的退伍军人获得就业成功的障碍的全面情况。为解决这些独特的障碍，特别是在农村地区，提出了与服务和资源分配有关的政策变化的建议。

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