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There are many calls for personalized learning (instruction) (in Germany 'Individuelle Förderung'), especially for persons with special educational needs in the transition to vocational training or retraining. Teachers can find a variety of concepts and instruments to construct personalized learning. The challenge is to combine and to connect several concepts and instruments (e.g. for competence diagnosis or for transferring results of the competence diagnosis to support competence development) as we do not have the one unique instrument that guarantees personalized learning instruction. Furthermore, teachers and students have problems with the implementation of some concepts and instruments, considering the conditions, resources, and goals in their practical field. Against this background, the contribution looks at the question of how teachers in these courses with usually heterogeneous groups design personalized learning instruction. A focus will be on the reception, adaption, and design of concepts and instruments. Described is the research design of the case study in a practical field of vocational rehabilitation according to design-based research. Several instruments (e.g. a curriculum with learning situations of vocational orientation, a learning diary, and an individualized education plan) were designed, implemented, evaluated, and re-designed in a cooperative process between actors of practice and actors of science. Based on problem-centered interviews and group discussions during the whole design process with teachers and learners, qualitative data were collected to reconstruct the personalized learning (instruction) in this practical field. Main findings with reference to the implementation of concepts and instruments are stated. The contribution ends with a short conclusion.

To increase the number of German employees undergoing rehabilitation rather than retiring early because of medical disabilities, a screening process was developed whereby the pension insurance institutions responsible for administering medical rehabilitation measures would identify persons in need of rehabilitation and urge them to take part. An experimental trial involving 600 people indicated the screening's effectiveness. (Author/JDD)

Background: This study aimed to describe sequences of vocational rehabilitation services among individuals with approved vocational rehabilitation in Germany and to identify typical service sequences. Methods: We used administrative data on vocational rehabilitation services and questionnaire data on health and work ability to describe frequencies and sequences of vocational rehabilitation services financed by the Federal German Pension Insurance. Through sequence analysis, we were able to map the service sequences. We did cluster analyses to identify typical different service sequences. Results: Our sample included 1,652 individuals with 2,584 services. Integration services and two-year vocational retraining were the most common services. We could identify three different service clusters around integration services: shorter ones, followed by employer benefits and without employer benefits. We found two different clusters around two-year vocational retraining: shorter and longer clusters. Two-year vocational retraining was more often initiated by preparatory services and followed by employer benefits than integration services. Longer services in both clusters were associated with better baseline data for physical health, work ability, risk of future work disability, and younger age than shorter services. People in two-year-vocational retraining reported at baseline better general health, better work ability, low risk of future work disability, and less mental illness compared to people in integration services. Conclusions: Multiple services, that is, sequences of services, were more likely to occur among individuals with more complex services like two-year vocational retraining. Utilization of complex services and longer services was influenced by health, age, risk of future work disability, and education. Trial registration: German Clinical Trials Register DRKS00009910, registration 25/01/2016. [ABSTRACT FROM AUTHOR]

In Germany, 1.7 million individuals received reduced earning capacity pensions in 2020, but reintegrating them into the labor market remains challenging. For individuals who have a reduced earning capacity, this often leads to adverse consequences (e.g., low quality of life, poverty, social stigma). The project 'Cooperation for prevention, fitness and health in the job center (KOPF22)' focuses on early risk detection and prevention strategies for clients of the job center (who are recipients of Citizen's Income) as they face various challenges in maintaining their ability to work. The padaCura App, a key component of the project, assesses the risk of reduced earning capacity using an ICF-based questionnaire. It offers immediate feedback reports to clients, categorizing their risk levels and suggesting actions in plain language with visual aids. Since the project emphasizes the client's autonomy and voluntary participation, clients decide how to proceed with their results. If they decide to cooperate with the job center, then several offers for prevention and intervention measures can be used to increase employability. The first evaluations of the app and the questionnaire demonstrate its effectiveness in differentiating between employable persons and incapacitated individuals. Future developments should focus on enhancing the result reports to include more targeted interventions and on collaboration between employment support resources and healthcare systems to meet clients' needs. [ABSTRACT FROM AUTHOR]

Purpose: Sociodemographic and structural conditions have consequences for the labor market participation of young persons with disabilities (YPWD) in vocational rehabilitation (VR). As the type of program determines the labor market chances, we analyze the processes of selecting active labor market programs (ALMP) in VR. Which factors determine the allocation to (1) programs in general and (2) moreover, the allocation to specific programs? Materials and methods: We conduct logistic (1) and multinomial regression (2) using register data of the German Federal Employment Agency. Besides variables on the micro level, we control for a wide range of structural and organizational influences. The sample comprises VR and employment biographies of 255,009 YPWD accepted to VR between 2010 and 2015. Program participation is restricted to start 180 days after VR acceptance. Results: Sociodemographic factors, like age and the status before entering VR as well as the local apprenticeship market as a structural condition, highly influence the general allocation to ALMP. For the allocation to specific ALMP, sociodemographics (age, education, type of disability, status before entering VR) are highly relevant. Furthermore, structural conditions (regional structure of subsidized vocational training and of the apprenticeship market as well as local work possibilities on a special labor market for PWD) and – to a lesser extent - re-organization processes at the FEA (NEO, VR cohort) are important determinants. Conclusion: (Automatic) paths into VR programs for especially persons with mental disabilities in sheltered workshop are clearly shown. Furthermore, it is somewhat questionable that YPWD participate more often in sheltered workshops in regions where sheltered work possibilities are more common, as well as where NEO was implemented locally; and participate more often in company-external vocational training where VR service providers are commissioned to a greater extent. [ABSTRACT FROM AUTHOR]

