基于全面康复视角的残疾儿童照护需求分析

doi:10.3969/j.issn.1006-9771.2021.10.001

Abstract

Abstract:

Objective To investigate the care needs and influencing factors for caregivers of children with disabilities.Methods From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. The Care Needs Assessment Tool for Children with Disabilities was used to measure the care needs rates and satisfaction, and multiple linear regression was performed to analyze the related factors.Results The rate of total need was 71.8%, which was high in the information support (83.7%), spiritual support (75.9%) and financial support (74.1%), and was at an intermediate level in alternative service support (62.9%) and professional support (62.2%). The satisfaction of total need was 39.4%, which was at a intermediate level in the spiritual support (50.8%) and professional support (45.5%), and was at a low level in alternative service support (32.8%), financial support (32.3%) and information support (30.3%). The caregivers needed less support for thoses with higher public policy satisfaction (B = -3.252, 95%CI -5.370 to -1.134, P = 0.003) and the children with vision and speech disability, and undetermined disability (B_{vision disability}= -12.160, 95%CI -21.976 to -2.344, P = 0.015; B_{speech disability}= -12.754, 95%CI -22.583 to -2.925, P = 0.011; B_{undetermined disability}= -16.553, 95%CI -24.714 to -8.392, P < 0.001), while mothers (B = 9.071, 95%CI 4.293 to 13.848, P < 0.001) needed more support than grandparents. The caregivers with higher public policy satisfaction (B = 7.392, 95%CI 5.523 to 9.262, P < 0.001), the children with vision disability, hearing disability and speech disability (B_{vision disability}= 8.612, 95%CI 0.081 to 17.144, P = 0.048; B_{hearing disability}= 8.686, 95%CI 1.920 to 15.451, P=0.012; B_{speech disability}= 9.515, 95%CI 1.184 to 17.846, P = 0.025), lower barriers to social inclusion (B = 1.932, 95%CI 0.457 to 3.408, P = 0.010) and shorter average daily care hours (B = -4.123, 95%CI -6.247 to -1.999, P < 0.001) were more satisfactory for support.Conclusion The care needs of children with disabilities are diverse, with the highest rate of need for information support and the lowest level of satisfaction. There is some variation in the care needs of children with different types of disabilities, family roles, average daily care hours and social environment characteristics.

Key words: children with disabilities, caregivers, care support needs, comprehensive rehabilitation

CLC Number:

ZHENG Hong-ying,SUN Mei,LÜ Jun,QIU Fu-bing,LI An-qiao,XIA Cong. Current Situation Analysis of Care Support Needs in Children with Disabilities: from a Comprehensive Rehabilitation Perspective[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1117-1126.

Figures/Tables 6

References 31

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需求项目	条目数(n)	需求率(%)	需求满足程度(%)	需求率与满足程度差值(%)
替代性服务支持	1248	62.9	32.8	30.1
专业支持	2161	62.2	45.5	16.7
经济支持	1838	74.1	32.3	41.8
精神支持	1883	75.9	50.8	25.1
信息支持	2492	83.7	30.3	53.4
总体需求	9622	71.8	39.4	32.4

