北京市西城区社区康复的实践与思考

社区康复是在社区水平上对康复对象开展全面康复的一种高效、经济可行的新的康复模式 ,其核心是利用有限的康复资源 ,扩大康复的受益面。社区康复作为康复医学的一种服务形式 ,是相对于医疗机构的康复和信息康复而提出的。我国的国情决定了应把社区康复作为我国康复医学发展的一个重点。社区康复应以社区为本 ,即社区康复服务的开展必须从社区的实际出发 ,充分利用社区内部的资源 ,低成本、广覆盖 ,以较少的人力、物力和财力投入 ,使更多的服务对象能够享受到康复服务 ,使社区康复服务真正做到社区组织、社区参与、社区支持、社区受益。北京…     

试论国际社区康复与我国残疾人“两个体系”建设

1 国际社区康复 1978年世界卫生组织首次提出社区康复,目的是使众多发展中国家的残疾人得到康复服务.20世纪90年代,社区康复的理论研究不断深入,实践成果逐步积累,社区康复的概念、管理框架、技术要素、监测评估等不断完善.进入21世纪,社区康复在国际社会得到进一步重视.2003年5月社区康复国际咨商会议在赫尔辛基召开,提出在社区康复实施过程中,不但要提供高效的服务,更要注重将社区康复发展融入到社区发展整体规划中.2004年国际《社区康复的联合意见书》,阐明社区康复是以社区为基础的康复,是为残疾人康复、机会均等、减少贫困和社会包容的一种社区整体发展战略.     

社区康复学见习教学的探讨

1978年世界卫生组织首次提出社区康复,目的是使众多发展中国家的残疾人在社区得到康复服务。2004年国际劳工组织、联合国教科文组织、世界卫生组织发表的《社区康复的联合意见书》,阐明社区康复是以社区为基础的康复,是为残疾人康复、机会均等、减少贫困和社会包容的一种社区整体发展战略。     

残疾人社区康复的认知与实践

在30余年的发展历史中,国际社区康复不断根据时代发展调整理念以适应残疾人需求,2010年《社区康复指南》作为社区康复的最新理念指导世界各国残疾人的工作。我国社区康复与国际社区康复提倡的理念差距较大,中国社区康复既要跟上国际先进理念,也要结合国情发展中国特色的社区康复。本文首先介绍了国际社区康复的发展及最新的社区康复内容,阐述了权利与参与如何体现在中国残疾人社区康复中,在此基础上,以国际助残越西项目为例,详细阐述国际助残项目是如何通过参与式社区发展规划,整合资源,推进残疾人社区康复和社会融合。     

湖南省工伤保险社区康复服务模式的初探

社区康复是机构康复的延伸,是康复的重要组成部分,让康复进入社区是工伤保险乃至工伤康复给予工伤职工的切实权益和福祉。因此,积极探索,因地制宜,多方式、多渠道建立社区康复服务模式是本文的主要目的,介绍资源中心社区服务模式是本文的重点。     

社区康复的调查工作

我国城乡的社区康复工作正在蓬勃发展。社区领导、康复工作者、残疾人及其家属等社区部门和成员的积极参与、密切协作、勇于探索、大胆实践,使近年来由世界卫生组织所倡导的社区康复在我国的实施愈来愈符合国情,社区康复所应具有的科学性、有效性也愈来愈为广大社区康复工作者所重视。社区康复调查工作自身的科学性是使社区康复科学有效发展的先决条件。本文就社区康复的调查工作(以下简称调查)进行探讨。     

石家庄市社区康复协作网工作模式

目的介绍石家庄市城区社区"康复协作网"社区康复工作模式。方法依据全国残疾人社区康复示范区工作标准对石家庄市桥东区社区康复工作进行评估,分析模式特点。结果石家庄市桥东区社区康复工作达到全国残疾人社区康复示范区标准。其中组织管理得分最高。结论石家庄市桥东区社区康复协作网具有政府主导,社区康复管理网络、技术网络健全,康复服务体系社会化的特点,体现了社区康复社会化模式内涵。     

