广东省城乡残疾人个体生活能力的分析

目的:通过分析广东省各类残疾人的生活自理和生活活动，探讨城乡之间各类残疾人个体生活能力的异同并提出对策。方法:采用广东省第二次全国残疾人抽样调查中残疾人活动与参与评定的生活自理和生活活动分项目数据进行等级资料的统计处理。结果:城市与乡村视力残疾人的生活自理和生活活动的等级差异有显著性意义；肢体残疾人的生活自理的等级差异有显著性意义，而生活活动的等级差异无显著性意义；听力、言语、智力及精神残疾人的生活自理和生活活动在城乡之间的等级差异无显著性意义。结论:城市与乡村视力、肢体残疾人的个体生活能力有差异；而听力、言语、智力及精神残疾人的生活状况在城乡之间差异不明显，可采取相应的康复对策。     

广东省残疾人社会参与状况与康复需求的关系

目的对广东省各类残疾人的社会参与状况与康复需求的调查数据进行分析,探讨各类残疾人不同程度社会参与状况与康复需求的关系,并提出相应的康复对策。 方法采用广东省第2次全国残疾人抽样调查中残疾人社会参与评定的分项目,以及个人主要需求的调查数据进行等级资料比较的统计处理。 结果听力、视力、肢体、智力残疾人不同社会参与状况在本人主要需求上的构成比差异有统计学意义,而言语、精神残疾人不同社会参与状况在本人主要需求的构成比差异无统计学意义。各类残疾人不同社会参与状况相对应的康复需求以医疗服务及救助、辅助器具配送和康复功能训练及服务为主。 结论各类残疾人不同社会参与状况与康复需求的差异不尽相同,主要集中在医疗服务及救助、辅助器具配送和康复功能训练及服务等基本医疗和社会的需求方面,可为采取相应的康复对策提供依据。     

广东省不同等级残疾人的康复需求分析

目的分析不同残疾等级残疾人的康复需求状况,为制定合理的康复与社会辅助对策提供依据。方法对广东省第二次全国残疾人抽样调查中不同残疾类型不同残疾等级人士间的康复需求分项目进行等级资料分析。结果不同等级视力、听力、肢体、智力残疾人间康复需求的构成差别有统计学意义（P〈0.05）,而不同等级言语、精神残疾人间康复需求的构成差别没有统计学意义（P〉0.05）。结论残疾程度越重对医疗服务与救助的需求越高,而对其他康复需求较低甚至没有。     

北京德胜地区残疾人社区康复宣教效果分析*

目的： 探索社区康复宣教对残疾人社区康复知识掌握、行为活动改变的影响。 方法：完善社区康复宣教网络,对辖区1412名残疾人进行问卷调查,了解残疾人康复知识认知状况与康复宣教需求。制定康复宣教目标;开展康复咨询、康复知识讲座、发放宣传材料、康复技术指导等活动。两年后,对残疾人康复知识掌握、行为改变情况进行调查,比较康复宣教前后各项数值变化。结果： 康复宣教使辖区残疾人对康复知识掌握情况较宣教前明显提高,差异有显著性意义（P＜0.05和0.01）。对行为活动改变项目中,戒烟限酒、参与社会活动项目差异无显著性意     

