兰州市城区残疾人生活质量与残疾态度和照顾质量的相关性分析北大核心CSCD

目的评价兰州市城区残疾人生存状态,探讨残疾人生活质量与残疾态度和照顾质量的相关性。方法 2016年8月至11月,多阶段分层整群抽取兰州市城关区登记在册的606例残疾人,使用世界卫生组织残疾人生活质量量表、残疾态度量表、残疾人照顾质量量表,以入户访谈形式完成调研。结果城区残疾人生活质量量表评分(40.76±14.79),不同人口学特征残疾人间生活质量评分有显著性差异(P<0.05)。Pearson相关性分析显示,残疾人生活质量各领域评分、总评分与残疾态度多数维度评分呈正相关(r>0.080,P<0.05),与照顾质量多数维度评分呈正相关(r>0.083,P<0.05)。结论应加强建设残疾人精准保障制度,着力构建全周期、全方位的残疾人社会支持体系。     

兰州市城区残疾人生活质量与残疾态度和照顾质量的相关性分析

目的评价兰州市城区残疾人生存状态,探讨残疾人生活质量与残疾态度和照顾质量的相关性。方法 2016年8月至11月,多阶段分层整群抽取兰州市城关区登记在册的606例残疾人,使用世界卫生组织残疾人生活质量量表、残疾态度量表、残疾人照顾质量量表,以入户访谈形式完成调研。结果城区残疾人生活质量量表评分(40.76±14.79),不同人口学特征残疾人间生活质量评分有显著性差异(P0.05)。Pearson相关性分析显示,残疾人生活质量各领域评分、总评分与残疾态度多数维度评分呈正相关(r0.080,P0.05),与照顾质量多数维度评分呈正相关(r0.083,P0.05)。结论应加强建设残疾人精准保障制度,着力构建全周期、全方位的残疾人社会支持体系。     

兰州市城关区残疾人生存质量的影响因素解析

目的:研究兰州市城关区残疾人生存质量,为加强城关区残疾人保障体系建设提供基线资料和询证.方法:采用多阶段分层整群抽样抽取兰州市城关区登记在册的606例残疾人,首先使用世界卫生组织残疾人生存质量量表、残疾态度量表、残疾人照顾质量量表和自编基本情况问卷以面访或指导自填形式完成,其次通过拟合生存质量影响因素结构方程模型构建多...     

湖北省残疾人照顾质量及其影响因素调查

目的调查残疾人照顾质量及其影响因素。方法 2015年11月,采用方便抽样对5个社区残疾人服务机构399名残疾人进行照顾质量量表和人口学问卷调查。结果残疾人照顾质量量表评分平均(38.11±6.24),其中照顾的给予、照顾的环境和照顾信息的获得评分达到该维度总分70%以上。不同年龄、居住地区、职业、医疗保障、家庭月支出、家庭月伙食消费水平残疾人,照顾质量评分有显著性差异(F4.487,P0.05)。多元线性回归分析显示,年龄(β=0.06,P0.01)与医疗保障情况(β=-0.850,P0.001)是照顾质量评分的独立影响因素。结论湖北省残疾人从服务机构接受的照顾质量较高。应加强对残疾人医疗保障体系建设,进一步提高残疾人照顾质量。     

民族地区残疾老人照顾质量的调查

目的 了解民族地区残疾老人的照顾质量及其影响因素.方法 采用多阶段分层随机整群抽样对该民族地区残疾老人进行问卷调查,并分析影响照顾质量的相关因素.结果 不同地区、民族、婚姻状况、居住和社会支持情况、文化程度、健康状况、残疾影响生活程度、职业、收入、健康状况的调查对象间照顾质量维度的得分比较差异有统计学意义;多因素逐步回归分析显示,其他民族、未婚、失业/下岗和待业中、残疾极严重影响生活对残疾老人照顾质量总分有影响.结论 提高对民族地区残疾老人的经济补助,重视未婚残疾老人的身心照护,完善并建立有效的残疾老人康复机制,可以提高残疾老人的照顾质量.     