上海市残疾人社区康复协调员及街道管理人员现状分析

目的了解上海市残疾人社区康复管理人员现状,为下一阶段残疾人社区康复管理队伍建设提供参考依据。方法利用自拟问卷普查上海市残疾人社区康复管理机构。结果上海市已初步建立一支基于康复协调员和街道管理人员的残疾人社区康复管理队伍。然而,队伍的人员结构和规模仍有待完善。结论上海市下一阶段社区康复管理队伍建设的重点是优化康复协调员人员结构,适度扩大街镇管理人员规模;同时,需努力缩小城郊残疾人社区康复服务差距。     

脑卒中患者13例社区康复情况

目的 通过研究13例脑卒中患者的社区康复情况，对目前社区康复治疗的现状进行初步探讨。方法 本研究始于2002年，在康复专家指导下，由负责社区康复的医护人员对病情稳定、重返社区的初发脑卒中患者进行社区康复治疗，并评定其康复疗效。结果 截至于2004年12月，共有13例脑卒中患者完成社区康复，其中显效8例，有效4例，无效1例。结论 脑卒中社区康复有其特有的优势，患者在社区康复环境下有利于其持续接受治疗，而全科医师是社区康复最有效的执行者，但还需要提高其对社区康复重要性的认识及社区康复治疗能力。     

脑卒中病人社区康复现状及展望

社区康复是目前国际社会提倡的残疾人发展战略,在脑卒中病人病情控制后促使致残功能尽快得到恢复、提高生活质量方面发挥着重要的作用。作者对脑卒中病人开展社区康复的重要性、社区康复现状、脑卒中病人社区康复的实施进行综述,展望了新时期脑卒中病人的社区康复。     

麻风病致残者的社区康复

目的探索开展社区麻风康复的方式。方法选择2个麻风残疾者较多的镇开展麻风残疾者社区服务康复站试点工作,以当地县、镇两级政府为主导,在镇卫生院内设立康复服务站,利用镇卫生院的卫生资源优势,实行麻风残疾者自愿原则,由县卫生行政主管部门对提供康复服务的医院和医生进行有偿补贴,定期免费为麻风残疾者提供康复服务。结果康复服务站工作呈惯性运行,服务区域范围扩大,绝大多数患者的暴露性结合膜炎、手足皲裂、足溃疡得到愈合或明显改善;康复服务站形式得到当地社会和麻风残疾者的认同;医院和医生从中得到一定的经济补偿。结论麻风残疾者社区康复应是今后我国麻风康复工作的重心,社区综合性医疗机构有偿开展麻风残疾康复工作是可行的,体现和深化了WHO提出的实现麻风防治工作可持续发展的一体化策略。     

Evaluation of community-based rehabilitation programmes: a search for appropriate indicators

Community-based rehabilitation (CBR) is a common form of service delivery and can provide services for people with disabilities in otherwise underserved areas. Despite a 20-year history of service delivery in many parts of the world by both government and non-government organization sectors, there are few indicators with which to measure the effectiveness of programmes. Among evaluations that have been undertaken there has been a tendency to describe practice rather than the effectiveness of that practice. One reason for this is the lack of robust indicators against which to measure practice. This study examines the activities and outcomes of 10 published evaluations of CBR programmes and proposes indicators for some of CBR practices based upon this examination. Readers are invited to comment upon these indicators or to try using them in their practice.     

社区康复管理和技术人员培训模式探讨

社区康复人才培养一直是社区康复工作重要一环,如何针对学员的背景、工作角色和职责及残疾人需求培养出懂知识、会操作、能服务的应用型人才,一直是社区康复培训组织者希望达到的目标。本文通过讨论中国残联/香港复康会合作项目中国社区康复合作项目中探索的一些方法,如逐级培训模式、参与式培训及实地探访等,为今后类似的培训提供一些借鉴和参考。     

Using participatory action research in community-based rehabilitation for people with acquired brain injury: from service provision to partnership with Aboriginal communities

Purpose.?Community-based rehabilitation (CBR) developed in response to delivery of rehabilitation services to people with disability in developing countries, and appears appropriate to address rehabilitation needs of rural and remote populations, including Australian Aboriginal People with acquired brain injury (ABI). This article will describe participatory action research (PAR) as a vehicle for exploring and translating the CBR model within a mainstream brain injury rehabilitation service in Queensland, Australia.