The normative and political call for an inclusive working world as the UNCRPD explicates is not consistent with the current employment realities of people with disabilities in Germany and in the Nordic countries such as Iceland, Norway or Sweden. Only a fraction is able to find employment on the labour market, while segregated systems are expanding at the same time. We reference the 'Work 4.0' discourse with a particular focus on substitutability potentials and automation processes in the course of digitalization. These developments go hand in hand with the pluralization of employment constellations as well as progressive expansion of education and devaluation of qualifications. This article takes a critical look at these processes of change in the working world with regard to their effects on people with disabilities. The central contradictions between political, legal, and normative demands for employment realities to be organized inclusively as well current developments in the area of technology, employment, and knowledge are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation aims to empower people to cope with their chronic conditions, to ensure societal and vocational participation and to prevent health-related early retirement. In Germany, medical and vocational rehabilitation are unconnected services. Expenditures on health-related early retirement in Germany rise while expenditures on vocational rehabilitation do not. Since the use of rehabilitation services often depends on the transition between services, the present study aims to shed light on barriers and facilitators for the transition between medical and vocational rehabilitation from the perspective of service providers working in different institutions., Methods: In this sub-study we made use of a qualitative approach and conducted semi-structured focus groups with service providers, namely employees of rehabilitation institutions which we analyzed using Qualitative Content analysis and an inductive-deductive Coding System., Results: Twenty-four employees of rehabilitation institutions participated in five different focus groups. Especially the pension funds as institutions and medical rehabilitation clinics' employees of different professions are considered to be relevant professional actors to ensure the continuity of care between medical and vocational rehabilitation. Facilitating and hindering factors include the labour market situation, the Covid-19-pandemic, feedback for employees, an interdisciplinary assessment, different time-related aspects as well as individual factors such as the rehabilitants' diagnoses., Conclusion: The findings are largely in line with previous research and point to the difficulty and importance of continuity of care between different rehabilitation services as well as the varying agency and responsibility attributed to different actors. The rehabilitation employees' view will later be integrated with the perspective of the rehabilitants., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the data protection officer and by the ethics committee of Brandenburg Medical School Theodor Fontane, Reference ID: E-01–20220128. All participants participated voluntarily, received information about the study and data protection and gave written informed consent. Consent for publication: Not applicable. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s).)

In Germany, vocational rehabilitation (VR) for young people with disabilities (YPWD) aims to counteract disadvantages on the training and labour markets. However, the school-to-work transitions (STWT) among YPWD are underexplored. This study investigates to what extent and for whom VR provides an institutional bridge into employment. Based on representative administrative data of the German Federal Employment Agency, young people in VR are observed for 6.5 years after completing lower or intermediate secondary education in 2008. Using optimal matching and cluster analysis, six typical STWT trajectories are identified. Most of the YPWD completed company-external vocational training, some undertook regular in-firm training. These forms of training often lead to regular employment, albeit with a delay for some. Other young people are guided from training in sheltered workshops into sheltered employment. Another group exhibits problematic STWTs in which recurring unemployment and (non-training) programmes fail to lead to training or employment. VR combined with in-firm or company-external vocational training can facilitate the STWTs of people with disabilities. However, individuals from poor families are less likely to benefit from VR. Similarly, restricted capabilities and problematic STWTs are observed when young people drop out of VR due to poor cooperation. Vocational training often is a prerequisite for labour market entry; however, if the structural conditions on the local labour market are unfavourable, young people with disabilities do not take up employment. Training within sheltered workshops often leads to highly institutionalised trajectories that should be reconsidered to permit greater permeability into the regular labour market. As young people with problematic STWT more often come from poor households, they should be targeted to a greater extent in the context of VR counselling. [ABSTRACT FROM AUTHOR]

