北京市六类残疾人康复需求现状分析

目的 了解北京市残疾人的康复需求及服务现状.方法 采用统计描述和统计推理对北京市第二次残疾人抽样调查中确诊为六类残疾4852名残疾人的康复需求数据进行分析,据此推测北京市总体康复需求现状.结果 城市残疾人的康复意识和康复需求均高于郊区残疾人,儿童对康复训练的需求最高占75.23%,老年人对辅助器具和与医疗服务的需求最高,分别是57.05%和66.86%;一级、二级残疾人以社区和家庭康复为主;三级、四级残疾人以机构康复为主.视力和肢体残疾人对机构康复的需求较大,分别为85.23%和59.91%;76.95%的智力残疾人有社区和家庭服务的需求;精神、视力和肢体残疾人的医疗服务需求较高,分别是92.80%、86.77%和68.24%;听力残疾人对辅助器具的需求高达83.09%;智力、言语和精神残疾人对康复训练与服务的需求分别是84.36%、77.42%和62.82%.除医疗服务外,残疾人对其他方面的需求与救助均较低.结论 残疾人的需求和曾接受服务之间有较大差距,应加强宣传,促使残疾人树立正确康复观.     

某北方城区肢体残疾人家庭康复需求调查

目的 对肢体残疾儿童与成年肢体残疾人家庭康复服务内容进行需求分析,为提高肢体残疾人家庭康复效果和力度提供建议.方法 采用典型抽样,选取某北方城市3个城区的131例肢体残疾人进行问卷调查,调查对象纳入标准参考第二次全国残疾人调查标准.结果 肢体残疾儿童对于家庭康复服务的需求普遍高于成年肢体残疾人,残疾儿童主要致残原因为先天/遗传因素,成年肢体残疾人主要是外伤、疾病因素.超过85.7％的残疾儿童与81.7％的成年肢体残疾人都认为家庭康复很重要.肢体残疾儿童与成年肢体残疾人在家庭康复效果的影响因素方面比较一致,主要是：缺乏专业人员指导（57.1％）、不懂康复方法（42.0％）及不能长期坚持训练（37.5％）.结论 虽然肢体残疾人认为家庭康复很重要,但是由于缺乏专业知识和专业人员指导,导致残疾人家庭康复服务的需求普遍较低.     

昆明市五华区持证残疾人基本情况及康复需求调查分析

目的通过分析昆明市五华区持证残疾人目前面临的基本问题和康复需求,为今后全市的残疾人康复工作收集一些参考数据,为康复政策的制定提供理论依据。方法对五华区的7 537名持证的残疾人现状与康复需求进行问卷调查。结果男性有4 175名,占55.4%,女性3 362名,占44.6%;年龄3~99岁,平均50岁,肢体残疾占较大比例42.9%,其次视力残疾者(16.2%),智力残疾(12.2%),精神残疾(10.1%);49.4%的残疾人无劳动能力,39.2%能从事轻体力劳动;生活需求方面:对康复救助的需求最多(23.3%),其次是社会救助(17.2%)和申请低保(17.5%);在康复需求方面:视力残疾人主要的康复需求主要为视力功能训练(91.5%)、盲人定向行走训练(83.4%)和辅助器具需求(80.6%);听力残疾人主要的康复需求为听觉言语能力训练(80.2%);语言残疾人主要对听觉言语能力训练的需求(88.1%);肢体残疾人主要需求为运动功能训练(92.0%)、生活自理训练(64.0%)、作业治疗训练(79.4%);智力残疾人主要需求为感知认知能力训练(90.7%);精神残疾人主要需求为感知认知能力训练(32.0%),多重残疾人对各项康复训练都有需求。不同残疾类型残疾人对生活和康复的需求有所不同。结论昆明市五华区持证残疾人涵盖各类残疾,残疾人就业范围局限,就业率偏低,不同残疾类型的残疾人对生活和康复的需求有所不同,残疾人的生产生活水平偏低,需要政府和社会根据不同残疾人的康复需求给予全方位救助。     

巢湖市居巢区残疾人流行现状及康复需求调查

目的了解巢湖市居巢区残疾人的流行现状及康复需求。方法 2006年4月在巢湖市居巢区随机抽取3 373人,对6类残疾人的流行现状、级别、致残原因及康复需求进行统计分析。结果巢湖市居巢区残疾现患率为5.25%,6类残疾患病率依次为听力(2.99%)、肢体(1.16%)、视力(0.80%)、言语(0.50%)、精神(0.44%)和智力(0.44%);居巢区不同残疾人的康复需求不同,主要康复需求为贫困救助与扶持(37.98%)、医疗服务与救助(32.69%)及辅助器具(20.91%)。结论居巢区6类残疾人的流行状况、级别、致残因素及康复需求各不相同。应将残疾人康复工作纳入到基本公共卫生服务的范畴。     