Method.?PAR was conducted with two self-selected remote Aboriginal communities in Far North Queensland. Key components to this project were the employment of a local Aboriginal worker, facilitating community engagement and consultation. PAR elements of planning, action and review were conducted through individual and group meetings and activities within the communities across a 3-year period.

Results.?The project has facilitated expansion and change within the current brain injury rehabilitation service model in line with CBR philosophical foundations, including community development and partnership as a desirable way of engaging with key stakeholders.

Conclusions.?The focus on community consultation through PAR and the development of community partnerships has increased the cultural competency of the rehabilitation service, the capacity of participating communities and of the sector to respond in ways that are valued and owned by Aboriginal People with brain injury, their families and communities.     

The move towards community-based rehabilitation in industrialised countries: Are we equipped for the challenge?

Background.?Recent challenges to health systems in industrialised countries (e.g., health trends, workforce shortages, geographical dispersion, changing demographics and the growing demand for hospital beds) have prompted a rise in popularity of services loosely labelled community-based rehabilitation (CBR). The rise of CBR is based on the assumption that these models of service delivery have the potential to address some of these challenges by promoting efficient use of community resources. However, due to the way in which CBR has evolved in industrial countries, there is considerable ambiguity surrounding the concept, and even more uncertainty about the methods by which its implementation can be fostered.

Purpose.?To explore the CBR in an industrialised country and the implications of its implementation for the health workforce, health systems and service delivery.

Method.?This article reviews existing literature to explore the concept of CBR as it is applied in industrialised countries. It examines the possible implications of adopting CBR into health systems, including the need for conceptual clarity, a competency frameworks and ongoing professional development.

Conclusion.?This article has shown that for CBR is to become a viable model for the delivery of health services in industrialised countries, a competency framework is needed, together with strong leadership to facilitate the translation of theory into practice. Further, collaboration is required among practitioners, policy makers, unions, consumers, educators and professional associations to support this transformation.     

The research base of community-based rehabilitation

This paper provides an overview of the current research on community-based rehabilitation (CBR) which can be found in the public domain. A brief background to the concept of CBR is given, and it is shown how much of this published research reflects the fundamental principles of CBR service delivery, technology transfer, community involvement, and organization and management. Specific research is discussed under these headings. Additional topics reviewed include the target populations of, and disabilities addressed in, CBR research, and the epidemiology of disability. A summary of locations where the research has taken place is also presented. It is concluded that, while there is still a need for additional research and evaluation in the extensive field of CBR, there has been some reluctance to either undertake or permit such activities. However, CBR and ultimately the disabled can only benefit from placing research and evaluation of CBR into the public domain.     

The research base of community-based rehabilitation

This paper provides an overview of the current research on community-based rehabilitation (CBR) which can be found in the public domain. A brief background to the concept of CBR is given, and it is shown how much of this published research reflects the fundamental principles of CBR service delivery, technology transfer, community involvement, and organization and management. Specific research is discussed under these headings. Additional topics reviewed include the target populations of, and disabilities addressed in, CBR research, and the epidemiology of disability. A summary of locations where the research has taken place is also presented. It is concluded that, while there is still a need for additional research and evaluation in the extensive field of CBR, there has been some reluctance to either undertake or permit such activities. However, CBR and ultimately the disabled can only benefit from placing research and evaluation of CBR into the public domain.     

The research base of community-based rehabilitation

This paper provides an overview of the current research on community-based rehabilitation (CBR) which can be found in the public domain. A brief background to the concept of CBR is given, and it is shown how much of this published research reflects the fundamental principles of CBR service delivery, technology transfer, community involvement, and organization and management. Specific research is discussed under these headings. Additional topics reviewed include the target populations of, and disabilities addressed in, CBR research, and the epidemiology of disability. A summary of locations where the research has taken place is also presented. It is concluded that, while there is still a need for additional research and evaluation in the extensive field of CBR, there has been some reluctance to either undertake or permit such activities. However, CBR and ultimately the disabled can only benefit from placing research and evaluation of CBR into the public domain.