Purpose The aims of this study were (1) to develop a new classification for the scores of the Modified Spinal Function Sort (M-SFS) which is related to the level of physical work demands and (2) to test the predictive value of the M-SFS classification. Methods The classification was carried out in 194 subjects with musculoskeletal disorders (MSD) attending a work-related medical rehabilitation from four rehabilitation centers. External criterion was a Functional Capacity Evaluation (FCE)-based work capacity estimation according to the classification used in Germany ("REFA") which differentiates between light, light to medium, medium and heavy work. The optimal cut-offs for the M-SFS were allocated using the Youden index. Logistic regression models were calculated based on 147 subjects who participated in the follow-up survey to evaluate the predictive validity of the M-SFS classification with regard to sustainable return to work (RTW; employment at the 3-month follow-up combined with a low level of sick leave). Results Cut-offs for M-SFS scores were 44 (light work), 54 (light to medium work), 62 (medium work) and 73 (heavy work). A match between the M-SFS category and the level of physical work demands was associated with a more than threefold higher RTW chance compared to subjects with a negative discrepancy. In case the M-SFS category was above the physical demand level the RTW-chance was more than 13-fold higher. Conclusions M-SFS scores can be classified into four levels of physical work demands. If the perceived work capacity matches or exceeds the level of physical work demands patients with MSD have a substantially higher probability to return to work after rehabilitation. More studies are needed to confirm or reject our findings and overcome some of the weaknesses of this study. [ABSTRACT FROM AUTHOR]

Background: There is a vicious cycle between unemployment and mental health issues. Unemployed individuals with mental health issues require individualized support at multiple levels in order to promote their mental health, and obtain and retain employment. The 3for1-intervention program aims to provide such support with three components (short-term psychotherapy, job coaching based on the Individual Placement and Support approach, and peer support). This study protocol outlines how the effectiveness of this three-component intervention program in terms of re-employment, mental health, and psychosocial outcomes will be evaluated., Methods: The 3for1-intervention program will be evaluated with a non-randomized controlled trial design in a multi-center study. 500 eligible participants aged between 18 and 60 years from six job centers in Southern Germany will be allocated to a control group or an intervention group. Allocation is time-based, with the control group being recruited first, followed by recruitment of the intervention group. The control group will receive treatment as usual, whereas the intervention group will receive treatment as usual as well as access to the three intervention components over a period of 12 months. Assessment will be conducted at baseline (t0), and 12 (t1) and 18 (t3) months later. The primary outcome will be the proportion of participants who are in employment subject to social insurance contributions at t1. Differences between control and intervention group will be tested with logistic regression analysis, controlling for relevant covariates. Analyses of secondary outcomes will relate to group differences regarding re-employment, health and well-being, social integration, help-seeking, and self-stigma at t1 and t2, applying logistic regression analysis or analysis of covariance. Additionally, usage of health services will be measured to evaluate the intervention program's cost effectiveness., Discussion: The 3for1-intervention aims to improve employability and mental health outcomes of a vulnerable population with high need for assistance. Improvements for this population would benefit the German welfare state as well. This study could provide valuable insights into the feasibility, implementation, and sustainability of this individualized, multi-level support program within German job centers., Trial Registration: This trial is registered with the German Clinical Trials Register: DRKS00029002 (registered on 11 May 2022)., Competing Interests: Declarations Ethics approval and consent to participate The study protocol was approved by the ethics committee of Ulm University on 02 March 2022 (application number: 04/22) as well as subsequently by the ethics committee of the University of Tübingen on 06 May 2022 (application number: 159/2022BO2). The study will be conducted according to the Declaration of Helsinki, and international and local laws. Written informed consent is a prerequisite to participate in the study. After detailed verbal and written information about the study, individuals give their informed written consent to participate. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Depression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work., Methods: The sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses., Results: A total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS., Limitations: The sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited., Conclusions: People with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Individuals receiving means-tested benefits are at a higher risk of being diagnosed with a psychiatric illness compared to those who are employed, and the rate of those working in the first labor market is low. The intervention (Individual Placement and Support, IPS) aims at maintaining or regaining working ability and at facilitating reintegration into the (first) labor market following a "first place, then train"-approach. The objective of the study is to conduct the first RCT in Germany that addresses a broad group of long-term unemployed individuals with severe mental illnesses that receive means-tested benefits, and to test the effectiveness of the IPS intervention. Methods: In this randomized controlled trial, about 120 eligible participants aged between 18 years and local retirement age will be randomly allocated to an intervention group (IG) or to an active control group (CG) using a parallel arm design. The IG will receive IPS + high quality treatment as usual (TAU), the active CG will receive TAU + a booklet on integration measures. A block-randomization algorithm with a targeted assignment ratio of 1:1 for participants in IG and active CG will be used, stratified by sex and three age groups. Assessments will take place before the intervention at baseline (t0), and 6 (t1), 12 (t2), and 18 (t3) months later. Primary outcome will be the proportion of participants having worked at least 1 day in competitive employment since baseline, as assessed at t3. Secondary outcomes will be related to employment/ vocation and mental health. In addition, there will be a process evaluation. Treatment effects on outcomes will be tested using appropriate panel-data regression models, and acceptability, uptake and adherence will be evaluated using descriptive statistics and appropriate inference testing. Discussion: The results of this trial are expected to generate a better understanding of the efficiency, feasibility, acceptance, and relevance of the IPS intervention in a German setting. They could be a first step towards the implementation of the method and towards improving the situation of long-term unemployed individuals with severe mental health problems. Trial registration: German Clinical Trials Register (DRKS00023245), registered on 22.02.2021. [ABSTRACT FROM AUTHOR]