中山市三乡镇社区持证残疾人康复现状与需求调查分析

目的：通过对社区持证残疾人的现场调查评估,分析其生存现状、生活质量及康复需求,为科学开展社区残疾人的康复干预提供依据。方法：通过现场问卷调查和现场评估的方式,对152名持证残疾人进行康复需求评定、康复服务评价调查、焦虑与抑郁自评量表评价和功能独立性评定（FIM）量表的评估。结果：（1）年龄：残疾人群平均年龄（49.84±1.89）岁,主要以45周岁及以上（64.5%）的中老年残疾人为主。（2）文化程度：文化程度较低,主要为小学及以下（62.5%）、初中（27.6%）为主。（3）职业及家庭收入：83.6%的残疾人处于无业状态;残疾人群收入水平较低,人均家庭月收入主要集中在2000元以下（93.4%）。（4）残疾类型、程度：主要以肢体残疾和听力残疾为主;一级（14.5%）和二级（19.1%）（重度与极重度）残疾人群比例较大。（5）康复服务开展及评价情况：残疾人群对于所在地社区康复服务机构的知晓程度和满意度偏低,仅有14.5%的残疾人曾经或正在接受康复服务;社区康复机构的选址和康复服务设备是影响残疾人接受所在地社区康复服务的主要影响因素。（6）焦虑评分结果为（33.96±0.73）分,高于50分者4.46%;抑郁评分结果为（37.68±0.80）分,高于50分者9.82%;功能独立性评定中,能够独立者65.14%,有依赖者34.86%。结论：社区的残疾人群存在着受教育水平低,生活贫困,残疾等级较重,情绪较不稳,康复需求达不到满足等问题。     

上海市某区肢体残疾人生活现状调查分析

目的了解上海市某区肢体残疾人的生活现状,为改善肢体残疾人生活质量提供依据。方法对登记在册的肢体残疾人进行问卷调查,采用描述性流行病学方法对资料进行分析。结果共调查肢体残疾713人,体重正常仅占47.7%,肥胖率为12.5%;超重率为34.8%,男、女分别为39.6%、28.9%,差异有统计学意义(χ~2=9.012,P0.05);22.0%男性对自身饮食习惯不关心,女性为9.0%。自我健康状况评价良好占48.6%。超过90%的调查对象日常生活能够自理。结论目前上海肢体残疾人的日常生活自理能力较强,但自我健康管理的意识有待加强,需要给予他们更多的关注与服务。     

北京市视力残疾人的流行病学特点和康复需求分析

目的 对北京市视力残疾人的流行病学特点和康复需求进行分析,探讨更有效的视力康复对策.方法 以第二次全国残疾人抽样调查北京市确定的视力残疾555例为研究对象,运用统计描述、对比分析和多因素分析等统计方法,得到北京市视力残疾人的致残状况和康复现状与需求.结果 调查的视力残疾人中四分之三为60岁以上人群.白内障、视网膜和脉络膜疾病以及青光眼是导致视力残疾的前三位原因.尽管89.4%的被调查者曾经接受过医疗服务与救助,但医疗服务仍是北京市视力残疾人最迫切的需求,占视力残疾人的82.0%.只有36.6%的视力残疾人对辅助器具有需求,11.9%的视力残疾人对康复训练有需求.曾接受辅助器具的视力残疾人为26.7%,而曾接受过康复训练者仅占5.8%.不同年龄阶段和不同残疾程度的患者对康复的需求存在差异.结论 北京市视力残疾人缺乏对康复知识的了解;应普及视力残疾康复知识,促进眼科医生参与康复工作,加强社区康复服务.     

中国老年残疾人口康复服务利用现状及影响因素分析

目的：探索中国老年残疾人口康复服务利用现状及其影响因素。方法：使用第二次全国残疾人抽样调查数据。应用卡方检验分析老年群体间康复服务利用差异。应用多因素logistic回归模型分析老年残疾人口康复服务利用的影响因素。结果：老年残疾人口康复服务利用率(45.82%)远低于需求率(96.89%),各项康复服务均存在较大需求与利用缺口。罹患听力残疾、中轻度残疾(三、四级)、高龄(≥80)、离婚或丧偶对老年残疾人口利用康复服务有抑制作用;残疾类型为肢体残疾或精神残疾、男性、未婚、居住在城镇、有残疾人证、有社会保险、较高的受教育水平和户人均年收入对其服务利用有促进作用。不同因素在城乡间作用方向一致,作用程度存在差异。结论：中国老年残疾人口康复服务需求尚未得到较好满足。基本人口特征、家庭特征、社会环境支持、残疾状态均影响其康复服务利用。应落实残疾报告制度;统筹康复服务资源配置;开展老年群体的健康评估与跟踪;加快完善康复服务项目的医疗保障范畴,建立以功能恢复为导向的支付原则。     

