Vocational problems in hemophilia

Vocational experiences and career support opportunities among Canadian men with moderate and severe haemophilia

AIM

The purpose of this research was to provide haemophilia treatment centres (HTCs) with guidance for the potential development of appropriate and timely interventions related to employment and vocational counselling and supports.

METHODS

A multi-method approach was employed, where initial focus groups (n = 13) and review of the literature were used to construct a structured survey instrument (n = 75).

RESULTS

Focus group participants made choices about employment with keen awareness of how their bleeding disorder might limit them physically; they described the role of social networks in career choices; and they wrestled with issues of disclosure. Among survey respondents, 47% per cent of respondents reported that haemophilia had a small negative impact, 27% felt that it had a moderate negative impact and 13% indicated that it had a very large negative impact. One-third of respondents had at some point received employment-related advice from a member of their haemophilia treatment centre team. Roughly two-thirds of respondents suggested that vocational advice would be "somewhat" or "very" useful at present.

CONCLUSION

Canadian men with haemophilia continue to experience challenges related to employment and career development. There appears to be an opportunity for HTCs to incorporate additional supports on these topics into the range of services which they currently provide.

Psychiatric problems of hemophilic boys and their families

Some often described clinical observations on psychological problems of hemophilic boys and their families, were examined in a controlled study of twenty mothers of hemophilic boys and the same number of mothers of non-hemophilic healthy boys of the same age and similar socio-demographic background. The findings confirmed statistically the existence of considerable defiance and hostility of the boys and depressed mood of the mothers. The fathers showed a trend to provide little control and support. The defiance of hemophilic boys contrasts with the frequently described tendency towards compliance of asthmatic children. The differences between these two conditions are discussed. Therapeutic implications of the findings are outlined.