Background: For people who have experienced mental health crises or psychosocial disabilities, it is considerably more difficult to receive support to participate in work on an equal basis with others. In the town of Geesthacht, in Northern Germany, an integrative care network was implemented that allows for acute psychiatric treatment as well as participation in work and activities. This paper aims to explore the principles, advantages, and challenges of this innovative project. Methodology: Within the context of a participatory and collaborative process evaluation of a prospective controlled cohort study (PsychCare), researchers with and without experiential expertise conducted expert interviews and focus groups to evaluate the experiences of 37 employees, with and without lived experience, from various institutions associated with this care network. The data was analyzed using qualitative content analysis. Results: It was the change from financial compensation paid on a daily basis to a global treatment budget that allowed for a significant reduction of hospital beds in Geesthacht and freed up resources to implement a complex care network. Since then, various possibilities for participation, work, and activities for former service users, some of which are compensated financially, have been made available. These developments now allow for a less bureaucratic and often smooth transition from being a service user to involvement in participatory activities in the role of a peer, which is frequently perceived to be empowering and beneficial by participants with lived experience. At the same time, this care model has led to multiple role conflicts and different challenges for all parties involved. Conclusion: This innovative project in Geesthacht demonstrates the multifaceted potential of a global treatment budget system in the field of mental health care. To address certain downsides of the Geesthacht model, further development is necessary. [ABSTRACT FROM AUTHOR]

Background: Treatment results achieved after fulfilling an inpatient psychosomatic rehabilitation are often not permanent. Additional participation in outpatient rehabilitation aftercare may reduce the risk of recurrent disorders and support a successful reentry to working life. A therapy diary should accompany the aftercare and bring about the self-reflection process of psychosomatic rehabilitates, which could reduce recurrent disease progressions and support the recovery process as a whole. The study focuses on the evaluation of the effectiveness and implementation potentialities of a therapy diary in outpatient rehabilitation aftercare. Methods: In a qualitative study, seven therapists for outpatient rehabilitation aftercare in Central Germany and eleven outpatient psychosomatic rehabilitation patients were interrogated using partially standardized, guideline-based expert interviews. The data evaluation is based on the Qualitative Content Analysis according to Mayring. Results: The results show that an accompanying use of a therapy diary during the outpatient rehabilitation aftercare enables an intense commitment through own thoughts and feelings. By writing down thoughts, emotions, dysfunctional behaviors in problematic situations, great successes are experienced. Through this initiated self-reflection process, the rehabilitant gains a better knowledge of one's behavior in dealing with oneself and the environment and thereby, whenever necessary, learns to create new ways of acting. Conclusions: The voluntary use of the therapy diary in the outpatient rehabilitation aftercare could assist the therapy process and henceforward the recovery of the rehabilitants, and also increase the prospect of successful occupational rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose To investigate how completing vocational re-training influenced income and employment days of working-age people with disabilities in the first 8 years after program admission. The investigation also included the influence of vocational re-training on the likelihood of receiving an earnings incapacity pension and on social security benefit receipt. Methods This retrospective cohort study with 8 years follow up was based on data from 2399 individuals who had completed either a 1-year vocational re-training program (n = 278), or a 2-year vocational re-training program (n = 1754) or who were admitted into re-training but never completed the program (n = 367). A propensity score-based method was used to account for observed differences and establish comparability between program graduates and program dropouts. Changes in outcomes were examined using the inverse probability-weighted regression adjustment method. Results After controlling for other factors, over the 8 years after program admission, graduates of 1-year re-training, on average, were employed for an additional 405 days, 95% CI [249 days, 561 days], and had earned €24,260 more than without completed re-training, 95% CI [€12,805, €35,715]. Two-year program completers, on average, were employed for 441 additional days, 95% CI [349 days, 534 days], and had earned €35,972 more than without completed re-training, 95% CI [€27,743, €44,202]. The programs also significantly reduced the number of days on social-security and unemployment benefits and lowered the likelihood of an earnings incapacity pension. Conclusion Policies to promote the labor market re-integration of persons with disabilities should consider that vocational re-training may be an effective tool for sustainably improving work participation outcomes. [ABSTRACT FROM AUTHOR]

Vocational rehabilitation aims at getting people with health problems or disabilities back into work. In Germany, the Public Employment Service is a central provider of vocational rehabilitation services targeted at unemployed people. Against this background, the study examined the labour market effects of vocational rehabilitation for people registered as unemployed with the Public Employment Service. A comparison of the accepted and the rejected applicants for vocational rehabilitation using inverse probability weighting based on propensity scores provides an insight into its effects. The results suggest that the employment prospects of persons who were accepted in the programme improved modestly after the third‐year following application. A subgroup analysis identified stronger re‐employment effects of acceptance into vocational rehabilitation in eastern Germany as well as for men and older individuals. [ABSTRACT FROM AUTHOR]

Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a growing number of young people with psychological disabilities in vocational rehabilitation can be observed. The study at hand focuses on this group and examines their (un-)unemployment biographies before vocational rehabilitation, their access to vocational rehabilitation and identifies their individual challenges within the process of vocational rehabilitation. Methods Using a multi-methods approach, we analyze representative administrative data of the German Federal Employment Agency as well as biographical interviews conducted with young rehabilitants. We compare the population of young rehabilitants with psychological disorders to those with other disabilities in terms of vocational rehabilitation and initial labor market entry in order to get a representative picture about their school to work transitions. Since rehabilitants with psychological disabilities tend to be older than the remaining population, analyses are stratified by age groups. In addition, qualitative in-depth interviews provide an additional and deeper understanding of specific employment barriers youth with psychological disorders have to overcome. Furthermore, the individual perspective gives insight on how the crucial transition from school to work is perceived by the population under study. Results The pathway into vocational rehabilitation of youth with psychological disorders is often characterized by obstacles in their transition from school to work. During rehabilitation, it appears essential to provide psychological stabilization along with vocational training. Although their average level of education is higher than those of other rehabilitants, labor market transition after (often company-external) vocational training challenges many young people with psychological disabilities, leaving many of them with comparatively poor labor market prospects. Conclusions Young persons with psychological disabilities, who come from regular schools or dropped out from regular school or university, seem to find their way to vocational rehabilitation more indirectly. Furthermore, vocational rehabilitation itself is often prolonged for those with psychological disabilities possibly due to a corresponding stabilization process. However, vocational rehabilitation can be a core element within the stabilization process of a psychological disease. [ABSTRACT FROM AUTHOR]

Purpose: General practitioners (GPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different functions in the rehabilitation process, which need to be interlinked effectively to achieve a successful medical and occupational rehabilitation. In Germany, this cooperation at the interfaces is often suboptimal. The aim of this study was to identify and discuss perceived barriers to cooperation between GPs, OPs, and RPs. Methods: We used a qualitative study design with eight focus group discussions (FGD) with GPs, OPs, RPs, and rehabilitants. Two FGDs per expert group with 4-10 participants were conducted. The transcripts were analyzed using qualitative content analysis. Results: A number of obstacles to cooperation were reported by the participants, including (1) organizational (e.g., missing contact details, low reachability, schedule restrictions), (2) interpersonal (e.g., rehabilitants level of trust in OPs, low perceived need to cooperate with OPs, low motivation to cooperate), and (3) structural barriers (e.g., data privacy regulations, regulations concerning rehabilitation reports). Conclusion: The present data agree with study results from other countries, which addressed interfaces in the rehabilitation process. While some barriers could be overcome by the participants themselves, a multi-level stakeholder approach might be necessary. Future quantitative research is required to assess the relative weight of the findings. [ABSTRACT FROM AUTHOR]

As one of many fields of application, electronic monitoring (EM) of offenders can be used-in conjunction with other measures-for release preparation. Using such measures, policymakers expect an alleviation of the negative effects of imprisonment and the promotion of positive rehabilitative effects by adding structure and social support. At the same time, policymakers are willing to maintain community safety through the close supervision provided by EM. The present study examines participants' psychological and psychosocial changes during two measures of electronically monitored release preparation, namely, home detention and early work release. These findings are compared with a randomized group of participants who remained in custody. In sum, we found no distinctive positive effects of the tested measures. Because most participants already displayed functional psychological characteristics at pretest, there was only a small margin for improvement through electronically monitored release preparation. We conclude that if rehabilitation is sought by the use of such measures, it is important to select a target group that is actually in need of rehabilitative support and equally important to conduct further research on the rehabilitative potential of EM measures. [ABSTRACT FROM AUTHOR]

PurposeThe purpose of this study was to gather data about physical activity and quality of life (QoL) for people of working age with visual impairments to optimize upcoming physical activity-based interventions in vocational rehabilitation.MethodsTwo hundred and seventy-seven former participants of four vocational rehabilitation centres in Germany answered an online questionnaire. The health-related QOL has been assessed by means of the WHOQOL-BREF questionnaire. The data were analysed via multivariate analysis of covariances (MANCOVAs), univariate analysis of covariances (ANCOVAs) and discriminant function analysis.ResultsCompared to a normative group of adults aged 36–45, the study group showed lower values in all domains of QOL. The MANCOVA (visual acuity) produced no multivariate significant effect. Also, the ANCOVA showed no significant effect for the global dimension of the WHOQOL-BREF. The MANCOVA (leisure time activity) produced a multivariate significant effect. Post-hoc ANCOVAS revealed significant effects for all four domains of QoL. The ANCOVA analysing the global domain showed a similar significant effect as well. The active persons had higher values in all domains of QoL compared to the more passive participants.ConclusionInterventions in vocational rehabilitation should focus on leisure time activity to enhance QoL. At this stage, the role of physical activity is still unclear and further studies are needed. Implications for rehabilitationPeople with visual impairments often show a worse quality of life than normal-sighted people.The degree of severity of the visual impairment does not affect quality of life.Sport and physical activity are effective means of improving quality of life.An active leisure time activity supports the improvement of the quality of life of visual-impaired people that participated in a vocational rehabilitation. [ABSTRACT FROM PUBLISHER]