肢体残疾人自我效能感、照顾质量与生活质量的关系

目的 探讨肢体残疾人自我效能感、照顾质量和生活质量的现状及三者间关系。方法 2019年1月至2020年12月,整群分层随机抽样选取山东省357例肢体残疾人,采用一般资料调查表、世界卫生组织残疾人生活质量量表、自我效能感量表、世界卫生组织残疾人照顾质量量表进行网络问卷调查。结果 共回收调查问卷357份,其中有效问卷350份。肢体残疾人的生活质量为(115.00±20.70)分,自我效能感(23.33±5.78)分,照顾质量(50.43±10.56)分。肢体残疾人的生活质量及其各领域均与自我效能感呈正相关(r> 0.282, P <0.01),与照顾质量、照顾信息的获得、照顾的给予和照顾的环境维度呈正相关(r> 0.369,P <0.01)。就业情况、自我效能感和照顾质量总分是肢体残疾人生活质量的影响因素(t> 4.386, P <0.001);就业情况、自我效能感、照顾的给予和照顾的环境是生活质量生理领域、心理领域和环境领域的影响因素(t> 2.926, P <0.01);主要照顾者为父母、就业情况、自我效能感、照顾的给予和照顾的环境是生活...     

广州市不同类型成年残疾人的照顾质量及其影响因素分析

目的探讨广州市不同类型成年残疾人的照顾质量及其影响因素。 方法采用多阶段分层随机整群抽样的方法,从广州市抽取2912例一般成年残疾者和227例智力残疾者。采用一般情况调查表以及世界卫生组织残疾人照顾质量量表等跨文化量表了解调查对象的一般情况和照顾质量等信息。采用统计描述以及多重线性回归对资料进行分析。 结果一般残疾者和智力残疾者的照顾质量得分分别是（3.1±0.4）分和（2.1±0.3）分,处于中等水平。一般残疾者（除智力残疾以外的所有残疾者）的照顾质量受对待残疾的态度、居住情况和社会支持、残疾严重程度、残疾年限、收入水平、婚姻状态的影响,智力残疾者的照顾质量受对待残疾的态度、残疾严重程度和年龄的影响,其中,对待残疾的态度是影响所有残疾者的照顾质量的最主要因素。 结论广州市成年残疾人的照顾质量中等,影响因素较多,残疾态度的影响较大。     

慢性阻塞性肺疾病病人家庭照顾者希望水平及影响因素分析

[目的]了解慢性阻塞性肺疾病(COPD)病人家庭照顾者的希望水平及影响因素。[方法]采用一般资料调查表、Herth希望量表对94例住院COPD病人进行调查;采用一般资料调查表、Herth希望量表、WHO生存质量评估简表对其家庭照顾者进行调查。[结果]COPD病人家庭照顾者希望水平总分为(34.27±4.51)分,其中62.8%的照顾者处于中等水平,37.2%的照顾者处于高等水平;照顾者行动维度得分、希望水平总分与其生存质量总分、各领域得分及病人态度维度、行动维度、关系维度、希望水平总分呈正相关;影响照顾者希望水平的单因素有年龄、婚姻状况、是否在职、自觉健康状况、日均照顾时间;多元逐步回归分析显示病人希望水平及照顾者婚姻状况、生存质量、日均照顾时间是影响照顾者希望水平的主要因素。[结论]COPD病人家庭照顾者的希望水平处于中等至高等水平,医护人员应重视希望水平对家庭照顾者的影响,采取有效措施提高其希望水平。     

脑卒中恢复期病人主要照顾者疲劳感及其影响因素调查

目的:调查脑卒中恢复期病人主要照顾者疲劳现状,分析造成其疲劳的因素,为制订改善其不良心理状态的护理措施提供理论依据,进而促进病人的康复。方法:选取2018年6月—2019年6月住院治疗的脑卒中恢复期病人的主要照顾者405人为研究对象。采用一般资料调查表、疲劳量表和简易应对方式问卷在病人出院当天对其主要照顾者进行调查。结果:脑卒中恢复期病人主要照顾者疲劳感总分为(11.26±3.01)分,处于中重度疲劳。单因素分析结果显示,不同发病次数、生活自理能力的病人的主要照顾者疲劳感得分比较差异有统计学意义(P<0.05),不同性别、文化程度、健康状态、照顾时间、协助照顾人数、与病人关系的主要照顾者疲劳感得分比较差异有统计学意义(P<0.05)。相关性分析结果显示,脑卒中恢复期病人主要照顾者的积极应对评分与疲劳感总分及各维度评分呈明显负相关(P<0.01),脑卒中恢复期病人主要照顾者的消极应对评分与疲劳感总分及各维度评分呈明显正相关(P<0.01)。多元线性回归分析结果显示,照顾者健康状态、照顾者性别、照顾者照顾时间、病人生活自理能力是脑卒中恢复期病人主要照顾者疲劳感的影响因素(P<0.01)。结论:脑卒中恢复期病人主要照顾者普遍存在疲劳感,要采取干预措施,实现照顾者应对方式由消极向积极转变,要关注照顾者的健康状况,以减少疲劳发生,促进病人康复。     