河南省农村肢体残疾人康复需求与服务发展研究

目的研究河南省农村肢体残疾人的康复需求与服务发展。方法使用2016年度河南省残疾人基本服务状况和需求数据,对农村肢体残疾人康复需求与康复服务发展的状况进行统计分析和发展研究。结果本研究涉及河南省所辖全部19个地市的1,028,598名农村肢体残疾人,其中男性占61.7%。在康复需求方面,有手术需求19,348人次(1.9%),有药物需求202,855人次(19.7%),有功能训练需求197,592人次(19.2%),有辅助器具需求360,754人次(35.1%),有护理需求158,012人次(15.4%),不同康复服务需求人数在不同残疾等级方面均有非常高度显著性差异(χ~218.080,P0.001)。在接受康复服务状况方面,年度内接受手术康复服务6061人次(0.6%),接受药物康复服务93,905人次(9.1%),接受功能训练康复服务62,967人次(6.1%),接受辅助器具康复服务81,437人次(7.9%),接受护理康复服务34,595人次(3.4%),得到各种康复服务的人数在不同残疾等级方面有非常显著性差异(χ~215.920,P0.01)。在未得到康复服务的原因方面,康复政策认识学习不足165,172人次(20.3%),缺少足够康复经费支持151,448人次(18.6%),无法到达康复医疗机构20,369人次(2.5%),缺乏康复专业人员或康复机构服务能力低下等540,971人次(66.5%),不同原因的人数在不同残疾等级均有非常高度显著性差异(χ~219.182,P0.001)。结论本研究确认了河南省农村肢体残疾人的康复需求与服务发展状况,建议应大力培养康复专业人才并提高相关康复机构的服务能力,加大康复服务宣传培训力度,提高残疾人的认知能力,加大对于康复服务的资金投入,为需要康复服务的残疾人提供合理便利。     

ICF社会参与评定与社会康复

我国现有各类残疾人6 000多万.使残疾人回归社会、重新参与社会生活,是全面康复的核心问题、根本问题.但不同类型、不同性别和不同年龄的残疾人,其身体和心理障碍,以及参与社会的欲望、程度、条件、目的和结果均存在差异.笔者仅根据社会康复和职业康复的要求,从康复病案管理及国际功能、残疾与健康分类(International Classification of Functioning,Disability and Health,ICF)理论体系的角度,概括阐释对残疾人社会参与评定的认识.     

四川省阿坝州茂县大骨节病患者生活自理能力和社会参与状况的分析

摘要 目的:对四川省阿坝州茂县大骨节病患者的生活自理能力和社会参与状况进行调查,分析原因并探讨康复干预的可行性。 方法: 收集2009年2月25日—3月3日四川省阿坝州茂县凤毛村、罗山村和九龙村的抽样调查数据,每村抽取病患组及对照组各25例。生活自理能力的评定为WHO-DAS Ⅱ分项目中残疾人活动参与评定数据,社会参与状况数据为参与量表社会参与受限程度得分。采用关节角度测量尺和徒手肌力检查法对大骨节病患者分别进行被动关节活动度与肌肉力量的测量,同时记录相关疼痛情况。 结果:大骨节病患者组与健康对照组在生活自理能力和社会参与能力方面的等级差异均有显著意义（Z值分别为-9.459和-8.478）;大骨节病患者普遍存在的关节疼痛、活动受限及肌肉力量减弱等问题严重影响患者肢体功能。 结论: 四川省阿坝州茂县大骨节病患者存在不同程度的生活自理能力和社会参与局限。应加强三级康复网,建立社区康复服务,改变传统干预概念,帮助患者回归社会。     

精神残疾人康复需求与康复服务发展状况研究

目的探讨精神残疾人康复需求现状、康复服务的获取及其影响因素,为精神残疾人康复服务发展提供支持。方法采用河南省2016年度全国残疾人基本服务状况和需求实名制专项调查数据,对精神残疾人康复需求现状及康复服务获取情况进行描述性统计分析。结果精神残疾人康复需求主要包括医疗康复、功能训练和辅助器具,其中医疗康复需求率最高(58.99%),功能训练需求率最低(10.08%)。不同年龄、性别、户口性质、残疾等级、受教育程度、就业情况、家庭收入状况、贫困与建档立卡状况的精神残疾人,康复需求存在非常高度显著性差异。精神残疾人的康复服务包括医疗康复服务、功能训练服务、辅助器具服务,其中医疗康复服务获取率最高(25.82%),辅助器具服务获取率最低(3.06%)。精神残疾人康复服务获取受其户口性质、残疾等级、受教育程度、就业情况、家庭收入状况、贫困与建档立卡状况等因素的影响;"家庭经济困难"、"不了解相关知识"、"交通不便"和"其他原因"也对精神残疾人获得康复服务有重要影响。结论精神残疾人康复需求量大,对医疗康复服务需求率最高;康复需求受性别、户口性质、残疾等级等因素影响。精神残疾人康复服务获取率总体较低,医疗康复服务获取率相对较高。精神残疾人康复服务情况受家庭经济状况和交通等其他因素影响。精神残疾人康复需求报告率、康复服务覆盖率、康复服务质量和效率有待提高。     