Introduction Although there is much empirical evidence for a given relationship between health and labour market status (LMS), the following study focuses on a group for which little is known in the German context: people with disabilities in vocational rehabilitation for the purpose of re-integration into the labour market. In this specific context, the article analyses how a change in LMS affects physical, mental and general health. Methods Using a panel survey, 857 people with disabilities in vocational rehabilitation and their subjective health condition were observed between 2008 and 2010. To reduce bias due to unobserved heterogeneity, fixed-effects panel regression is applied. Results Results show that a move from non-employment to employment positively affects-particularly general-subjective health. In addition to LMS, the level of occupational limitation due to disability appears to be of particular relevance in estimating health. Interacting both the level of occupational limitation and LMS reveals that non-employed people reporting serious occupational limitation due to their disability have the worst subjective health across all aspects. However, people in employment experiencing similarly serious limitations due to their disability do not differ much from this group. These may be regarded as having taken up disability-inappropriate employment. Conclusion The results suggest that re-integration into employment particularly improves several health aspects if rehabilitants are integrated in an occupational environment where disability does not present an occupational limitation. Thus, placement in disability-appropriate employment needs to be particularly encouraged. [ABSTRACT FROM AUTHOR]

Vocational rehabilitation services have been implemented in a number of countries to facilitate the return to work of sick and injured workers, yet little research has been undertaken to document competencies required to provide services globally. This study compared the job tasks, functions, and knowledge domains deemed important by Australian and German rehabilitation professionals working in vocational rehabilitation settings to identify common practice domains. An online survey comprising items from the Rehabilitation Skills Inventory–Amended and the International Survey of Disability Management was completed by 149 Australian and 217 German rehabilitation professionals. Items from each measure were submitted to factor analysis, using principal axis factoring as the extraction technique. Three common domains were identified: (a) vocational counseling, (b) workplace disability case management, and (c) workplace intervention and program management. Differences in skill and knowledge domains centered on the levels of specialization in vocational rehabilitation practices in each country. Ongoing transnational research is required to ensure that a “global curriculum” covers core competencies, while at the same time allowing for specialization at a local level. [ABSTRACT FROM PUBLISHER]

Avoiding inequality of opportunities based on individual characteristics such as sex, race or disability is of central concern for social policy. One of the most important aspects of social inclusion is integration into working life. In Germany, a comprehensive system of vocational rehabilitation has been developed aiming to integrate disabled people into the labour market. This paper contributes to a better understanding of exclusion and inclusion mechanisms related to employment participation of disabled people through the application of concepts from systems theory. We identify the societal part systems influencing these mechanisms and structure them using a multi-level approach. [ABSTRACT FROM AUTHOR]

Copyright of International Journal for Educational & Vocational Guidance is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Since a growing number of patients are likely to return to work (RTW) after cancer diagnosis and treatment, there is an increasing recognition of the work situation, and the physical as well as psychosocial functioning among those survivors who returned to work. OBJECTIVE: To prospectively examine Health Related quality of Life (HRQoL) and different aspects of work satisfaction in cancer survivors. PARTICIPANTS: N=702 employed cancer patients (85% women) were recruited on average 11 months post diagnosis and assessed at the beginning (t_1), the end (t_2) and 12 months after cancer rehabilitation program (t_3). METHODS: Participants completed validated measures assessing work satisfaction, working conditions, job strain and HRQoL. RESULTS: Participants showed a high work satisfaction and were most satisfied with job related activities and least satisfied with work organization and leadership. Total work satisfaction was significantly associated with older age, higher monthly income, higher school education, and HRQoL, but not with any cancer- or treatment related characteristics. No significant changes in work satisfaction over time were observed except for a significant deterioration in satisfaction with job related activities (p=0.002; η ^2 =0.019), professional acknowledgement (p=0.036; η ^2 =0.009), and overall work satisfaction (p < 0.001; η ^2 =0.087) with small to moderate effect sizes. CONCLUSIONS: Our findings emphasize the need for comprehensive cancer rehabilitation programs and specific vocational interventions. [ABSTRACT FROM AUTHOR]

The article describes the current situation and development of supported employment in Germany during the past 20 years in the context of the German vocational rehabilitation system. [ABSTRACT FROM AUTHOR]

Copyright of Ergotherapie & Rehabilitation is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Germany at present, 64% of women and 59% of men who receive a diagnosis of cancer are still alive five years later. 45% of men and 57% of women with cancer are still of working age. Cancer can markedly harm their ability to work. Methods: We analyzed data from selected publications to calculate the percentage of cancer patients in Germany who are now returning to work. Results: The efficacy of oncological rehabilitation has not been demonstrated by a randomized controlled trial, nor is it clear whether the existing studies have accounted for potentially confounding variables. A combined assessment of reports from various countries reveals that 63% of cancer patients who are of working age go back to work after being unable to work for an average of five months. The situation varies markedly across countries: In Germany, the percentage of women with breast cancer who return to work is only 59%, compared to 80% in the USA and 82% in the United Kingdom. Younger and better educated patients are more likely to return to work, as are those who have received less invasive treatment with fewer complications. Conclusion: Most cancer patients of working age go back to work, but the percentages vary widely from one country to another, perhaps reflecting differences in social systems. [ABSTRACT FROM AUTHOR]