早产产妇产褥期生活质量及其影响因素调查

[目的]调查早产产妇在产褥期的生活质量及其影响因素,采取有效措施提高产褥期早产产妇的生活质量。[方法]采用生活质量测定量表简表(WHOQOL-BREF)、社会支持评定量表(SSRS)对115例早产产妇和104例正常足月产妇进行调查。[结果]早产产妇的WHOQOL-BREF总分及其各维度得分、SSRS总分均低于足月产妇(P0.05)。多元逐步回归分析显示影响早产产妇产褥期生活质量生理维度的因素有婴儿住院时间、家庭月收入、月嫂或月子中心照顾、分娩方式、婴儿出生体重;心理维度影响因素有婴儿出生胎龄、社会支持、照顾者人数、夫妻关系;社会维度的影响因素有职业、社会支持、是否有产后随访;环境维度的影响因素有居住地、职业、月嫂或月子中心照顾、婴儿出生体重、家庭月收入、婴儿出生胎龄;总分影响因素有婴儿出生体重、社会支持、月嫂或月子中心照顾、家庭月收入、产妇年龄、照顾者人数。[结论]早产产妇产褥期生活质量低于正常足月产妇,影响因素较多,应建立完善支持系统,给予产妇有针对性、个性化的健康指导,提高其自我保健及科学育儿能力,促进母婴生活质量同步提高。     

上海市闸北区280 名残疾人生活质量研究

目的调查2009 年上海市闸北区同意接受“居家养护”服务的所有残疾人的生活质量,并分析其影响因素。方法采用中文版健康调查简表(SF-36)进行入户调查。结果闸北区280 名残疾人生活质量总体得分为(59.72±20.03)。不同年龄段、不同残疾类型、不同低保情况的残疾人生活质量平均得分具有非常显著性差异(P<0.01),年龄与生活质量呈负相关(P<0.01),教育程度、低保情况与生活质量呈正相关(P<0.05, P<0.01)。结论上海市闸北区残疾人生活质量较低。     

Pain assessment in intellectually disabled people: non-verbal indicators

BACKGROUND: Although important progress has been made during the past decade, research on pain in people with intellectual disabilities is still scarce. Pain assessment in people with intellectual disabilities is a frequent and difficult problem, especially for nurses working with people with intellectual disabilities on a daily basis. Gathering more information about pain in people with intellectual disabilities is of major importance and relevance for nursing, and adds to the developing body of knowledge. OBJECTIVE: To investigate the nature and relative importance of non-verbal indicators used by nurses to assess pain in people with a severe or profound intellectual disability. METHODS: A questionnaire consisting of 158 indicators of pain was used. A total of 135 nurses from nine institutions specializing in the care of people with intellectual disability were asked to rate each indicator on a scale of 1-10 to show which non-verbal expressions they considered important in diagnosing pain. RESULTS: A total of 109 nurses responded. All 158 indicators were mentioned as being important to indicate pain. All except four had a range of 9. Seven (moaning during manipulation, crying during manipulation, painful facial expression during manipulation, swelling, screaming during manipulation, not using (affected) body part, and moving the body in a specific way of behaving) were reported as 'very important' by more than 50% of nurses. The lowest score (median 5.5; minimum 1, maximum 10) was given to the indicator 'waving arm movements'. The pain of people with severe intellectual disability appeared to be assessed differently from that of people with profound intellectual disability. Indicators belonging to the 'physiological' category scored relatively higher in the group of nurses specializing in profound disability. In contrast, indicators belonging to the 'social-emotional' category were scored relatively higher by nurses specializing in severe disability. CONCLUSION: Nurses used a wide range of indicators to assess pain in people with intellectual disability. Functional abilities and level of disability seem to influence the indicators used.     

Assessment of GPs' beliefs relating to the care of people with intellectual disabilities: a Taiwan-based, opportunity-guided approach