中国残疾人康复需求与发展研究

目的研究中国残疾人的主要康复需求和康复服务发展状况。方法对第二次全国残疾人抽样调查中康复需求与发展状况的数据进行统计分析,并就2006年至2016年中国残疾人事业发展统计公报有关康复的数据进行分析研究。结果我国残疾人的康复需求主要包括:医疗服务与救助、辅助器具、康复训练与服务、贫困残疾人救助、无障碍设施、信息无障碍和其他康复需求。需求最高的是医疗服务与救助(34.84%)和贫困残疾人救助(33.25%)。不同残疾类别残疾人在康复需求上存在非常显著性差异(χ~2=40322.1,P0.01)。在我国各类残疾中,有约41.46%的残疾人未曾接受过任何服务和救助,接受最多的服务是医疗服务与救助(30.45%),接受最少的是信息无障碍(0.55%)。专家为各类残疾人提供的康复形式建议主要集中在机构康复和社区与家庭服务;专家建议医疗服务作为精神残疾类(68.18%)和视力残疾类(60.28%)的主要康复内容,辅助器具作为听力残疾类(51.67%)的主要康复内容,康复训练与服务作为智力残疾类(57.36%)和言语残疾类(47.06%)的主要康复内容。不同残疾类别残疾人在专家为其提供的康复形式和康复内容上存在非常显著性差异(χ~2=12489.9,χ~2=52528.93,P0.01)。结论中国残疾人的康复需求主要表现为医疗服务与救助、辅助器具、康复训练与服务和贫困残疾人救助,不同类别残疾人康复需求存在差异;残疾人接受最多的是医疗服务与救助;中国残疾人得到的贫困残疾人救助与其需求差距最大;专家为不同类别残疾人建议的康复形式和康复内容存在差异。建议构建国家和地方康复政策支持体系和康复服务治理架构;以残疾人的康复需求为导向,提供精准康复服务;建立综合性康复服务体系,实现人人享有基本康复服务的目标;大力培养专业康复人员,提升康复服务提供能力和水平;运用《国际功能、残疾和健康分类》开展康复科学研究,为促进康复事业发展提供科学支持。     

