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The quality of life of single adults with severe disabilities participating in extended employment programs in Northern Israel.

The lack of consumers' perspective is central in understanding the quality of life of persons with severe disabilities participating in extended employment programs in Israel Israel, in the Bible
Israel (ĭz`rēəl, ĭz`rāəl) [as understood by Hebrews,=he strives with God], according to the book of Genesis, name given to Jacob as eponymous ancestor of the Hebrews, the chosen people of God.
. According to according to
prep.
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3.
 the Israeli National Insurance Institute, persons with severe disability are defined as having at least 75% "medical disability", inability to support themselves from work or occupation, and not earning a sum equivalent to 25% of the average wage. Most of the persons with severe disabilities participating in extensive employment programs in Israel fit the above definition with inability to be placed in competitive employment and be gainfully gain·ful  
adj.
Providing a gain; profitable: gainful employment.



gainful·ly adv.
 employed.

Extended employment programs are defined as a work-oriented rehabilitation rehabilitation: see physical therapy.  facility, operating in controlled environment for the provision of employment-related services. In Europe Europe (yr`əp), 6th largest continent, c.4,000,000 sq mi (10,360,000 sq km) including adjacent islands (1992 est. pop. 512,000,000). , legislators and policy makers use the term sheltered employment and it is viewed as a job-creation measure, established in order to create work for persons with severe disabilities who otherwise would not be likely to obtain work in the open employment market (Thornton Thornton, city (1990 pop. 55,031), Adams co., NE Colo., a residential and industrial suburb of Denver; inc. 1956. Industries include oil and gas development and the production of computer graphics systems, wood products, coffee and tea, building components, infant  & Lunt, 1997). About 3.4% of the workforce in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area.  (US) is employed of same form of extended employment, a rate similar to that in Germany and France (Samony & Waterpalse, 1992).

Extensive employment programs known in the past as sheltered employment was discussed in the late 70's and 80's by several researchers as the core employment program for persons with severe disabilities that could not be competitively employed (Bellamy, Homer Homer, principal figure of ancient Greek literature; the first European poet. Works, Life, and Legends


Two epic poems are attributed to Homer, the Iliad and the Odyssey.
, & Inman, 1981; and; Brown, et al., 1984. Bellamy, Rhodes & Albin (1986) criticized the model as lacking continuum Continuum (pl. -tinua or -tinuums) can refer to:
  • Continuum (theory), anything that goes through a gradual transition from one condition, to a different condition, without any abrupt changes or "discontinuities"
 and movement toward competitive employment. Only 3-5% of all people in these settings actually moved toward competitive employment (Bellamy, Rhodes, & Albin, 1986). In addition, extended employment programs are based primarily on subcontract sub·con·tract  
n.
A contract that assigns some of the obligations of a prior contract to another party.

intr. & tr.v. sub·con·tract·ed, sub·con·tract·ing, sub·con·tracts
 work, the kind of work available rarely resembles actual jobs in the community. A recent review of sheltered employment policies in 18 countries, including European European

emanating from or pertaining to Europe.


European bat lyssavirus
see lyssavirus.

European beech tree
fagussylvaticus.

European blastomycosis
see cryptococcosis.
 countries and Australia, criticized these programs as providing inadequate working conditions and employment contracts (Thornton & Lunt, 1997).

Despite this significant criticism, extended employment programs are widely used by persons with severe disabilities (Mank, 1994). A review of the employment trends among persons with disabilities in the US between 1986-1992, revealed that parallel to the increased number of placements in competitive employment there was also a significant increase in participation in extended employment programs. Thornton and Lunt (1997) compared policies in 18 countries toward extended and sheltered employment programs and identified mixed attitudes. In some countries sheltered employment policies encouraged the expansion of programs and the creation of extended employment sector (France, Spain, and Portugal) and in others it was viewed as marginal (Australia and the UK).

While numerous studies have attempted to evaluate the effectiveness of these programs and the various training and production approaches that are utilized (Wehman, Kregel, Banks, Hill, & Moon, 1987), few studies have studied the consumers' perspective (Dudley & Struhsaker-Schatz, 1985; Goode, 1989) or their quality of life.