PURPOSE: This study was designed to investigate general practitioners' (GPs) beliefs about the perceived importance of their role in, and their satisfaction with, providing healthcare to people with intellectual disabilities. The identification of healthcare issues with potential for improvement was assessed using gap analysis and an opportunity-guided method. METHOD: A cross-sectional census survey by a mail-structured questionnaire recruited 331 GPs (response rate--16%) who provided information on healthcare for people with intellectual disabilities in 2006 in Taiwan. RESULTS: The results indicated that GPs considered their role in providing healthcare for people with intellectual disabilities to be important (mean score 7.2-8.3). However, the respondents generally did not feel satisfied (mean score 4.6-5.5) with their achievements in treating patients with intellectual disabilities. We found that the gender and educational level of the respondents were statistically correlated to the perceived importance they considered their work to have, while the factors of age, medical practice setting and training experience in intellectual disability were statistically correlated to GPs' perceived satisfaction in providing healthcare to people with intellectual disabilities (p < 0.05). Those healthcare issues of'training and experience in intellectual disability', 'multi-disciplinary and multi-sectoral cooperation', 'adequate competence in disability diagnosis', 'genetic consulting services', 'duty of disease prevention and health promotion', and 'adequate medical consultation time' were the five most promising areas to be improved in healthcare for people with intellectual disabilities according to the opportunity-guided analysis. CONCLUSIONS: This study highlights that health professionals need to examine carefully healthcare issues pertaining to people with ID, and that much more effort is required to develop appropriate healthcare policies based on the opportunity-guided health issues identified here.     

Assessment of GPs' beliefs relating to the care of people with intellectual disabilities: A Taiwan-based,opportunity-guided approach

Purpose. This study was designed to investigate general practitioners' (GPs) beliefs about the perceived importance of their role in, and their satisfaction with, providing healthcare to people with intellectual disabilities. The identification of healthcare issues with potential for improvement was assessed using gap analysis and an opportunity-guided method.

Method. A cross-sectional census survey by a mail-structured questionnaire recruited 331 GPs (response rate = 16%) who provided information on healthcare for people with intellectual disabilities in 2006 in Taiwan.

Results. The results indicated that GPs considered their role in providing healthcare for people with intellectual disabilities to be important (mean score 7.2 – 8.3). However, the respondents generally did not feel satisfied (mean score 4.6 – 5.5) with their achievements in treating patients with intellectual disabilities. We found that the gender and educational level of the respondents were statistically correlated to the perceived importance they considered their work to have, while the factors of age, medical practice setting and training experience in intellectual disability were statistically correlated to GPs' perceived satisfaction in providing healthcare to people with intellectual disabilities (p < 0.05). Those healthcare issues of ‘training and experience in intellectual disability’, ‘multi-disciplinary and multi-sectoral cooperation’, ‘adequate competence in disability diagnosis’, ‘genetic consulting services’, ‘duty of disease prevention and health promotion’, and ‘adequate medical consultation time’ were the five most promising areas to be improved in healthcare for people with intellectual disabilities according to the opportunity-guided analysis.

Conclusions. This study highlights that health professionals need to examine carefully healthcare issues pertaining to people with ID, and that much more effort is required to develop appropriate healthcare policies based on the opportunity-guided health issues identified here.     

Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers

OBJECTIVE: To develop and test a new instrument to assess environmental barriers encountered by people with and without disabilities by using a questionnaire format. DESIGN: New instrument development. SETTING: A rehabilitation hospital and community. PARTICIPANTS: Two convenience samples: (1) 97 subjects, 50 with disabilities and 47 without disability, and (2) 409 subjects with disabilities from spinal cord injury, traumatic brain injury, multiple sclerosis, amputation, or auditory or visual impairments. In addition, a population-based sample in Colorado of 2269 people (mean age, 44 y; 57% men) with and without disabilities. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Item development; factor structure; test-retest, subject-proxy and internal consistency reliability; content, construct, and discriminant validity; and subscale and abbreviated version development. RESULTS: Panels of experts on disability developed items for the Craig Hospital Inventory of Environmental Factors (CHIEF). The instrument measured the frequency and magnitude of environmental barriers reported by individuals. Five subscales were derived from factor analysis measuring (1) attitudes and support, (2) services and assistance, (3) physical and structural, (4) policy, and (5) work and school environmental barriers. The CHIEF total score had high test-retest reliability (intraclass correlation coefficient [ICC]=.93) and high internal consistency (Cronbach alpha=.93), but lower participant-proxy agreement (ICC=.62). Significant differences were found in CHIEF scores among groups of people with known differences in disability levels and disability categories. CONCLUSIONS: The CHIEF has good test-retest and internal consistency reliability with evidence of content, construct, and discriminant validity resulting from its development strategy and psychometric assessments in samples of the general population and among people with a variety of disabilities.     