河南省“一户多残”家庭社会经济发展状况与服务需求研究

目的研究河南省"一户多残"家庭的社会经济发展状况及其服务需求。方法使用2016年度河南省残疾人基本服务状况和需求数据,对"一户多残"家庭的社会经济发展状况与服务需求进行研究。结果本研究涉及河南省所辖全部19个地市的74,732名"一户多残"残疾人,占总调查人数的4.0%,其中男性54.9%,农业户口83.2%。在人均收入方面,非农业户口残疾人收入低于低保标准41.8%,低于低收入标准或低保边缘标准14.7%,其他43.1%;农业户口残疾人属于国家建档立卡贫困户23.9%,疑似贫困人口未建档立卡35.7%,非贫困人口39.9%。在住房状况方面,非农业户口残疾人自有产权住房75.3%,享受住房保障政策7.1%,无房12.9%;农业户口残疾人自有住房状况良好70.5%,自有住房鉴定为危房3.5%,自有住房疑似危房15.9%,无房1.7%,自有住房2016年度内已接受危房改造2.2%。非农业户口"一户多残"残疾人经济与住房状况在不同残疾类别上均有非常高度显著性差异(χ~251.267,P0.001),收入低于低收入标准或低保标准边缘和其他的残疾人在不同残疾等级上有显著性差异(χ~28.400,P0.05)。农业户口"一户多残"残疾人经济与住房状况在不同残疾类别上均有非常高度显著性差异(χ~270.149,P0.001),在不同残疾等级上均无显著性差异(χ~26.446,P0.05)。在就业扶贫服务需求方面,职业技能培训5.0%,职业介绍3.9%,农村实用技术培训6.6%,资金信贷扶持7.6%,其他10.7%。河南省"一户多残"残疾人就业扶贫需求在不同残疾类别上均有非常高度显著性差异(χ~273.180,P0.001),有职业技能培训需求、职业介绍需求、农村实用技术培训需求和资金信贷扶持的在不同残疾等级上有非常显著性差异(χ~211.440,P0.01)。在托养服务需求方面,居家托养54.1%,日间照料11.1%,寄宿托养2.9%。河南省"一户多残"残疾人托养服务需求在不同残疾类别和残疾等级上均有非常高度显著性差异(χ~238.960,P0.001)。在康复需求方面,手术2.1%,药物22.5%,功能训练16.1%,辅助器具29.8%,护理14.8%。河南省"一户多残"残疾人康复服务需求在不同残疾类别上有非常高度显著性差异(χ~299.220,P0.001),有护理需求的残疾人在不同残疾等级上有非常显著性差异(χ~2=12.465,P0.01)。在无障碍改造服务需求方面,户外坡道、扶手改造17.7%,房门改造14.2%,卫生间改造30.3%,厨房改造20.5%,闪光可视门铃改造3.4%,煤气泄漏警报发声装置改造2.3%,上网读屏软件改造0.6%,其他改造30.1%。除闪光可视门铃,煤气泄漏报警发生装置和上网读屏软件外,河南省"一户多残"残疾人无障碍改造服务需求在不同残疾类别上均有非常高度显著性差异(χ~268.000,P0.001),有闪光及可视门铃、煤气泄漏警报发声装置和上网读屏软件改造需求的残疾人在不同残疾等级上均有非常高度显著性差异(χ~246.960,P0.001)。结论 "一户多残"家庭社会经济发展状况面临风险。相关政策建议包括提高支持力度,保障其基本住房状况,关注他们在就业扶贫需求上的个别化差异,为其提供更多就业机会,为有能力创业的残疾人提供资金信贷支持,加大对于居家托养的支持力度,加大康复服务的资金和辅助器具投入,且要关注他们的无障碍改造需求,为其生活提供合理便利。     

On autonomy and participation in rehabilitation

Purpose : To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method : A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. Results : The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions of autonomy vary among individuals and cultures, but a crucial distinction can be made between decisional autonomy (the ability to make decisions without external restraint) and executional autonomy (the ability to act as one wishes). The liberal-individualist account of autonomy over-emphasizes physical independence and does not sufficiently recognize the inter-dependency of all people, including those with disabilities. An ethic of care, complementary to the principle of respect for autonomy, should guide the development of rehabilitation strategies to enhance individual autonomy and participation in daily living. For rehabilitation, this entails an attentive attitude, maximizing opportunities for informed choices, taking full account of each person's preferences, needs and social contexts. Conclusions : Autonomy is central to client-centred rehabilitation since it is a pre-requisite for effective participation. It is suggested that autonomy, conceived as a basis for participation, is the ultimate aim of rehabilitation.     