The current research examined the quality of life of Israeli single adults with severe disabilities participating in extended employment sites in Northern Israel as related to their personal characteristics, objective and subjective perception of their severity of disability and employment variables? The following literature review discusses variables associates with quality of life of participants in these programs.

Quality of life of persons with disabilities: A literature review

Quality of life has different conceptualizations ranging from "subjective well-being" to value-based approaches. Oleson (1990) defined quality of life as an individual's satisfaction or happiness with life in domains he or she considered important. Historically, the term was known as "life satisfaction" or "subjective well-being." It is often referred to as "overall quality of life" or "global quality of life" to distinguish it from "health related quality of life."

A person's assessment of the satisfaction with life involves two subjective considerations: how important a given domain is for that person, and how satisfied one is with that domain. Flanagan (1982) offered a useful taxonomy taxonomy: see classification.
taxonomy

In biology, the classification of organisms into a hierarchy of groupings, from the general to the particular, that reflect evolutionary and usually morphological relationships: kingdom, phylum, class, order,
 including five domains: Physical and material well being, relations with other people, social, community and civic activities, personal development, fulfillment ful·fill also ful·fil  
tr.v. ful·filled, ful·fill·ing, ful·fills also ful·fils
1. To bring into actuality; effect: fulfilled their promises.

2.
 and recreation.

Quality of life has become an important outcome measure in the disability area, especially related to persons with developmental disabilities developmental disabilities (DD),
n.pl the pathologic conditions that have their origin in the embryology and growth and development of an individual. DDs usually appear clinically before 18 years of age.
. Schalock (1990) offered an interesting conceptualization con·cep·tu·al·ize  
v. con·cep·tu·al·ized, con·cep·tu·al·iz·ing, con·cep·tu·al·iz·es

v.tr.
To form a concept or concepts of, and especially to interpret in a conceptual way:
 of quality of life of persons with developmental disabilities. He reviewed three perspectives in assessing quality of life: social indicators, psychological indicators and goodness of fit Goodness of fit means how well a statistical model fits a set of observations. Measures of goodness of fit typically summarize the discrepancy between observed values and the values expected under the model in question. Such measures can be used in statistical hypothesis testing, e. . The social indicators generally refer to external, environmentally based conditions such as health, social welfare, friendships, standard of living, education, public safety, housing, neighborhood, and leisure. These indicators represent measures used to examine the collective quality of community life. The psychological indicators approach measures the subjective reactions to life experiences. It is assessed by variables such as psychological well-being psychological well-being Research A nebulous legislative term intended to ensure that certain categories of lab animals, especially primates, don't 'go nuts' as a result of experimental design or conditions , personal satisfaction or happiness.

Schalock and Keith (1993) offer a quality of life model for persons with developmental disabilities including concepts such as personal satisfaction, competence/productivity, empowerment/independence and social belonging/community integration. This integrative model reflects quality of life as related to the person's personal experience and objective circumstances CIRCUMSTANCES, evidence. The particulars which accompany a fact.
     2. The facts proved are either possible or impossible, ordinary and probable, or extraordinary and improbable, recent or ancient; they may have happened near us, or afar off; they are public or
, perception of reference others and personal beliefs. Schalock (1990, p. 1) strongly believes that quality of life refers to "a person's subjective experience of his or her life." Scherer (1988) identified two personal factors that are consonant consonant

Any speech sound characterized by an articulation in which a closure or narrowing of the vocal tract completely or partially blocks the flow of air; also, any letter or symbol representing such a sound.
 with the term among persons with physical disabilities: the potential to improve life outcome and the perceived desire for assimilation Assimilation

The absorption of stock by the public from a new issue.

Notes:
Underwriters hope to sell all of a new issue to the public.
See also: Issuer, Underwriting



Assimilation
 into society.

The following is an attempt to review variables associated with quality of life of persons with disabilities in extended employment (sheltered employment) programs. Most of the studies reviewed participants with developmental disabilities in these programs.