People with severe mental disorders are often without work, although work may have a positive effect on their health. The paper presents some results in this field from the German S3 guidelines on psychosocial therapies. In terms of evidence-based medicine supported employment (SE - first place then train) has proven to be most effective. Nevertheless, SE is still rare in Germany. Pre-vocational training, however, follows the concept first train then place and is offered in rehabilitation of the mentally ill (RPK) centres in Germany. There is some evidence that the programs are beneficial for users. The UN Convention for the Rights of Persons with Disabilities outlines an obligation for work on an equal basis with others and for vocational training. So far, the German mental health system only partly meets these requirements. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews have confirmed the effectiveness of work-related rehabilitation with significant cognitive-behavioural components for patients with musculoskeletal disorders (MSDs). In Germany, however, work-related rehabilitation focuses mainly on functional capacity training and less on psychosocial work demands. Objective: To evaluate the efficacy of multimodal work hardening (MWH) with a cognitive-behavioural approach. Methods: Patients with MSDs resulting in severe restriction of work ability were randomly assigned to treatment by either MWH or conventional musculoskeletal rehabilitation (controls). The primary outcome was work status. The work status at 6 months of follow-up was defined as positive if the patient was working and had &les; 6 weeks of sick leave, and that at 12 months was defined as positive if the patient was working and had &les;12 weeks of sick leave. Follow-up data were collected by postal questionnaires. Results: 236 patients consented to participate. Follow-up data were obtained from 169 (71.6%) participants at 6 months and 146 (61.9%) participants at 12 months. At 6 months, participants in the MWH group had a 2.4 times higher chance of a positive work status than the controls (OR=2.363; 95% CI: 1.266 to 4.410; p=0.007). At 12 months, the chances of a positive work status were still higher, but this difference was not statistically significant (OR=1.914; 95% CI: 0.849 to 4.317; p=0.118). Significance of the interaction term of treatment and time indicated more favourable outcomes for depression and anxiety, mental and physical health-related quality of life, and pain management in the MWH group. Conclusions: MWH improves health-related quality of life and is able to enhance the mid-term chances of work-life participation. [ABSTRACT FROM AUTHOR]

Introduction Vocational rehabilitation (VR) emphasizes a need for medical support, rehabilitation and biopsychosocial approach to enable individuals to successfully participate in the workforce. Optimal rehabilitation management relies on an in-depth knowledge of the typical spectrum of problems encountered of patients in VR. The International Classification of Functioning, Disability and Health (ICF) is based on a universal conceptual model and provides a holistic view of functioning of the lived experience of people such as those undergoing VR. The objectives of this study are to describe the functioning and health of persons undergoing VR and to identify the most common problems around work and in VR using the ICF as the reference framework. Methods An empirical cross-sectional multicenter study was conducted using convenience sampling from March 2009 to March 2010. Data were collected using a Case Record Form rated by health professionals which was based on an extended version of the ICF Checklist containing 292 ICF categories and sociodemographic information. Results 152 patients with various health conditions participated. We identified categories from all four ICF components: 24 for body functions, six for body structures, 45 for activities and participation, and 25 for environmental factors. Conclusions Our study identified a multitude of ICF categories that describe functioning domains and which represent the complexity of VR. Such a comprehensive approach in assessing patients in VR may help to understand and customize the process of VR in the clinical setting and to enhance multidisciplinary communication. [ABSTRACT FROM AUTHOR]

Copyright of Sozialer Fortschritt is the property of Duncker & Humblot GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To assess the longitudinal effectiveness of a comprehensive vocational rehabilitation program in Germany. In a non-randomized open study, 106 participants of two comprehensive rehabilitation programs were prospectively and multidimensionally compared to a control group ( n = 75) at program termination and at a 9 months follow-up. Primary outcome was employment status at 9 months follow-up, secondary outcome parameters were changes in symptoms (Positive and Negative Syndrome Scale), subjective well-being (WHOQOL-Bref), and level of functioning (Level of Functioning Scale) during the study. Regarding the primary outcome measure, there was significant more day structuring employment (mainly sheltered) in the rehabilitation group than in the comparison group (39.7 vs. 18.7%) at 9 months follow-up. Regarding secondary outcomes, rehabilitation participants showed a better course in general symptoms, subjective well-being and level of functioning. Vocational services proved to be effective to find day structuring employment for subjects with severe mental illness. Furthermore it had positive effects on functioning and psychological well-being during a 9-months follow-up period. [ABSTRACT FROM AUTHOR]