Accelerating the Implementation of the Incheon Strategy to Make the Right Real for Persons with Disabilities

The Background of the Asian and Pacific Decade of Persons with Disabilities The Asia and Pacific Region Asia and Pacific is a vast region.It has about 60％of the world population.In Asia,you can find some of the oldest civilizations and religions;some of the most advanced as well as poorest economies,and many Asians living in rural and mountainous areas.Diversities and differences among governments and peoples of Asia are the norm rather than the exception. Poverty situation of people with disabilities in Asia:People with disabilities in the region are facing critical and severe situations.About 80％ of Asian people with disabilities live in rural or remote areas.Among the 900million very poor people in the Region,the disabled are among the most discriminated against and the most impoverished.     

Rehabilitation an international perspective: a Zimbabwean experience

Purpose/Method: The article discusses rehabilitation practices in Zimbabwe from both a local and international perspective. It considers the nature of formal and informal rehabilitation services in the country, and rehabilitation personnel training. Results: Indigenous disability-related practices dominate the informal rehabilitation sector whereas modern rehabilitation practices characterize the formal rehabilitation sector. Rehabilitation clients make use of both the formal and informal rehabilitation systems. Persons with disabilities in Zimbabwean urban centres have more access to the formal rehabilitation service system than those in the rural areas. Conclusions: Rural communities may have more habilitation than rehabilitation, and are more accommodating of disability-related differences.     

Using intersectionality to explore experiences of disability and HIV among women and men in Zambia

Abstract

Purpose: Little is known about the experiences of people with disabilities (PWD) who live with HIV. Existing research largely assumes a “double burden” approach, which views HIV as doubling the load for people already burdened by disability. Intersectionality (a dynamic process of converging systems of relationships) offers an alternative approach for understanding differences in experience. This study uses an intersectional approach to explore the experiences of PWD in Zambia who have become HIV-positive. Methods: We conducted semi-structured, in depth interviews with 21 PWD who live with HIV in Zambia (12 women, 9 men). Participants had various impairments (visual, hearing, mobility, intellectual). Interviews were conducted to meet participants’ accessibility preferences. Results: Our intersectional analysis demonstrates the dynamic and situational emergent meanings and consequences for PWD who are living with HIV related to: (1) meanings of HIV and disability linked with time and trajectory; (2) oppression and negotiation related to accessing health services and (3) social roles and relationships. Three case studies illustrate these circumstances. Conclusions: Intersectionality offers a complementary approach for examining the complex interrelationship among HIV, disability, gender and time among PWD living with HIV. Findings illustrate directions for improved services and policies for this important group.

• Implications for Rehabilitation

• Rehabilitation services need to take a cross-disability (multiple disabilities) approach working with people living with HIV and disability.

• Rehabilitation, as illustrated by a CBR approach, needs to include services that will facilitate not only health, but education, jobs and housing for people living with HIV and disability.

• Rehabilitation needs to make more direct connections with Zambia social service sector to help address the fluctuating experience of living with HIV and disability.

     

The impact of community based rehabilitation as implemented by community rehabilitation facilitators on people with disabilities,their families and communities within South Africa

Purpose. To find out the impact of community based rehabilitation (CBR) as implemented by mid-level rehabilitation workers known as community rehabilitation facilitators (CRFs) on people with disabilities (PWD), their families and the communities in South Africa.

Method. A qualitative research design was used with an emphasis on participatory methods with PWD and their family members. Data collection took the form of individual interviews, focus groups and transects walks in both urban and rural settings within six provinces of South Africa.

Results. Although CRFs work with individuals, groups, families and the community, they appear to have had a stronger impact on individuals with disabilities rather than the community at large. Various gaps were also identified and were related to the poor recognition of the scope of practice of CRFs as well as to individual CRFs abilities to carry out certain tasks.

Conclusions. Although the results suggest that CRFs have had a positive impact, there are still a number of issues that need to be addressed. These include proper support of CRFs and intersectoral collaboration between government departments to ensure the future of CBR in South Africa.     