The researchers identified groups of variables as predictors of quality of life: personal characteristics, severity of disability (objective and subjective measures) and those related to employment experience and outcome. In examining the association between personal data and quality of life, Stark and Falkner (1996) reported that young adults with developmental disabilities were more motivated mo·ti·vate  
tr.v. mo·ti·vat·ed, mo·ti·vat·ing, mo·ti·vates
To provide with an incentive; move to action; impel.



mo
 to be involved in employment programs. The person's residential situation is associated to the person's quality of life. In this context, Griffin, Rosenberg, Cheyney and Greenberg. (1996) found that participants with intellectual disabilities in supported and sheltered employment programs in semi-independent residential programs reported greater self-esteem self-esteem

Sense of personal worth and ability that is fundamental to an individual's identity. Family relationships during childhood are believed to play a crucial role in its development.
 than those living at home with their families.

Two disability severity variables are associated with quality of life: Percentage of medical disability (an objective measure) and the person's perception his/her severity of disability (subjective measure). Kiernan, McGauhey and Scalock (1988) evaluated occupational measures of 113,000 persons with developmental disabilities in the US and found a relationship between severity of disability and job retention and wage. Persons with milder disability had higher retention rates and higher income compared to those with severe disabilities. Based on Israeli Social Security Administration data- base, Inbar (1998) found that only 32 percent of those with severe medical disability were employed after participating in vocational rehabilitation programs Noun 1. vocational rehabilitation program - a program of rehabilitation through job training with an eye to gainful employment
rehabilitation program - a program for restoring someone to good health
 compared to 71 percent of persons with mild medical disability. Conversely con·verse 1  
intr.v. con·versed, con·vers·ing, con·vers·es
1. To engage in a spoken exchange of thoughts, ideas, or feelings; talk. See Synonyms at speak.

2.
, Fabian (1992) raised doubt about the validity of objective measures of disability in predicting rehabilitation outcome. She found that objective measurement of the degree of disability was a poor predictor of the person's perception of his/her well-being.

Based on the literature review, three employment variables relevant to person's quality of life in extended employment programs have been identified: years of seniority, monthly wage, and participation in non-employment activities. Whitehead whitehead /white·head/ (hwit´hed)
1. milium.

2. closed comedo.


white·head
n.
1.
 (1986), who summarized the problems in sheltered employment programs n the US in the early 80's, focused on the low monthly wage received by most of the participants. Therefore, workers in these programs perceived themselves as inferior INFERIOR. One who in relation to another has less power and is below him; one who is bound to obey another. He who makes the law is the superior; he who is bound to obey it, the inferior. 1 Bouv. Inst. n. 8.  to those working in competitive settings.

Dudley and Struhsaker-Schatz (1985) studied the relationship between years of stay in sheltered employment workshop and employment outcome among persons with severe developmental disabilities. They reported that those working more years expressed greater satisfaction compared to newcomers who stayed there less than two years. The latter were dissatisfied dis·sat·is·fied  
adj.
Feeling or exhibiting a lack of contentment or satisfaction.



dis·satis·fied
 about their employment status, work conditions and monthly wage. Fabian (1992) presented similar findings in studying workers with psychiatric psy·chi·at·ric
adj.
Of or relating to psychiatry.


psychiatric adjective Pertaining to psychiatry, mental disorders
 disabilities participating in sheltered employment programs (Fabian, 1992). The researcher explained their dissatisfaction by their difficulty in stabilizing stabilizing,
v to hold a limb motionless in order to ground its energy; a standard isometric resistance technique, it releases tension and lengthens muscle fibers.
 and adjusting to the new demands.

Contradicting findings were published recently by Crudden, McBroom, Skinner Skin·ner , B(urrhus) F(rederick) 1904-1990.

American psychologist. A leading behaviorist, Skinner influenced the fields of psychology and education with his theories of stimulus-response behavior.
, & Moore Moore, city (1990 pop. 40,761), Cleveland co., central Okla., a suburb of Oklahoma City; inc. 1887. Its manufactures include lightning- and surge-protection equipment, packaging for foods, and auto parts.  (1998) regarding the association between length of stay in sheltered employment program and employment outcome among persons with visual impairment Visual Impairment Definition

Total blindness is the inability to tell light from dark, or the total inability to see. Visual impairment or low vision is a severe reduction in vision that cannot be corrected with standard glasses or contact lenses and
. The survey of 166 employed persons with visual impairments showed that level of satisfaction declined after five years of work in sheltered industries. Newcomers believed that they could move from there to competitive employment but those who worked longer felt that this goal was unrealistic.