维度	变量		替代性服务支持	专业支持	经济支持	精神支持	信息支持	总体需求率
残疾儿童	性别	男	65.9	63.3	74.6	76.5	85.0	73.1
		女	58.0	60.5	73.3	74.9	81.7	69.9
	年龄(岁)	0~< 6	60.6	60.4	73.2	75.9	83.4	70.8
		6~< 12	63.0	62.6	73.2	74.4	82.9	71.3
		12~18	75.0	71.2	81.9	80.8	88.1	79.3
	残疾类型	视力残疾	57.0	57.1	73.8	59.4	68.2	63.1
		听力残疾	58.3	73.4	84.4	79.2	91.4	78.3
		言语残疾	50.8	53.6	58.8	70.6	76.6	62.4
		肢体残疾	63.0	67.1	80.2	77.2	88.0	75.4
		智力残疾	70.8	59.8	73.0	77.0	77.8	71.1
		精神残疾	72.5	60.2	75.7	86.9	89.1	76.3
		多重残疾	75.5	68.0	72.6	81.9	88.0	77.0
		未定残	50.0	45.4	58.4	63.9	73.9	58.2
照护者	家庭角色	父亲	63.5	64.4	71.6	74.5	81.3	71.2
		母亲	67.3	65.9	77.6	79.7	87.0	75.5
		祖辈	53.8	53.4	69.0	69.5	78.9	65.0
	年龄(岁)	≤ 40	64.8	63.7	73.6	76.9	84.0	72.7
		> 40~< 60	64.2	63.8	76.3	76.6	85.4	73.3
		≥ 60	56.0	55.6	72.5	71.8	80.3	67.3
	日均照护时长(h)	≤ 5	67.9	67.7	74.6	77.9	84.2	74.6
		> 5~< 10	55.6	61.4	71.6	74.0	85.3	70.1
		≥10	62.4	58.5	75.1	75.2	82.7	70.6
环境	家庭规模	≤ 3人	65.7	66.1	77.0	77.1	87.6	74.9
		4~5人	62.3	61.7	73.5	76.0	83.7	71.5
		≥ 6人	59.3	56.0	70.1	73.3	76.0	66.8
	家庭人均月收入(元)	< 5000	64.2	62.1	76.8	75.2	83.2	72.3
		5000~< 10000	61.5	62.9	75.2	74.2	86.1	72.2
		≥ 10000	62.2	61.5	69.0	78.5	81.4	70.6
	公共政策	不满意	73.9	67.1	77.4	80.4	86.2	76.7
		较少满意	72.4	64.3	73.6	86.4	86.8	76.3
		一般满意	61.5	60.2	77.1	73.1	83.9	71.2
		较多满意	58.8	65.0	70.6	75.8	81.8	70.9
		非常满意	44.8	59.5	56.7	65.8	78.5	62.2
	社会融入	严重阻碍	79.3	65.9	80.0	89.8	89.0	80.0
		部分阻碍	62.9	59.6	73.3	72.5	88.9	71.5
		没有帮助	61.1	56.0	69.7	70.8	72.2	65.6
		较少帮助	60.7	64.2	75.0	77.5	81.7	72.0
		很大帮助	60.4	70.0	76.3	79.1	85.2	74.8

维度	变量		替代性服务支持	专业支持	经济支持	精神支持	信息支持	总体满足程度
残疾儿童	性别	男	34.2	45.9	31.6	50.4	30.4	38.8
		女	33.0	47.9	34.8	53.8	31.6	40.4
	年龄(岁)	0~< 6	36.0	47.2	32.7	51.9	31.5	40.1
		6~< 12	32.5	47.7	32.4	53.2	30.6	39.8
		12~18	24.9	40.0	34.9	45.4	27.8	33.9
	残疾类型	视力残疾	50.5	57.1	32.3	64.9	43.4	47.5
		听力残疾	44.4	62.8	47.8	55.4	36.2	49.6
		言语残疾	35.2	55.1	38.1	56.8	32.6	46.2
		肢体残疾	33.5	46.2	35.1	55.5	32.4	40.4
		智力残疾	23.0	41.2	26.9	45.7	26.3	33.0
		精神残疾	33.9	36.9	22.3	45.1	26.2	33.2
		多重残疾	28.7	40.4	33.4	43.8	26.5	34.3
		未定残	28.3	39.9	22.4	50.2	27.0	34.0
照护者	家庭角色	父亲	42.3	51.6	38.1	57.2	36.0	45.1
		母亲	33.6	44.2	30.9	47.4	29.3	37.1
		祖辈	27.6	48.1	32.9	56.3	30.2	39.8
	年龄(岁)	≤ 40	39.5	48.5	33.6	50.0	32.3	41.1
		> 40~< 60	26.4	40.7	30.7	51.8	28.4	35.5
		≥ 60	28.0	50.3	34.3	56.4	30.4	40.5
	日均照护时长(h)	≤ 5	47.6	52.8	36.4	55.4	37.1	46.1
		> 5~< 10	32.6	46.7	32.9	47.8	28.6	38.5
		≥10	23.5	42.0	30.2	50.1	26.6	34.6
环境	家庭规模	≤ 3人	34.8	47.6	33.9	49.4	31.6	40.4
		4~5人	34.0	46.3	33.0	53.0	30.3	39.2
		≥ 6人	30.5	45.9	30.0	52.0	31.1	37.7
	家庭人均月收入(元)	< 5000	27.4	45.1	32.6	50.0	29.9	37.1
		5000~< 10000	34.0	47.3	33.9	51.0	29.1	39.3
		≥ 10000	41.2	48.2	32.0	54.4	34.0	42.4
	公共政策	不满意	22.6	34.8	12.5	42.2	16.5	25.7
		较少满意	25.6	36.6	22.1	45.2	22.6	31.5
		一般满意	32.1	45.4	32.3	49.7	30.2	37.9
		较多满意	48.6	58.3	46.8	63.7	41.0	51.8
		非常满意	43.8	71.4	64.6	68.0	54.1	59.4
	社会融入	严重阻碍	25.5	36.6	25.1	40.5	24.6	30.4
		部分阻碍	29.8	45.0	29.7	46.5	27.1	35.8
		没有帮助	39.2	46.8	32.1	53.0	29.8	40.1
		较少帮助	29.5	44.3	31.8	52.2	30.9	38.4
		很大帮助	51.7	62.1	49.0	69.1	45.3	55.8

