极重度和重度成年智力残疾人护理需求与护理服务结构方程模型

doi:10.3969/j.issn.1006-9771.2020.05.008

Abstract

Abstract:

Objective To explore the characteristics and related factors of unmet needs of nursing care and service for adults with extremely severe and severe intellectual disabilities.Methods A total of 127 547 adults with extremely severe and severe intellectual disabilities were sampled. Descriptive statistics and multiple response analysis were conducted, and a structural equation model of unmet needs of nursing care and received the services was developed. Results A total of 26 038 adults with extremely severe and severe intellectual disabilities reported unmet needs of rehabilitation, including nursing care (52.50%), medicine (36.90%), assistive device (20.90%), functional training (19.70%) and surgery (0.80%) respectively. A total of 11 640 adults with extremely severe and severe intellectual disabilities reported received rehabilitation services, including nursing care (49.90%), medicine (36.80%), functional training (19.10%), assistive device (14.10%) and surgery (1.00%) respectively. The structural equation model showed that received nursing care service (main effect = 0.646) and received rehabilitation services (included nursing care) (main effect = 0.014), age (main effect = 0.031), household registration (main effect = 0.015) and educational level (main effect = -0.158) had effects on unmet needs of nursing care (P < 0.001). Conclusion Adults with extremely severe and severe intellectual disabilities reported unmet needs mainly involved in field of nursing care, and their rehabilitation services mapped to their main needs. It proposed to develop rehabilitation services tailored to their rehabilitation experience, age, socioeconomic status, functional conditions and characteristic of unmet needs, to develop accessible services items and individualized nursing care programs, and to expand the nursing care service supply and coverage of nursing care.

Key words: intellectual disabilities, nursing care, unmet needs of rehabilitation, services of rehabilitation

CLC Number:

CHEN Jia-ni,LI An-qiao,LI Lun,QIU Zhuo-ying,SUN Hong-wei,TIAN Bao,SHEN Zhao-hui,LI Xin,CHEN Di,ZHU Ting,MA Hong-zhuo,TIAN Hong-mei,CHENG Zi-wei. Unmet Needs and Services of Nursing Care for Adults with Extremely Severe and Severe Intellectual Disabilities Using Structural Equation Analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(5): 534-538.

Figures/Tables 6

References 20

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项目		n
性别	男	71864
	女	55683
年龄	18~< 60岁	105684
	≥ 60岁	21863
户口性质	农业	116038
	非农业	11509
残疾类别	单纯智力残疾人	118994
	含智力残疾的多重残疾人	8553

项目		护理	手术	药物	功能训练	辅助器具
性别	男	7512(52.2)	134(0.9)	5142(35.7)	2961(20.6)	2999(20.8)
	女	6165(53.0)	77(0.7)	4455(38.3)	2176(18.7)	2438(20.9)
年龄	18~< 60岁	11199(52.9)	171(0.8)	7694(36.4)	4344(20.5)	4108(19.4)
	≥ 60岁	2478(50.8)	40(0.8)	1903(39.0)	793(16.3)	1329(27.2)
户口性质	农业	12509(52.7)	176(0.7)	8623(36.3)	4665(19.6)	4950(20.8)
	非农业	1168(51.1)	35(1.5)	974(42.6)	472(20.6)	487(21.3)
残疾类别	单纯智力残疾	12624(53.8)	173(0.7)	8581(36.6)	4649(19.8)	4414(18.8)
	含智力残疾的多重残疾	1053(41.1)	38(1.5)	1016(39.6)	488(19.0)	1023(39.9)
合计		13677(52.5)	211(0.8)	9597(36.9)	5137(19.7)	5437(20.9)

项目		护理	手术	药物	功能训练	辅助器具
性别	男	3285(50.5)	67(1.0)	2300(35.4)	1283(19.7)	929(14.3)
	女	2520(49.0)	46(0.9)	1982(38.6)	941(18.3)	718(14.0)
年龄	18~< 60岁	4728(50.2)	91(1.0)	3405(36.1)	1848(19.6)	1256(13.3)
	≥ 60岁	1077(48.6)	22(1.0)	877(39.5)	376(17.0)	391(17.6)
户口性质	农业	5314(49.8)	99(0.9)	3884(36.4)	2069(19.4)	1495(14.0)
	非农业	491(51.2)	14(1.5)	398(41.5)	155(16.2)	152(15.8)
残疾类别	单纯智力残疾	5345(51.2)	85(0.8)	3784(36.3)	2012(19.3)	1277(12.2)
	含智力残疾的多重残疾	460(38.1)	28(2.3)	498(41.2)	212(17.5)	370(30.6)
合计		5805(49.9)	113(1.0)	4282(36.8)	2224(19.1)	1647(14.1)

潜变量之间的关系		总效应	直接效应	间接效应
有无接受过护理服务	护理需求	0.646	0.646	0.000
有无接受过康复服务	护理需求	0.014	0.485	-0.471
有无接受过康复服务	有无接受过护理服务	-0.729	-0.729	0.000
年龄分组	护理需求	0.031	0.031	0.000
户口性质	护理需求	0.015	0.000	0.015
户口性质	有无接受过康复服务	0.030	0.030	0.000
受教育情况	护理需求	-0.158	-0.094	-0.064
受教育情况	有无接受过护理服务	-0.050	-0.050	0.000
受教育情况	有无接受过康复服务	-0.065	-0.065	0.000

Unmet Needs and Services of Nursing Care for Adults with Extremely Severe and Severe Intellectual Disabilities Using Structural Equation Analysis

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