The study explored posttraumatic growth (PTG) and its relationship with the quality of life (QOL), posttraumatic stress, and resilience among survivors of terror attacks over 10 years post-injury. Participants were patients of Hadassah Medical Center, Israel, who were injured in terror attacks between 2000 and 2004 during the second Intifada. Variables of interest were obtained from a survey and patients' medical files. In total, 42 patients participated, 66% were men, and the average age was 41.4 years. Multivariate analysis was utilized to predict PTG from a variety of demographic variables including gender, ethnicity, relationship status, age, education, income, religiosity, and injury/disability type. Additional primary variables of study included current levels of QOL, posttraumatic stress, and resilience. Results revealed that married/partnered individuals had higher levels of PTG than divorced or single individuals. Findings suggest that social support following trauma is important for PTG and should be prioritized in recovery interventions with trauma survivors.

This paper is the second part of a two part series that examines the perceived roles and effectiveness of rehabilitation providers. The first paper examined the perceptions of rehabilitation providers regarding their roles in, and perceived barriers to, occupational rehabilitation. In this paper, key stakeholders' perceptions of the role of rehabilitation providers in the management of workplace injury were assessed via interviews and surveys. Forty-nine injured workers were interviewed and 407 returned a survey questionnaire. Two surveys of employers were conducted: one in the Newcastle/Hunter region of NSW, Australia (N = 93), the other a state-wide survey (N = 612) of a representative sample of employers in NSW. In addition, nine treating doctors and 14 insurers were interviewed. Results indicated that two thirds of workers were satisfied with the service they had received from the rehabilitation provider. The major concerns of injured workers were the rehabilitation providers' lack of knowledge of the demands of particular workplaces, the problems associated with particular injuries and the pressure on rehabilitation providers from employers and insurers to return the injured worker to work. Sixty percent of employers reported that rehabilitation providers were effective in restoring injured workers to work. Treating doctors were generally hostile to rehabilitation providers, claiming that they were unprofessional, inexpert and poorly trained. Finally, insurers complained of stereotypical case management plans, role confusion, and over-servicing.

The objectives of this study were (1) to evaluate the measurement structure of the Perceived Empathic and Social Self-Efficacy Scale amongst 194 individuals with serious mental illness (SMI) and (2) to establish construct validity for the Perceived Empathic and Social Self-Efficacy Scale. Confirmatory factor analysis yielded a two-factor measurement structure of the Perceived Empathic and Social Self-Efficacy Scale, which was positively associated with insight, social support, and life satisfaction. The Perceived Empathic and Social Self-Efficacy Scale is a useful measure to assess social skills amongst individuals with SMI in rehabilitation counselling.

This study examined the quality of life of compensable accident victims. The sample comprised 254 participants who completed the World Health Organization's EUROHIS Quality of Life scale as part of a vocational assessment. As hypothesised, there was substantially lower quality of life with a mean rating of 2.70 (SD = 0.74) on a five-point scale from very dissatisfied to very satisfied. There were statistically significant differences in quality of life, favouring those living in a rural vs city location, those living in areas of low unemployment and those with higher skill levels. Those who had a non-work accident had higher levels of quality of life as did those without a spinal cord injury or psychiatric sequelae. Participants who returned to work had the highest level of quality of life. The time since the personal injury averaged 3.58 years (SD = 3.61) and quality of life was not correlated positively with the effluxion of time (r = 0.057). A tentative process model of quality of life was proposed based on the significant factors from this study and divided the factors into three stages based on their occurrence across time as early, intermediate or late in relation to the injury.

The study aimed to understand the use and barriers to use of post-acute-care services by persons with acquired brain injury (ABI). A total of 21 primary family caregivers of persons recently discharged from an ABI acute-care facility in a large southwestern city in the United States participated. Service use in 14 domains appeared consistent with post-discharge needs. In five service areas, participants were not aware the service was available. Professionals in acute ABI rehabilitation units need to be fully aware of the range of available potential supports and diligent in informing injured persons and their families about available post-discharge services.

This paper examines employment issues concerning deafened adults, especially those with cochlear implants. The analysis shows that deafened people have fewer educational qualifications and are less likely to be in paid employment when compared with people without a hearing disability. In consequence, they report lower income levels. Conversely, respondents with cochlear implants reported higher levels of employment and income. In addition to disability, social factors such as age and sex may contribute to a person's socio-economic status. As such, rehabilitation interventions need to consider the person's social as well as auditory needs.

The impact of long-term unemployment is not confined to the vocational sphere but also includes a psychosocial component. Many who are out of work for long periods of time not only report deskilling but also lack of support, poor self esteem and low self confidence. This paper examines some of these issues by reference to both the Australian government's ‘Working Nation’ paper on unemployment and research carried out with 77 unemployed persons in Sydney, Australia. While it is not unusual for rehabilitation counsellors to receive referrals of people with disabilities who have been unemployed for considerable periods, contact with the general long-term unemployed population has been less common. The rehabilitation counselling profession is closely examined in terms of the degree to which its skill and knowledge base matches the needs profile of this general unemployed population. Rehabilitation counselling was found to be an appropriate profession to deal with the complex mix of vocational and psychosocial issues confronted by persons who have remained unemployed for long periods of time.

This study examined the personal factors as measured by the Vocational Rehabilitation Index and their influence on returning to work after compensable occupational injuries. The participants comprised 462 patients (335 males; 127 females) who underwent a vocational assessment. The length of time since the injury occurred varied from less than 1 year to 15 years with a mean of 3 years (SD = 2). Results indicated that only 23% had returned to work. Just on 30% of the patients had not worked at all since the accident and some 48% had returned to work but were now not working. The major influences on return to work following an occupational injury that were statistically significant (p < 0.001) were (a) the length of treatment (i.e., time since the injury), and (b) whether there was a psychological problem. The findings support the validity of the Vocational Rehabilitation Index for predicting the probability of return to work following an accident.

Objective. The study examined the evidence for the influence of chronic pain on proximal work participation behaviours important for job retention such as presenteeism, absenteeism and job satisfaction.

Method. A comprehensive literature search was undertaken using various databases including PsycINFO, Medline, Scopus and other sources which resulted in the identification of 353 articles of which 15 articles were chosen for analysis and inclusion. Eligibility was based on a mixed methodological framework using the Consolidated Standards of Reporting Trials (CONSORT) checklist.

Results. There is evidence to suggest that chronic pain influences work participation qualities including absenteeism, presenteeism and job satisfaction. Personality and work content factors mediate the relationship between chronic pain and the proximal work participation variables.

Conclusion. Interventions targeting proximal work context behaviours appear to hold promise for long-term work participation by people with chronic pain. Rehabilitation interventions for job retention with chronic pain will likely be successful with attention to ongoing, changeable work participation behaviours that predict job retention.

Work stress and burnout are common problems in rehabilitation services. Usually, attempts to account for stress and burnout focus on the qualities of the individual and the demands of the organisational environment. However, the current paper has responded to recent demands in the occupational stress literature to examine burnout from a third perspective, namely the institutional level. This level of analysis transcends the boundaries of organisations and can be defined by the various political, economic, social and legal constraints that characterise a broad area. It is argued that the rapid growth of insurance-based rehabilitation in Australia has created a unique institutional context that has significant implications for the development of stress and burnout among rehabilitation counsellors. Rehabilitation counsellors in this context face a diverse array of conflicting demands within a system that often does not support the goals of rehabilitation. It is proposed that the development of strategies to reduce stress and burnout in this area would benefit from an institutional-level analysis. While individualised stress management training clearly has a role in the minimisation of stress and burnout, it is proposed in the current paper that this issue has human resource management and educational implications that must be addressed.

Fifty patients with myocardial infarction were recruited from a hospital based Cardiac Education and Assessment Program (CEAP) in Sydney, Australia. The Exercise Motivation Inventory-2 (EMI-2) and the Depression, Anxiety and Stress Scale (DASS) were administered prior to commencement in the program and re-administered by telephone interview at 5-month followup. Four exercise adherence measures were completed: attendance, exercise stress test, self-report ratings and a 7-day activity recall interview. There was a 46% adherence rate for MI patients during the hospital based CEAP. Of those individuals who completed CEAP, 91% obtained functional improvement on the exercise stress test. For the 38 patients who were followed-up by telephone interview at 5 months, 71% were exercising according to CEAP prescription. Higher levels of anxiety were associated with lower levels of self-reported exercise adherence. The 3 strongest motivations for exercise in this group of MI patients were all health related; wanting to be free from illness, maintaining good health and recovering from the effects of coronary heart disease. The discussion highlights the implications of these findings for cardiac rehabilitation programs and the need for empirically driven guidelines for measuring exercise adherence.

The Helping Hands program commenced in 1999 and partners volunteers with mental health consumers for support and to increase social contact, recreational and friendship opportunities. The aim of the present study is to describe the evolution and sustainability of the program over the first 6 years. A description of consumers accessing the program using recovery-oriented measures and traditional measures of behavioural functioning is also provided. Service data was collected on the development of the program, service utilisation, volunteer participation and funding patterns. Cross-sectional measures of recovery and baseline and follow-up Health of the Nation Outcome Scales (HoNOS) were collected on 27 participants. Results showed that the Helping Hands program has evolved significantly since start-up with the development of numerous recreational, health and support groups and 48 active volunteers and 62 active clients. Consumer feedback indicates that the service increases the quality of life of participants considerably. Current clients showed less severe disability at referral than did the original group. There were improvements in the area of relationships on the HoNOS for those who had baseline and follow-up measures. The high volunteer participation rates and positive consumer outcomes represent significant value in return for the modest level of funding.

Originally presented at the National Injury Management and Prevention Conference: Transition and Change, on April 27, 2006, which was held at the Hyatt Regency, Adelaide, South Australia. Reprinted with the permission of the authors.

Work in the Australian construction industry is fraught with risk and the potential for serious harm. The industry is consistently placed within the three most hazardous industries to work along with other industries such as mining and transport (National Occupational Health and Safety Commission, 2003). In the 2001 to 2002 period, construction work killed 39 people and injured 13,250 more. Hence, more effort is required to reduce the injury rate and maximise the value of the rehabilitation/back-to-work process.

This study investigated pain coping profiles using the Coping Strategies Questionnaire-24 (CSQ-24) in a sample of 171 workers’ compensation clients with chronic musculoskeletal pain from Canada. Cluster analysis identified three distinct coping profiles: mixed coping, catastrophising, and positive coping. Multivariate analysis of variance (MANOVA) results revealed that the positive coping group had lower levels of activity interference and depression as well as higher levels of quality of life than the mixed coping and catastrophising groups. Study findings indicate clients with chronic musculoskeletal pain can be categorised according to pain coping strategies, and pain coping strategies used are related to rehabilitation outcomes. The implications of these pain coping profiles for rehabilitation counselling practice are discussed.

The Compulsory Third Party (CTP) system in Queensland is in need of modification to ensure efficacious rehabilitation outcomes for individuals injured in motor vehicle accidents (MVAs). In an attempt to address this concern, a study was conducted to examine the perceptions of three major stakeholders in this CTP process, namely, insurers, rehabilitation providers and solicitors. Further, the systemic chemistry inherent to the system was explored. Pervasive within this study was the notion that a culture of blame resulted from competing stakeholder agendas, the nature of the partnerships established between these stakeholders, and the widespread confusion resulting from the interplay of complex systemic factors. These systemic factors contributed significantly to ineffective rehabilitation and return to work for persons injured in MVAs. This paper is the first in a series about these concerns.

There are a number of scales intended to measure workplace attitudes toward people with disabilities. However, there is limited demonstration of validity evidence, especially theoretical validity. This article reports on the development of the Co-Worker Acceptance of Disabled Employees (CADE) Scale, including an examination of theoretical and empirical validity evidences. Theoretical validity is supported by screening each scale item through the difference model of disability. Empirical validity evidence is generated through a content validity study and an initial validity study. Exploratory factor analysis reveals that workplace attitudes toward employees with disabilities are based on perceived differences between those with disabilities and others. The CADE Scale will support workplace training and provide evidence of attitude change subsequent to workplace disability-related interventions.

This paper discusses the potential limitations, and barriers to acceptance, of qualitative research methodologies. Qualitative research has been dismissed for consisting of small unrepresentative samples that limit the generalisability of findings, for lacking reliability and validity, for providing analyses that mask the individual differences that it purports to highlight, and for being too subjective. It was argued that these criticisms have to be considered against a different set of criteria to those applied to quantitative research. Moreover, the rationale behind qualitative research can provide rehabilitation counsellors with a better understanding of living with disability. This paper seeks to encourage rehabilitation counsellors to (a) gain insight into the different perspectives of persons with disabilities; (b) develop their clinical or knowledge base; and (c) be self-reflexive and critically self-examine their interaction with clients.

The study explored the lived experiences of people with injury events in their residential environment. Participants were 65 people with disabilities and chronic diseases in Sweden with residential living injuries (females = 40 (61.5%), men = 25 (38.5%), age range 20–90 year old). They completed qualitative interviews on their experiences of injury events in their residential environment. Thematic analysis of the data yielded evidence to suggest the following issues: (1) individual coping resource preferences; (2) support services; and (3) family engagement needs. Participants coped utilizing positive reframing of their living with injury and the incidents they experienced. Social support functions were important for safety in the housing environment. Rather disconcerting is the fact that participants would not always tell their social network about the risks and injuries they experienced.

Demonstrating the effectiveness of health care interventions requires valid measurement of the impact, or outcome of those interventions. It is increasingly suggested that Quality of Life (QoL) is the ‘gold standard’ outcome internationally (Bowling 1995) and in Australasia (Mordue & Parkin, 1997). Although a number of QoL measures are now available, questions remain about the definition of the concept itself and the psychometric properties of those measures. A consequence of major concern is that health services research or clinical studies of healthcare interventions using inadequately defined outcomes or invalid measures will in turn produce results that lack validity. This paper explores a number of such issues concerning the concept of QoL and the way it is measured.

New Zealand's Accident Compensation Corporation (ACC), which provides no-fault 24-hour cover for accidents, has been the subject of continuous debate since its inception in 1974. This article provides an up-to-date summary of changes to the legislation and how they have, or might, impact on providers and consumers of services. An attempt is made to look at the outcomes for ACC claimants in different broad categories. Although the ACC system has shown itself over time to be fairly resilient in the face of change, providers and consumers may not agree that the amount of change has delivered a better product for New Zealand.