Rehabilitation an international perspective: a Zimbabwean experience

Purpose/Method: The article discusses rehabilitation practices in Zimbabwe from both a local and international perspective. It considers the nature of formal and informal rehabilitation services in the country, and rehabilitation personnel training. Results: Indigenous disability-related practices dominate the informal rehabilitation sector whereas modern rehabilitation practices characterize the formal rehabilitation sector. Rehabilitation clients make use of both the formal and informal rehabilitation systems. Persons with disabilities in Zimbabwean urban centres have more access to the formal rehabilitation service system than those in the rural areas. Conclusions: Rural communities may have more habilitation than rehabilitation, and are more accommodating of disability-related differences.     

The physical, mental, and emotional health of older people who are living alone or with relatives

In Korea, as in other countries, the number of older adults is growing substantially, and the proportion of older adults is projected to be 14.3% by 2022 [Ministry of Health and Social Affairs, Republic of Korea. (2003). Yearbook of health and social affairs statistics for 2003, vol. 49. Seoul, Korea: Government Printing Office]. The number of older people who are living alone in rural areas has been sharply increasing as a result of the migration of younger adults to urban areas for employment. However, information on the health status of elders who live alone is limited. Therefore, the purpose of this study was to compare the physical, mental, and emotional health status of elders who are living alone and those living with relatives in rural areas in South Korea. A cross-sectional survey design was used, and data were collected by interviewing subjects. A two-stage cluster sampling process was utilized for those living alone (n = 110) and those living with family members (n = 102). Both groups were enrolled in KyungRo-Dangs (senior centers), which are like community centers in the province. The results indicate that elders who are living with relatives scored significantly higher on several physical and mental health parameters than elders who are living alone. However, elders who are living with relatives had a significantly higher emotional health status in almost every item than elders who are living alone. These findings suggest that interventions to increase health status, especially the emotional health of elders who are living alone, are imperative and that the intervention should be sensitive to changes in the social structure of elders who are living alone in rural areas. Further studies are needed to understand the factors that are associated with the physical, mental, and emotional health of elders who are living alone and those who are living with relatives.     

Participation in Sports by People with Intellectual Disabilities in England: A Brief Report

Background Participation in sports has been linked to a range of physical, social and mental health benefits. Little is known about the extent to which people with intellectual disabilities take part in sports. This study looks at participation in sports and factors associated with participation by people with intellectual disabilities in England. Method Data on participation in sports and measures of personal characteristics, living situation, social participation, and socioeconomic status associated with participation were analysed based on a sample of 2784 people with intellectual disabilities in England. Results Overall, 41% of participants had taken part in sports in the past month, nearly all of whom had enjoyed it. Of those who did not take part, 34% said they would like to. Participation in sport was associated with some personal characteristics but not with support needs, and was also associated with indicators of socioeconomic status. Conclusions Targeting interventions to increase participation in sports by people with intellectual disabilities may make a significant contribution to improving their health and well‐being.     

Urban–rural differences in mental health among Chinese patients with multiple chronic conditions

Mental health is impacted by social, economic, and environmental influences related to where people live. Mental health problems commonly co‐occur with long‐term physical conditions and impact individuals’ health synergistically. Multiple chronic conditions (MCCs) including mental health problems are becoming a public health challenge globally. However, there is limited information about urban–rural differences in mental health among patients with MCCs in China. The present study aimed to identify differences in mental health between urban and rural patients with MCCs. Using a cross‐sectional design, 347 patients with MCCs were recruited from a tertiary hospital in North Anhui, China. A self‐reported questionnaire, including socio‐demographic and clinical variables, the 12‐item Short‐Form survey version 2 on quality of life, and the Hospital Anxiety and Depression Scale, was administered to outpatients. Findings showed that rural participants reported more symptoms of anxiety and depression and had worse mental health compared to urban participants. Unemployment status, lower educational level, more long‐term health conditions, and a higher degree of anxiety were associated with worse mental health. This study highlights disparities in mental health among patients with MCCs living in urban and rural areas of China. Appropriate mental health support programmes should be developed for patients with MCCs, especially for those living in rural areas.