Mosely (1988) interviewed persons with severe developmental disabilities who had moved from sheltered employment to supported employment settings and reported greater satisfaction due to higher monthly salaries they received in supported employment settings. Griffin et al. (1996) reported that persons with mild intellectual disabilities participating in sheltered employment programs expressed dissatisfaction about their work status and monthly wage.

Most of the sheltered employment settings also provide other benefits (Whitehead, 1986). These programs offer participants complimentary education, clinical services, and leisure and social activities. Do participants in sheltered employment programs tend to view the programs as employment or as providers of additional services such as leisure, friendship and social activities? According to Freedman freed·man  
n.
A man who has been freed from slavery.


freedman
Noun

pl -men History a man freed from slavery

Noun 1.
 and Fesko (1996) most of the participants with significant disabilities in their study perceived the sheltered employment program beyond work activities and as their main social milieu mi·lieu
n. pl. mi·lieus or mi·lieux
1. The totality of one's surroundings; an environment.

2. The social setting of a mental patient.



milieu

[Fr.] surroundings, environment.
. Most of the service providers included social and leisure activities as part of or in addition to employment.

Based on the literature review we have examined the contribution of these variables on the quality of life of single workers in sheltered workshops shel·tered workshop
n.
A workplace that provides a supportive environment where physically or mentally challenged persons can acquire job skills and vocational experience.

Noun 1.
.

Methodology

Population

The population studied included all of the 128 single persons with severe disabilities working in six extended employment facilities in the northern part of Israel. These facilities located in five cities and towns (Beit Shean, Hadera, Haifa (2), Nazareth, and Migdal Haemek Migdal HaEmek (Hebrew: מִגְדַּל הָעֶמֶק‎, also officially spelt Migdal HaEmeq, Arabic: ) serve beneficiaries with severe disabilities. According to National Insurance Institute, those who are assigned as·sign  
tr.v. as·signed, as·sign·ing, as·signs
1. To set apart for a particular purpose; designate: assigned a day for the inspection.

2.
 to these programs cannot support themselves from work or occupation, and do not earn a sum equivalent to 25% of the average wage. Their personal (demographic) characteristics are presented in Table 1.

Participants' were persons with all types of severe disabilities, average age was in the early 30's, there were slightly more men than women. They had partial high school education, and the majority lived with their parents. In terms of the objective measure of severity of disability, the mean was 91.7% medical disability. Conversely, in subjective terms, the majority of the participants perceived the severity of their disability as mild to moderate. Participants in these programs had a mean of five years of seniority (stay), a monthly wage of slightly above 400 Shekels (the minimum monthly wage in Israel is slightly above 3,000 Shekels) in addition to their social security benefits.

Instrumentation instrumentation, in music: see orchestra and orchestration.
instrumentation

In technology, the development and use of precise measuring, analysis, and control equipment.


The questionnaire was consisted of four sections: (a) personal (demographic) data included the following information: gender, age, and living situation (living independently, in a semi-sheltered residence and with parents); (b) disability data included type of disability (physical, cognitive, psychiatric), severity of disability measured by percentage of medical disability as determined by the Medical Decision Committee of Social Security Administration (called in Israel the Social Insurance Institute) and the participant's subjective perception of the severity of his/her disability (mild, moderate, severe); (c) employment data included the following: years of seniority (stay) in the program, monthly wage (in Shekels) and participation (yes/no) in non-employment activities such as educational, recreational and other leisure activities in the site ; and (d) the Quality of Life Questionnaire (QOL QOL,
n quality of life, a subjective assessment of one's emotional and physical well-being.
.Q) (Shalock & Keith, 1993). The scale total score (40 items) has a Cronbach alpha reliability of .84. A factor analysis yielded four factors: Satisfaction (items 1-10) with alpha=.75; Competence/Productivity (items 11-20) with alpha of .69; Empowerment/Independence (items 21-30), with alpha=70 ; and Social Belonging/Community Integration (items 31-40) with alpha=.79. Each item has 3-point scoring (1 lowest to 3 highest). The score for each scale can range from 10-30. A total score can be obtained from by adding the scores for the four scales. The scores may range from 40 to 120, with a high score meaning higher level of quality of life.