维度	变量(参照变量)	B	S.E.	95%CI	β	t值	P值
残疾儿童	残疾类型(多重残疾)
	视力残疾	-12.160	4.996	-21.976~-2.344	-0.127	-2.434	0.015
	听力残疾	3.523	3.985	-4.307~11.353	0.054	0.884	0.377
	言语残疾	-12.754	5.002	-22.583~-2.925	-0.131	-2.550	0.011
	肢体残疾	0.775	3.598	-6.295~7.845	0.015	0.216	0.829
	智力残疾	-3.896	4.307	-12.360~4.567	-0.052	-0.905	0.366
	精神残疾	-2.295	4.164	-10.477~5.886	-0.032	-0.551	0.582
	未定残	-16.553	4.153	-24.714~-8.392	-0.233	-3.986	< 0.001
照护者	家庭角色(祖辈)
	父亲	4.909	3.004	-0.995~10.812	0.084	1.634	0.103
	母亲	9.071	2.431	4.293~13.848	0.194	3.731	< 0.001
环境	家庭规模	-2.944	1.530	-5.950~0.061	-0.084	-1.925	0.055
	公共政策	-3.252	1.078	-5.370~-1.134	-0.134	-3.017	0.003
常量		84.863	5.708	73.647~96.079		14.868	< 0.001

维度	变量(参照变量)	B	S.E.	95%CI	β	t值	P值
残疾儿童	残疾类型(多重残疾)
	视力残疾	8.612	4.341	0.081~17.144	0.097	1.984	0.048
	听力残疾	8.686	3.443	1.920~15.451	0.145	2.523	0.012
	言语残疾	9.515	4.239	1.184~17.846	0.109	2.244	0.025
	肢体残疾	4.906	3.068	-1.124~10.935	0.102	1.599	0.111
	智力残疾	2.669	3.704	-4.610~9.948	0.039	0.721	0.472
	精神残疾	4.009	3.549	-2.966~10.984	0.062	1.129	0.259
	未定残	-0.268	3.523	-7.190~6.655	-0.004	-0.076	0.940
照护者	家庭角色(祖辈)
	父亲	0.950	2.812	-4.575~6.475	0.018	0.338	0.736
	母亲	-2.687	2.079	-6.772~1.397	-0.063	-1.293	0.197
	日均照护时长	-4.123	1.081	-6.247~-1.999	-0.174	-3.815	< 0.001
环境	公共政策	7.392	0.951	5.523~9.262	0.334	7.771	< 0.001
	社会融入	1.932	0.751	0.457~3.408	0.113	2.573	0.010
常量		17.284	5.366	6.740~27.828		3.221	0.001

Current Situation Analysis of Care Support Needs in Children with Disabilities: from a Comprehensive Rehabilitation Perspective

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