Primary health care provision for adults with a learning disability

BACKGROUND: During the last decade, primary care has been designated as the main provider of health care to people with learning disabilities. Practice nurses based in primary care teams are increasingly the first points of contact with health services. They make an important contribution to promoting good health, with health screening and illness prevention work being a significant part of their role. However, little is known about their views or involvement regarding the provision of primary care for people with learning disabilities. There is therefore a need to explore the nursing perspective, from within primary care, on the current provision of care for people with a learning disability. RESEARCH AIM: To inform the learning disability service of the role of primary care in current service provision for people with learning disabilities. RESEARCH METHOD: A survey of all practice nurses currently employed by Grampian Health Board in Aberdeen was conducted in June 2001. An initial pilot study was conducted in primary care and learning disability services. Data collection took place during June and July 2001. All practice nurses working in the geographical region of Grampian were invited to participate. RESULTS: Communication barriers exist, preventing access to health screening and treatment for some people with learning disabilities. Independent living skills, for example dietary management and budgeting, require additional community support. These conditions pose complex problems for practice nurses and other members of the primary care team. CONCLUSION: This study indicates a need for closer support and partnership with the learning disability service. The factors necessary for providing health care to people with learning disabilities extend beyond the domain of primary care teams. The findings of this survey have important implications for education and support to enable carers and professionals to provide a high standard of care.     

成年残疾人康复需求与康复服务发展研究

目的研究成年残疾人的残疾状况、主要康复需求特征、康复服务发展状况及其影响因素。方法以2019年度省级2315498名成年残疾人实名制数据为样本,运用多重响应分析统计成年残疾人的残疾状况,分析其康复需求特征和康复服务发展状况;Logistic回归分析影响康复需求与康复服务的相关因素。结果省级成年残疾人的残疾分布从高到低分别为肢体残疾(62.2%)、视力残疾(9.9%)、智力残疾(8.4%)、精神残疾(7.3%)、听力残疾(6.9%)、多重残疾(2.8%)和言语残疾(2.5%)。成年残疾人报告康复需求从高到低分别为辅助器具需求(49.0%)、药物需求(33.3%)、护理需求(27.7%)、功能训练需求(20.2%)和手术需求(1.9%)。成年残疾人报告获得康复服务从高到低分别为辅助器具服务(44.1%)、护理服务(26.6%)、药物服务(25.9%)、功能训练服务(22.2%)和手术服务(1.3%)。Logistic回归显示残疾类别和残疾等级对成年残疾人报告康复需求和康复服务的概率有非常显著影响(P<0.001)。结论残疾人功能状态影响到其康复需求报告,康复需求与康复服务之间仍然存在结构性差异,为提升精准康复服水平,应根据ICF关于功能、残疾和健康分类的理论模式和方法,制定针对特定残疾类别的康复需求报告方法并开发精准的个别化的康复服务项目。     

Improving care for people with learning disabilities in hospital

Evidence suggests that people with learning disabilities have greater healthcare needs than the general population and that these needs are often unmet. A literature search was conducted to identify factors influencing general hospital care for people with a learning disability. Electronic databases, general internet searches and references from the initial search were used to identify relevant studies published between January 1990 and December 2010. Fourteen studies were identified that matched the inclusion criteria. Recurrent themes included the effect of being in hospital on the individual with a learning disability, attitude and knowledge of staff, the hospital environment, role of carers and recommendations for improvement. A critical appraisal tool was used to assess the quality of the selected literature. Despite limitations, all the studies contributed to the evidence base. Although much has been written about general hospital care for people with a learning disability, credible research in this area is lacking. The areas of good practice identified from the available literature need to be evaluated and disseminated so that all people with a learning disability can receive the best possible health care.     

Assessing health and rehabilitation needs of people with disabilities in Cameroon and India

Purpose: To assess the association between disability and serious health problems, and the access and uptake of health and rehabilitation services in Cameroon and India.

Methods: We undertook a population-based case–control study, nested within a survey in Fundong Health District, North West Cameroon (August–October 2013) and in Mahbubnagar District, Telangana State, India (February–April 2014). Disability was defined as the presence of self-reported difficulties in functioning or clinical impairments. One control without disability was selected per case, matched by age, gender and cluster. Information was collected using structured questionnaires on: socioeconomic status, health, access to health services and rehabilitation.

Results: Cases with disability were significantly more likely to report a serious health problem in the last year compared to controls in both India (OR?=?3.2, 95% CI 2.1–4.8) and Cameroon (OR?=?1.9, 1.4–2.7). The vast majority of people sought care when seriously ill, and this did not vary between cases and controls. Awareness and use of rehabilitation services was extremely low in both Cameroon and India.

Conclusions: Further focus is needed to improve awareness of rehabilitation services among people with disabilities in India and Cameroon to ensure that their rights are fulfilled and to achieve the goal of Universal Health Coverage.

• Implications for Rehabilitation

• People with and without disabilities equally seek health care in India and Cameroon.

• However, people with disabilities experience more frequent serious health problems than people without.

• Extremely few people with disabilities were aware of rehabilitation services despite their existence in the study settings.