Procedure and Data Analysis

The researchers received a letter of approval from the Executive Director of the extended employment programs to study six extended programs in northern Israel. Each director of sheltered workshop received a letter specifying the procedure and a request for receiving consent form for each participant (including a guardian approval, if required). After receiving the filled consent forms, eight social work students interviewed participants in each site individually. They interviewed only the unmarried participants because they were 90 percent of the population. After the completion of data collection, all questionnaires were entered for statistical analysis. A Multiple Regression Multiple regression

The estimated relationship between a dependent variable and more than one explanatory variable.
 Analysis was used to test how much the independent variables contributed to Quality of Life (QOL) measures. Based on the literature review, the independent variables were entered in order, first the personal variables, than disability data and finally employment variables.

Findings

An early analysis of correlating between the independent variables with the outcome score showed that the participants' age (r=-.21; p<.03), perception of disability (r=-.42; p<.001) and whether they took part in non-employment activities, such as recreation and leisure (r=.22; p<.03) had significant correlation with the quality of life total score. Oneway Analysis of Variance The discrepancy between what a party to a lawsuit alleges will be proved in pleadings and what the party actually proves at trial.

In Zoning law, an official permit to use property in a manner that departs from the way in which other property in the same locality
 between participants' type of disability and quality of life total score did not show any significant differences. A multiple regression analysis of the personal, disability and employment variables with the QOL total score (see Table 2) yielded a score of [R.sup.2] =.36.

A detailed analysis of the independent variables entered (first personal, than disability and last employment variables) with QOL total score showed that two independent variables were significant: Perception of severity ([beta]=-.397, p<.01) and degree of participation in non-employment activities (mainly social programs), [beta]= -.277; p<.0l). Participants perceiving their disability as mild and tended to participate less frequently in non-employment programs had reported greater QOL.

An analysis of the four factors of the Quality of Life Scale is presented in Table 3 (side by side). A multiple regression of the personal, disability and employment variables with satisfaction yielded a score of [R.sup.2] =.31. A detailed analysis of the independent variables entered showed that age ([beta]=-.221, p<.05), perception of severity([beta]=-.412; p<.01) and participation in non-employment programs (social programs) carried out in the site ([beta]=-.244, p<.01) were significant with satisfaction factor of QOL.

A multiple regression of the above independent variables with competence/productivity (the second factor of QOL) yielded a score of [R.sup.2]=.120. The specific analysis of the independent variables showed that only perception of severity ([beta]=-.212, p<.05) and participation in non-employment activities (mainly social programs) in the site had a [beta] of-.290, p<.01. A multiple regression of personal, disability and employment variables with empowerment/independence (the third factor) of QOL yielded [R.sup.2] of .24. Two independent variables were identified as significant with this factor: Living independently ([beta]=-.318, p<.01) and seniority in program ([beta]=-322, p<.01).

Finally, we carried out regression analysis In statistics, a mathematical method of modeling the relationships among three or more variables. It is used to predict the value of one variable given the values of the others. For example, a model might estimate sales based on age and gender.  of all independent variables with belonging/community integration (the forth factor) of QOL and found [R.sup.2] of .33. A detailed analysis of the personal, disability and employment variables showed four significant variables: Perception of severity ([beta]=-.297, p<.01); seniority in the program ([beta]=-.237, p<.05); monthly wage ([beta]=.222, p<.05), and participation in non-employment programs (mainly social programs) ([beta].=-.236, p<.05).

Discussion

Overall quality of life of single adults with severe disabilities working in extended employment programs in Northern Israel was not associated with their type of disability (physical, mental, intellectual or other) but with two significant predictors: Perception of severity of disability as milder rather than severe and by less frequent participation in non-employment activities such as recreational and leisure activities, carried out by the sheltered employment programs. Participants' who perceived their disability as milder and who tended to use the working site for only for employment and not for the non-employment activities (such as leisure and recreation) reported greater quality of life than those who lived in more protected housing, viewed their disability as severe and participated in non-employment activities in their extended employment program.

Although the average participant worked in the program more than five years, they tended to perceive quality of life as related to their non-employment environment. If quality of life refers to the person's desire for assimilation into society (Scherer, 1988), participants expressed their expectations beyond the sheltered employment program. Similar findings were identified in Freedman and Fesko's qualitative study on the meaning of work in the lives of people with significant disabilities (1996). The consumers, persons with significant disabilities, viewed their job outcomes and expectations as related to their personal goal settings rather than their current reality. They viewed their greatest obstacle in the stigma stigma: see pistil.
Stigma
mark of Cain

God’s mark on Cain, a sign of his shame for fratricide. [O. T.: Genesis 4:15]

scarlet letter
 and societal so·ci·e·tal  
adj.
Of or relating to the structure, organization, or functioning of society.



so·cie·tal·ly adv.

Adj.
 attitudes toward persons with severe disabilities.

A detailed regression analysis for the total QOL score as well as the four factors: Satisfaction, competence/productivity, empowerment/independence and belonging/integration yielded interesting findings. The most frequent predictors of total score were the person's perception of his/her severity of disability as mild followed by less frequent participation in non-employment activities. These findings indicate that the person's quality of life has less to do with the participants' objective measure of disability (percentage of medical disability) or age but their subjective view of their own or desired function. This finding is consonant with Fabian's view that the subjective experience and not the objective situation is a more valid indication of how the person with disability experiences his quality of life (1992). Together with the second predictor, less frequent participation in non-employment program, it may express the participants' view that quality of life is the common expectation of those who perceive themselves are highly functioning and less involved in sheltered employment milieu (Freedman & Fesko, 1996).

Interestingly younger participants had greater satisfaction than older participants. This, in addition to seniority in the program, evident in the third (empowerment/independence) and forth (social belonging/community integration) factors, indicates that quality of life decreases with greater engagement with sheltered employment. Finally, participants saw their quality of life in social belonging/community integration (the forth factor) as related to high monthly wage.

Implications

These findings indicate that the Quality of Life Questionnaire is effective in identifying and understanding person's experiences in sheltered employment environments. Professionals should reexamine re·ex·am·ine also re-ex·am·ine  
tr.v. re·ex·am·ined, re·ex·am·in·ing, re·ex·am·ines
1. To examine again or anew; review.

2. Law To question (a witness) again after cross-examination.
 their views about participants in extended employment programs. They should be more sensitive to their experiences and desires to live and be accepted by society. The fact that persons with disability were assigned to extended employment programs does not mean that they have to stay there and be rejected from new experiences (Goode, 1992).

Our findings are quite encouraging as the needs and desires of Israeli single adults with disabilities participating in extended employment are similar to all persons with or without disabilities. Despite the fact that they spent years of their life in undesired employment setting they have similar dreams as other workers with disabilities and the non- non- word element [L.]not .

non-
pref.
Not: noninvasive. 
 disabled population.

There is a need to examine quality of life of participants in supported employment programs and to be more aware about changes that can occur in their quality of life during their transition from school to work or one work setting to another. In addition, it is recommended to include quality of life measure as part of the comprehensive evaluation of participants in extended employment programs.
Table 1: Participants' Characteristics (N=128)

       Characteristics                    Descriptive Data

Gender
       Male                                  72 (56.2%)
       Female                                56 (43.8%)

Age (years)
       M                                     32.4
       SD                                     9.3

Living Independently
       Own Apartment                         21 (16.4%)
       Semi-independent residence            20 (15.6%)
       Live with parents                     87 (68.0%)

Years of Formal Education
       M                                      9.7
       SD                                     2.6

Primary type of Disability
       Physical                              31 (24.2%)
       Psychiatric                           33 (25.8%)
       Intellectual                          33 (25.8%)
       Other                                 31 (24.2%)

Perception of Severity
       Mild                                  54 (42.2%)
       Moderate                              40 (31.3%)
       Severe                                34 (26.5%)

Percentage of Medical Disability
       M                                    391.7
       SD                                   313.1

Monthly Wage (in Israeli Shekels)
       M                                    413.9
       SD                                   259.6

Years of Stay in Sheltered Employment
       M                                      5.3
       SD                                     4.7

Table 2: Summary of Regression Analysis for Variables
Predicting of QOL Score (N=128)

Variable                          B         SEB     [beta]

Age                           -2.273E-03    .004    -.072
Live Independently            -2.114E-02    .022    -.091
Medical Disability (in %)     -5.128E-04    .002    -.022
Perception of Severity        -.163         .040    -.397 **
Seniority (in years)          -8.863E-03    .007    -.135
Monthly Wage (in Shekels)      1.838E-04    .000     .158
Non-employment Activities     -.173         .058    -.277 **

Note. [R.sup.2]=.36

* p<.05

** p<.01)

Table 3: Regression Analysis for Four Factors of Quality of Life'

Factor                 Satisfaction                Competence/
                                                   Productivity

Variable             B      SEB    [beta]        B        SEB    [beta]

Age             9.61E-03   .005     -221     -5.759E-03  .005    -.135
                      (P=.049)

Live            1.058E-02  0.31     .0343    .154E-02    .032     .105
Indepen-
dently

Medical         2.2203E-03 .003     .072     -1.645E-03  .003    -.055
Disability
(in %)

Perception      -.224      .054     -12      -.113       .057    -.212
of Severity            (P=.000)                       (P=.05)

Seniority       8.316E-03  .009     0.96     1.247E-02   .010     .147
(in years)

Monthly         5.292E-05  .000     .034     1.073E-04   .000     .071
Wage
(in Shekels)

Non-            -.202      .080     -.244    -.235       .08     -.290
employment            (P=.013)                         (P=.006)
Activities

                   Note. [R.sup.2]=.31         Note. [R.sup.2]=.31

Factor                   Empowerment/                  Belonging/
                         Independence                 Integration

Variable             B      SEB    [beta]           B      SEB   [beta]

Age             5.343E-03  .005     -.118    -1.635e-03  -.006   -.031

Live            -.102      .033     -.318    -2.886E-02   .036   -.079
Indepen-                (P=.003)
dently

Medical         7.814E-04  .003      .025    -3.706E-03   .004   -.102
Disability
(in %)

Perception      -.113      .058     -.200    -.192        .064   -.297
of Severity             (P=.057)                        (P=.004)

Seniority       -2.890E-02 .010     -.322    -2.433E-02   .011   -.237
(in years)              (P=.006)                        (P=.031)

Monthly         1.631E-04  .000     .102     4.046E-04    .000    .222
Wage                                                    (P=.027)
(in Shekels)

Non-           -1.639E-02 .086     -.019     -.231       .094     -.236
employment                                              (P=.016)
Activities

                  Note. [R.sup.2]=.24            Note. [R.sup.2]=.33


References

Bellamy, G.T., Homer, R., & Inman, D. (1981). Vocational rehabilitation Noun 1. vocational rehabilitation - providing training in a specific trade with the aim of gaining employment
rehabilitation - the restoration of someone to a useful place in society
 of severely retarded re·tard·ed  
adj.
1. Often Offensive Affected with mental retardation.

2. Occurring or developing later than desired or expected; delayed.
 adults: A direct service technology. Baltimore Baltimore, city (1990 pop. 736,014), N central Md., surrounded by but politically independent of Baltimore co., on the Patapsco River estuary, an arm of Chesapeake Bay; inc. 1745. : University Park Press.

Bellamy, G.T., Rhodes, L.E., & Albin, J.M. (1986). Supported employment. In W. Kiernan., & J.Stark (Eds.), Pathways to employment for adults with developmental disability developmental disability
n.
A cognitive, emotional, or physical impairment, especially one related to abnormal sensory or motor development, that appears in infancy or childhood and involves a failure or delay in progressing through the normal
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Brown, L., Shiraga, B., York York, former name of Toronto, Canada
York, Ont.: see Toronto, Ont., Canada.
York, city, England
York, city (1991 pop. 123,126) and district, North Yorkshire, N England, at the confluence of the Ouse and Foss rivers.
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Crudden, A., McBroom, L W., Skinner, A.L., & Moore, J.E. (1998). Comprehensive examination of barriers to employment among persons with visual impairment. Mississippi State University Mississippi State University, at Mississippi State, near Starkville; land-grant and state supported; coeducational; chartered 1878 as an agricultural and mechanical college, opened 1880. From 1932 to 1958 it was known as Mississippi State College. , Rehabilitation Research and Training Center for Low Vision, Mississippi Mississippi, state, United States
Mississippi (mĭs'əsĭp`ē), one of the Deep South states of the United States. It is bordered by Alabama (E), the Gulf of Mexico (S), Arkansas and Louisiana, with most of the border formed by
 State, MS 39762.

Dudley, J.R., & Struhsaker-Schatz, M. (1985). The missing link in evaluating sheltered workshp programs: The clients input. Mental Retardation mental retardation, below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living. , 23, 235-240.

Fabian, E.S. (1992). Supported employment and the quality of life: Does a job make a difference? Rehabilitation Counseling rehabilitation counseling,
n counseling started in the United States in 1920 to assist individuals disabled by industrial accidents; originally included physical, psychologic, and occupational training; expanded over the next 70 years and laid the
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New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of
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Griffin, D.K., Rosenberg, H., Cheyney, C., & Greenberg, B. (1996). A comparison of self-esteem and job satisfaction of adults with mild mental retardation in sheltered workshops and supported employment. Education and Training in Mental Retardation and Developmental Disabilities, 31, 142-150.

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European Community (EC)

Organization formed in 1967 with the merger of the European Economic Community, European Coal and Steel Community, and European Atomic Energy Community.
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Schalock, R.L. (1990). Quality of life: Perspectives and issues. Washington D.C.: American Association American Association refers to one of the following professional baseball leagues:
  • American Association (19th century), active from 1882 to 1891.
  • American Association (20th century), active from 1902 to 1962 and 1969 to 1997.
 on Mental Retardation.

Schalock, R.L& Kieth, K.D. (1993). Quality of Life Questionnaire manual. IDS Publishing Corporation.

Scherer, M. (1988). Assistive device assistive device Public health Any device designed or adapted to help people with physical or emotional disorders to perform actions, tasks, and activities. See Americans with Disabilities Act, Architectural barriers, Assistive technology.  utilization and quality of life in adults with spinal cord injuries Spinal Cord Injury Definition

Spinal cord injury is damage to the spinal cord that causes loss of sensation and motor control.
Description

Approximately 10,000 new spinal cord injuries (SCIs) occur each year in the United States.
 or Cerebral Palsy cerebral palsy (sərē`brəl pôl`zē), disability caused by brain damage before or during birth or in the first years, resulting in a loss of voluntary muscular control and coordination. . Journal of Applied Rehabilitation Counseling, 19, 21-28.

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The University of York is a campus university in York, England.
, Social Policy Unit.

Wehman, P., Kregel, J., Banks P.D., Hill, M., & Moon, M.S. (1987). Sheltered versus supported employment work programs: A second look. Rehabilitation Counseling Bulletin. 31, 42-53.

Whitehead, C.W. (1986). The sheltered workshop dilemma: Reform or replacement. Remedial REMEDIAL. That which affords a remedy; as, a remedial statute, or one which is made to supply some defects or abridge some superfluities of the common law. 1 131. Com. 86. The term remedial statute is also applied to those acts which give a new remedy. Esp. Pen. Act. 1.  and Special Education, 7, 18-24.

Arie Rimmerman

University of Pennsylvania (body, education) University of Pennsylvania - The home of ENIAC and Machiavelli.

http://upenn.edu/.

Address: Philadelphia, PA, USA.


Pro. Arie Rimmerman, school of Social Work, Center for the

Study of Youth Policy, 4200 Pine Street, 3rd floor, University of

Pennsylvania Pennsylvania (pĕnsəlvā`nyə), one of the Middle Atlantic states of the United States. It is bordered by New Jersey, across the Delaware River (E), Delaware (SE), Maryland (S), West Virginia (SW), Ohio (W), and Lake Erie and New York , PA 19104-4090.

Email: arik@ssw.upenn.edu

Richard Crossman Richard Howard Stafford Crossman, known as Dick Crossman, (15 December 1907 – 5 April 1974) was a British Labour Party politician, author and editor of the New Statesman.

University of Pennsylvania
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Author:Crossman, R.H.S.
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