544 KB46 KB200820252015Fulder, BojanaJakopec, ZlatkaPrajnc, LizaTemlin, Kamilaletnik:14številka:2str. 16-25ISSN:1580-9315COBISSID:2113641URN:URN:NBN:SI:doc-Q95EBC78slUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)bolečinaPainphysical factorspoklicna rehabilitacijapsihologijapsihološki dejavnikipsihosocialna podporapsychological factorsPsychologypsychosocial supportRehabilitation, VocationalSocial supportsocialna podporatelesni dejavnikiUporabnost Vprašalnika za oceno izboljšanja zdravja (BHI2) za ocenjevanje napredovanja v poklicni rehabilitaciji| Usefulness of the Battery for Health Improvement (BHI2) for assessing progress in vocational rehabilitation|Background: Along with activities aimed at the development of working abilities, vocational rehabilitation focuses on psychosocial rehabilitation, whose goals include the improving the quality of life, well-being, self-image and more effective coping with problems and limitations. The aim of our study was to determine whether persons undertaking vocational rehabilitation show signs of progress in various psychological and psychosocial factors, and if there are differences between people with positive and negative outcomes as well as between groups of people with mainly physical or mainly mental health problems. Methods: The study was conducted on a sample of 34 people who are undertaking vocational rehabilitation programs at the Centre for Vocational Rehabilitation Maribor. The participants were asked to complete the Battery for Health Improvement (BHI2) at the start and at the end of their rehabilitation. BHI2 has previously not been used in Slovenia. It is a standardised psychodiagnostic instrument, which was developed with the purpose of psychological evaluation of patients with physical health problems and the monitoring of changes during rehabilitation. Results: Rehabilitation with positive outcome (employment) was completed by 77% of the participants, while 23% of them were evaluated as unemployable at the end of rehabilitation. When compared to the results achieved at the start of the study, participants showed signs of progress in the areas measured by the BHI2 questionnaire at the end of rehabilitation. The most statistically significant progress (p<0.01) was achieved on the scales of Depression, Anxiety, Chronic Maladjustment, Survivor of Violence, Job Dissatisfaction and the reported level of maximum pain. We observed moderate progress (p<0.05) on the scales of Pain Complaints, Hostility, Borderline, Substance Abuse, Family Dysfunction and the reported level of minimum pain. Other scales showed trends of improvement, but the results were not statistically significant. Improved performance on the BHI2 questionnaire was linked to positive results in rehabilitation: the participants who were employed at the end of rehabilitation showed marked progress on the BHI2 scales, whereas those who were evaluated as unemployable did not. Conclusion: Our results indicate that rehabilitation has a positive influence in terms of the proportion of persons who manage to find employment as well as in terms of changes regarding the psychological and psychosocial factors and job satisfaction. We believe that the BHI2 is a useful tool for assessment of participants' needs and in the planning of rehabilitation, as it covers a wide spectrum of medical, psychological and psychosocial factors. It thus provides a comprehensive insight into an individual's condition, and repeated measurements allow us to monitor progress during rehabilitationIzhodišča: V poklicni rehabilitaciji je poleg dejavnosti, ki so usmerjene v razvijanje delovnih zmožnosti, velik poudarek na psihosocialni rehabilitaciji z različnimi vsebinami in cilji, ki se nanašajo na izboljšanja kakovosti življenja, počutja, samopodobe ter učinkovitejšega spoprijemanja in obvladovanja težav in omejitev. V raziskavi smo želeli ugotoviti, ali se pri osebah, vključenih v poklicno rehabilitacijo, kaže napredovanje na področju različnih psiholoških in psihosocialnih dejavnikov, ali se na teh področjih pojavljajo razlike med osebami s pozitivnim izidom rehabilitacije in tistimi z negativnim izidom in med skupinama oseb s prevladujočimi telesnimi in duševnimi težavami. Metode: V raziskavi je sodelovalo 34 oseb, vključenih v programe poklicne in zaposlitvene rehabilitacije v Centru za poklicno rehabilitacijo Maribor. Udeleženci so Vprašalnik za oceno izboljšanja zdravja (BHI2) izpolnili dvakrat, ob začetku in ob zaključku rehabilitacije. BH12 predstavlja novo metodo ocenjevanja in v Sloveniji še ni bil uporabljen. Je standardiziran psihodiagnostični instrument, ki so ga avtorji razvili za psihološko ocenjevanje bolnikov in spremljanje sprememb med rehabilitacijo. Rezultati: Rehabilitacijo je s pozitivnim izidom, to je z zaposlitvijo, zaključilo 77 % udeležencev raziskave; 23 % smo jih ob zaključku ocenili kot nezaposljive. V primerjavi z začetno oceno smo ob zaključku rehabilitacije ugotovili številne spremembe na področjih, ki smo jih ocenjevali z BHI2. Največji napredek (p<0,01) so pokazali rezultati na lestvicah za oceno depresije, anksioznosti, neprilagojenosti, nasilja, nezadovoljstva z delom in ocenjene stopnje maksimalne bolečine. Zmerno izboljšanje (p<0,05) so našli pri lestvicah za oceno pritožb v zvezi z bolečinami, sovražne nastrojenosti, mejne osebnostne motnje (angl. borderline), zlorabe substanc, družinskega nesoglasja in ocenjene stopnje minimalne bolečine, medtem ko smo pri rezultatih ostalih lestvic sicer našli trend izboljšanja, vendar razlike niso bile statistično značilne. Večje izboljšanje ocen z BHI2 je povezano s pozitivnim rehabilitacijskih izidom. V skupini oseb, ki so se ob zaključku zaposlile, smo ugotovili statistično značilne razlike, pri udeležencih, ki so bili ob koncu rehabilitacije ocenjeni kot nezaposljivi, pa jih ni bilo. Zaključek: Rezultati kažejo na pozitiven vpliv rehabilitacije, tako v smislu deleža oseb, ki se zaposlijo, kot tudi pozitivnih sprememb na področju psiholoških in psihosocialnih dejavnikov ter zadovoljstva z delom. Ugotavljamo, da je vprašalnik BHI2 koristen pripomoček pri ocenjevanju rehabilitacijskih potreb in načrtovanju rehabilitacije, saj pokriva širok spekter telesnih, čustvenih, osebnostnih in psihosocialnih dejavnikov, s čimer omogoča celovit vpogled v posameznikovo stanje ter z zaporednimi ocenjevanji omogoča oceno napredovanja v programih rehabilitacijeTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča