Cognitive deficits among supported employment clients with schizophrenia / Normala Sorikan
Cognitive deficits are related to impairment in functional abilities. As the goal of treatment for schizophrenia is broader in that it involves not only clinical remission but also functional recovery, employment is one aspect of the recovery process. In schizophrenia patients, they have more dif...
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| Format: | Thesis |
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2019
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| Online Access: | http://studentsrepo.um.edu.my/11551/ http://studentsrepo.um.edu.my/11551/4/normala.pdf |
| Summary: | Cognitive deficits are related to impairment in functional abilities. As the goal of
treatment for schizophrenia is broader in that it involves not only clinical remission but
also functional recovery, employment is one aspect of the recovery process. In
schizophrenia patients, they have more difficulties in maintaining rather than acquiring
a job despite of on-going job support and coaching. The aim of this study is to examine
the association of deficit in specific cognitive domains as the predictive factor of
employment outcome.This is a cross-sectional study. Sixty two (n=62) participants who
were enrolled under the supported employment programme in Hospital Permai for at
least one month were recruited and categorized under either the working or terminated
group (31 participants in each group). They were assessed with six cognitive tests that
corresponded to three cognitive domains (processing speed, working memory and
executive function) based on the MATRICS Consensus Cognitive Battery. The
terminated groups were assessed for the reasons of termination using Job Termination
Interview. The neurocognitive tests were done once and simultaneously between the
two groups during the study period. There is a significant difference in the level of
working memory, speed of processing and reasoning and problem solving between
working and terminated group with p value < 0.001. Analysis on association between
cognitive deficit and job termination showed there is significant association between
deficit in working memory, speed of processing and executive function with job
termination. However, from the multivariate analysis, among the three cognitive
domains, only working memory deficit (p<0.05) has significant association with job
termination.There is significant association between primary reason of termination and
working memory deficit with p value < 0.05. The highest percentage of primary reason
is problem with work quality among working memory deficit group. However, we are
unable to prove that the work quality has significant association with working memory
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deficit by using logistic regression test. Deficit in working memory is significantly a
predictor of employment outcome in schizophrenia patients despite of ongoing job
support in supported employment program. Further studies with larger sample size are
needed to explore this area of research. Pilot study on cognitive remediation therapy is
also recommended.
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