This article examines learning potential as a predictor of the success of a vocational rehabilitation program for patients with severe mental illness in Germany. Fortyone schizophrenia patients completed a pretest-training-posttest version of the Wisconsin Card Sorting Test as a measure of learning potential. Pretest scores indicated basic cognitive performance, and posttest scores indicated individual learning potential. Rehabilitation outcome was assessed using measures for work capability during the rehabilitation program and the level of vocational integration at 3-month follow-up. Individual learning potential was a better predictor of work capability and the level of vocational reintegration than basic cognitive performance. Our study demonstrates that learning potential is an informative predictor for rehabilitation outcome and adds information beyond basic cognitive performance. [ABSTRACT FROM AUTHOR]

The current paper examines an assessment instrument used for combined medical and occupational rehabilitation (MOR) in a group of German hospitals. Patients with a history of musculo-skeletal disease make up a significant proportion of those undergoing rehabilitation. Scale and factor structures, discriminant factors and clustering procedures used in the Bavaria rehabilitation patient assessment method (BRPAM) are investigated in a cross-sectional study involving a sample of 800 patients. Although the results reveal good correlation between differences in the job demand/patient capability profiles and the typical stresses to which the relevant occupation is exposed, analyses also indicate that several factors and items are unstable. According to subjective assessment by the patients, the therapeutic objectives are fully attained in some 80% of cases. Discrepancies between job demands and patient capability revealed by the BRPAM yield pointers to choice of therapy and its chances of success, but these need to be examined in greater detail in long-term studies. [ABSTRACT FROM AUTHOR]

The article focuses on health reforms related to vocational rehabilitation and sharing in the working life in Germany. The present average age in the German enterprises amounts to between 38 and 42 years. Due to the demographical development, this average age will increase clearly in the next years. Of the 55-to 65% population today only approximately 43% are employed. Thus Germany lies within the European union in the center zone. In Sweden for example, 70% of the age group of 38-42 are gainfully employed. As a result of this various problems are evident in the context of Germany. Increasingly more employees become increasing frailer--towards a demographically induced unemployment and a need for certified manpower from increasingly older years with increasing operational requirements. To escape from these, one needs to embody understanding of prevention and intervention as far as employment in Germany is concerned. Thus, various policies related to operational integration management are employed by German business enterprises.

The article presents a general framework related to problems and perspectives of the achievements of participating in the working life. In the context the occupational support work in Hamburg, Germany which is a part of a network of 28 occupational support works in Germany is observed. The occupational support work includes the areas of Schleswig-Holstein, Hamburg, North Lower Saxony and Western Mecklenburg-West Pomerania in Germany. As a center for professional rehabilitation, it produces for a space with about 5 million people the achievements to the participating in the working life and the society. In the course of the article the author puts the occupational support work in Hamburg in the center of his executions, as an example of the occupational support works, which produce achievements SGB IX to the participating in the working life and in the society. For the author, it is about quantitative and also the qualitative aspects of the subject. It soils not only on participating in the work by chance, but associated disadvantages should be avoided for handicapped people or be equalized at least.

Examines the vocational rehabilitation outcomes achieved by Great Britain and Germany. Growth in the social security benefits paid to disabled people; Labor market situation of disabled people in the two countries; Comparison between the quota schemes in the countries.

The article focuses on private recruitment agencies in Germany as a solution for reintegrating workers after being unemployed for a long period of time. The legal parameters with regard to private recruitment agencies are examined and various obstacles to vocational reintegration are outlined. The tension between the Federal Employment Office and private agencies is discussed.

Objective: This paper aims at assessing the vocational integration attained after a 3-year period by psychiatric patients who participated in different vocational rehabilitation programmes. Method: In the north-western German region of Westphalia-Lippe a naturalistic follow-up study was carried out on 471 patients from three different types of vocational rehabilitation programmes. The sample comprised chronically ill patients with a history of repeated and longterm hospitalization. Results: After 3 years 11% of the patients were in competitive employment, 67% (still) in sheltered employment, 7% in out-patient work therapy programmes and 15% were unemployed. It is important to notice that 74% achieved their subjective rehabilitation goals expressed at baseline. Conclusion: Vocational rehabilitation programmes are an essential part in the treatment of people with chronic mental illness. Integration into work varies markedly while patients' satisfaction is comparably good. Competitive employment represents a realistic objective only for patients with high motivation and favourable preconditions. [ABSTRACT FROM AUTHOR]

The article discusses long-term unemployment concerns in Germany and presents an overview of the situation as compared to other developed national economies including Australia, Japan, and Great Britain. Difficulties in reintegrating unemployed individuals in the workforce are outlined, such as loss of qualification or motivation. Strategies for long-term unemployment prevention are discussed.

The article focuses on vocational rehabilitation, specifically for older individuals. Issues pertaining to vocational training, the reintegration process and changes to the rehabilitation process based on demographics are discussed. Factors such as the chance of reintegration, the level of quality of employment and qualification levels after rehabilitation are considered.

The article discusses welfare services governed by public law compared with privately governed welfare provisions. In addition, financial autonomy for both public and private services is examined and applied to various scenarios including vocational rehabilitation. Repercussions for German citizens are discussed with regard to state benefits.