Çalışmayan şizofreni hastalarında çalışma güdülenmesi ve ilişkili demografik etkenler

Amaç: Şizofreni hastalarında iş yaşamına katılım oranı oldukça düşüktür. Bununla beraber çalışmayan hastaların çalışma isteği ve iş arayışı olabilmektedir. Hastaların çalışma güdülenmesinin nedenleri ve güdülenmeyle ilişkili etkenlerin bilinmesi mesleksel rehabilitasyon çalışmaları için yol gösterici olabilir. Bu araştırmada çalışmayan şizof- reni hastalarında, çalışma güdülenmesinin nedenleri ve güdülenmeyle ilgili öngörücülerin saptanması amaçlandı. Yöntem: Altı merkezde en az iki yıldır şizofreni veya şizoaffektif bozukluk tanısıyla izlenen ve herhangi bir işte çalışmayan 379 hastanın demografik, klinik ve iş yaşamıyla ilgili özellikleri incelendi. Çalışma isteğinin nedenleri sorgulandı. Hem çalışma isteğinin, hem de iş arayışının olması çalışma güdülenmesi olarak değerlendirildi. Güdü- lenmesi olan ve olmayan hastalar demografik ve hastalıkla ilgili veriler açısından karşılaştırıldı. Güdülenmeyi yorda- yan etkenleri saptamak için lojistik regresyon analizi yapıldı. Bulgular: Yaş ortalaması 42, eğitim ortalaması dokuz yıl, hastalık süresi ortalaması 18 yıl olan katılımcıların çoğu erkek ve bekardı. Hastaların %33’ünde çalışma güdü- lenmesi saptandı. Güdülenimin nedenleri arasında maddi gereksinmeler (%45) ve bağımsız yaşama isteği (%35) öne çıkarken, güdülenmesi olmayan hastalarda işin üstesinden gelemeyeceği (%66) ve sosyal yardımların kesil- mesi düşüncesi (%24) ağırlıktaydı. Erkek cinsiyet (OR=2.0), meslek edinimi (OR=2.0), hastalık sonrası iş deneyimi (OR=1.2), eğitim düzeyi (OR=1.1) ve hastalık süresi (OR=0.9) çalışma güdülenmesinin yordayıcıları olarak saptan- dı. Sonuç: Çalışmayan hastaların üçte birinde çalışma güdülenmesinin olması önemli bir bulgudur. Sosyal destek kaybının olmaması bazı hastalar için işe girme açısından güdüleyici olabilir. Özellikle meslek edinmiş, eğitim düzeyi yüksek, iş deneyimi olmuş ve hastalığın erken döneminde olan hastaların işe yerleştirme hizmetleri için aday olduk- ları söylenebilir. (Anadolu Psikiyatri Derg 2020; 21(1):23-29)

Work motivation and related demographic factors in unemployed patients with schizophrenia

Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemployed patients might have desire to work and look for a job. Identifying the reasons underlying the patients’ work motivation and related factors can be instructive for the vocational rehabilitation services. The purpose of this study was to deter- mine the reasons for work motivation and to identify the predictors of motivation in unemployed patients with schizo- phrenia. Methods: Sociodemographic and working life information of 379 unemployed patients with schizophrenia or schizoaffective disorder diagnosed for at least two years was collected from six different centers. The patients were questioned about their desire to work and its reasons. Having desire to work and job seeking behavior together was considered as work motivation. Patients with and without having work motivation were compared regarding to their sociodemographic information and illness characteristics. Logistic regression analysis was conducted to find the factors predicting the work motivation. Results: The participants’ mean age was 42, level of education was nine years, duration of illness was 18 years, and majority consisted of males and single patients. It was found that 33% of the patients were motivated to work. While distinct underlying reasons of the work motivation were found as financial needs (45%) and will for independent living (35%), idea of not being able to deal with the requirements of the job (66%) and not receiving social welfare payment (24%) were dominant in patients who weren’t motivated to work. The predictors of work motivation were found as male gender (OR=2.0), having a profession (OR=2.0), having work experience after the illness (OR=1.2), level of education (OR=1.1), and duration of illness (OR=0.9). Conc- lusion: We found that one-third of unemployed patients with schizophrenia have work motivation as an important finding. The patients may feel more comfortable and motivated to work if they would continue to receive social wel- fare payment after they started a job. It could be concluded patients who have a profession, high level of education, previous job experience, and who are at the early stage of their illness are suitable candidates for the vocational rehabilitation services. (Anatolian Journal of Psychiatry 2020; 21(1):23-29)

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