上海金山工业区残疾人“1+1+1”家庭医生签约服务效果评价

目的 了解上海市金山工业区家庭医生的康复服务能力情况以及“1+1+1”家庭医生签约服务后残疾人机体功能改善、满意度、医疗费用支出情况,为后续精细化干预提供支持。 方法 通过自拟问卷于2016年8－10月和2017年8－10月调查金山工业区14名家庭医生基本情况及掌握康复服务技能种类等以及733名残疾人的基本人口学信息、残疾特征信息和机体功能改善情况、满意度情况和医疗支出情况等。 结果 14名家庭医生年龄集中在20~50岁,均具有多种康复服务技能,能为残疾人提供个性化的“1+1+1”签约服务。733名残疾人男女性人数比为1.08:1,肢体残疾人数最多,为334人(45.57%),残疾等级中四级残疾人数最多,共342人(46.66%)。“1+1+1” 家庭医生签约上门服务人数和康复治疗人数较家庭医生制团队服务分别增加130人和312人。接受“1+1+1”家庭医生签约服务后,186名(25.38%)残疾人机体功能改善,47名(6.41%)残疾人机体功能恢复。签约残疾人满意度有一定提升,满意和非常满意人数总和由签约前的585人(79.81%)升至签约后的714人(97.41%)。签约残疾人医疗费用则呈现下降趋势,同比下降22.82%。 结论 “1+1+1”家庭医生签约服务能够提升残疾人对康复服务的满意度,改善残疾人机体功能,降低残疾人医疗支出。     

上海市徐汇区凌云街道残疾人社区康复服务需求调查

为推动我市残疾人事业发展,进一步改善残疾人生活状况,根据<上海市残疾人事业"十一五"发展纲要>中"以残疾人'人人享有康复服务'和重残人员养护为重点,完善残疾人康复服务工作体系"的目标,我们于2006年11月对凌云街道残疾人进行了社区康复服务需求现况调查,为实现2015年残疾人"人人享有康复服务"目标提供科学依据.     

上海市儿童孤独症康复机构现状研究

目的 分析目前上海市儿童孤独症(ASD)康复机构的现状,为政府相关部门政策制定提供实证依据.方法 采用定量与定性相结合的方法对上海市残疾人康复工作办公室46家约定康复机构和其中4名教师进行调查.结果 政府优惠政策的覆盖面小;近3年平均每家机构的ASD康复儿童数量连续为55.0人/年、62.5人/年和58.2人/年,无法满足患儿需求;康复训练标准不统一,监管缺失;康复人员有医学和教育背景的只占15.8%和15.1%,培训有待规范,民办机构工作人员待遇低下;社会宣传和支持力度不够,机构发展面临许多困境.结论 必须扩大优惠政策覆盖面,增加康复机构数量,加强政府统一监管,规范人员培训,以及强化宣传倡导.     

Unmet health, welfare and educational needs of disabled children in an impoverished South African peri-urban township

BACKGROUND: Childhood disability in South Africa has failed to receive adequate attention from governmental agencies, such as the health, education and social welfare departments, despite there being more than 1 million disabled children in the country. This study sought to assess the unmet rehabilitation, education and welfare needs of disabled children living in a peri-urban township. METHODS: As no register of disabled children existed, snowball sampling was used to recruit a convenience sample of 156 disabled children living in Orange Farm township near Soweto, South Africa. Children's impairments, their health and educational needs, and the availability and utilization of services were assessed using a structured interview. RESULTS: Few disabled children attended pre-school (35%) or school (44%). Only a quarter (26%) of children in need of rehabilitation received such services. Children with motor impairments were more likely to receive rehabilitation than those with intellectual impairment (44% vs. 8%, P < 0.0001). Of the 233 assistive devices required, only 64 (28%) had been issued. Less than half (45%) of the children entitled to a social assistance grant were receiving it. Lack of money, limited awareness about available services, and bureaucratic obstacles were the main reasons offered by caregivers for the low utilization of available services and resources. CONCLUSION: Children with disabilities living in Orange Farm are not enjoying the rights and services to which they are entitled. Innovative, co-ordinated service delivery strategies, and better-informed caregivers combined with community recognition of, and support for, the needs of disabled children are required to address these unmet needs.     

Relationship marketing and disadvantaged health care segments: using internal marketing to improve the vocational rehabilitation process

The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.     

Disabled people and professionals differ in their perceptions of rehabilitation needs

BACKGROUND: This study set out to explore whether there are systematic differences in unmet needs for rehabilitation services and resources as identified by disabled people and nominated key professionals. METHODS: A cross-sectional interview survey of 87 pairs of community-dwelling disabled people (aged 16-65) and their nominated key professionals was conducted in southern England. The Southampton Needs Assessment Questionnaire (SNAQ) was used to examine unmet needs and the Office of Population Censuses and Surveys (OPCS) Disability and Severity Scale to examine level of disability. RESULTS: Eighty-seven pairs of disabled people and their nominated key professionals participated. People were severely disabled (median OPCS score 8; interquartile range 6-9). Disabled participants reported significantly more unmet needs than did professionals. There was zero concordance on identified unmet needs between disabled participants and professionals in 56 per cent of cases. Concordance between disabled participants and professionals was significantly better if the disabled participant had reported more unmet needs. There was a trend for general practitioners to be poorer at reporting disabled participants' needs than other professionals. There was fair agreement between disabled participants and professionals in five areas of unmet need only (in descending order): adaptations, physiotherapy, equipment, assistance with 'non-care' activities and the use of a day centre. In all the other areas of unmet need the agreement was poor. CONCLUSIONS: Needs for rehabilitation services and resources (for disabled people) are perceived differently by disabled people and professionals. Until we know who is right about rehabilitation needs, it is important to determine both users' and providers' views when planning and commissioning services.     

The effects of social resources on recovery and perceived sense of control among the disahled*

Abstract This study examines the effects of social resources on recovery and perceived sense of control among the physically disabled. Data were obtained from personal interviews with 770 non-institutionalized disabled adults. Two types of social resources are distinguished: those derived from primary group affiliations and those derived from secondary (formal) group relationships. Secondary group sources of supportive services for the disabled may be necessary but not sufficient elements in the recovery process and in determining the disabled's perceived control over the situation. It is hypothesized that recovery and sense of control will be enhanced for those disabled who tend to utilize their social resources. The results are equivocal. An absence of any marked effect of primary group resources and an observed negative effect of secondary group resources appears to enhance recovery. Use of these social resources has little effect on one's perceived sense of control at the time of recovery. The implications of these limited findings are discussed in terms of conceptual and methodological issues involved in delineating and measuring key factors in the process of rehabilitation and recovery.     

Pediatric Residency Training and the Needs of Gay, Lesbian, and Bisexual Youth

Objective: This study surveys the education of pediatric residents about the needs of gay, lesbian, and bisexual (GLB) youth. The report measures the extent to which such training is considered valuable by those responsible for its administration and it evaluates the awareness of community referrals for GLB youth. Methodology: U.S. pediatric residency directors and chief residents were surveyed using a questionnaire designed by the authors. Percentage tabulation of the questions was performed. Chi-square analysis of two questions was done to determine if there was an association between the responses given and whether or not a respondent was from a program that offered training to their residents. Results: Over half of the respondents indicated that their programs offered training in the care of GLB youth. This increased to over three fourths when those respondents who indicated that their program was planning such training efforts were included. There was a broad distribution in the form and prevalence of training techniques. Over 90% of the respondents indicated that they valued the inclusion of GLB youth issues into residency curricula. A lesser majority indicated an awareness of community referrals for GLB youth. Conclusions: A large majority of pediatric residencies are either training their residents about the needs of GLB youth or are developing such training opportunities. The form and extent of the training varies widely. As such, the continued development of educational approaches and evaluation measures are encouraged.     

Attitudes to cuts in expenditure and increased fees in health care

The aim of this postal questionnaire study was to measure attitudes to cuts and increased fees in health care in various Finnish population groups. Four groups were identified: a population sample of 2000 subjects, aged 18–70 y; a random sample of 1500 medical doctors of working age; a random sample of 1000 nurses of working age; and a sample of 2200 politicians involved in health and social care administration, mostly at the municipal level (altogether 6700 subjects). The main questionnaire included, among other things, the following questions: (1) Which of 18 specified medical activities at the primary health care level could be cut without causing severe harm to the population? (2) For which of 13 specified medical activities should clients pay at least 50% of the real cost? All the groups indicated the greatest willingness to cut expenditure on health education, occupational health sevices, hygienee inspection, substance abuse care, rehabilitation services for war veterans, and family planning. All the groups were least willing to make cuts in home care for disabled and elderly people, maternity services and clinics for under-fives. Most respondents in all groups felt that the activities for which clients should pay at least 50% of the cost were visits to physicians, occupational health services and dental services, whereas clinics for under-fives and home care for disabled and elderly persons should be kept free of charge. As a conclusion, primary health care and prevention of diseases for small children, mothers, the elderly and disabled persons, were prioritised by all the groups.