功能障碍人群辅助器具适配度评价及影响因素分析

doi:10.3969/j.issn.1006-9771.2025.11.012

Abstract

Abstract:

Objective To investigate the current status of assistive device adaptation among people with dysfunction in China, identify unmet assistive needs for assistive products, and determine key factors influencing attitudes toward assistive device use.

Methods Based on data from the Chinese segment of the Global Rapid Assistive Technology Assessment (rATA) survey, 5 935 individuals with dysfunction from Beijing, Anhui, Fujian, Hubei, Sichuan and Shaanxi were included. The adaptation status of assistive devices was analyzed, and a theoretical framework was constructed using the technology acceptance model. Multiple linear regression analysis was applied to identify factors influencing attitudes toward assistive device use.

Results The utilization rate of rehabilitation assistive devices among people with dysfunction was 65.9%, with a notable prevalence of multiple functional impairments. Fit rate was the highest (68.44%) in individuals with visual impairments, while those with communication impairments had the lowest (1.52%). Fit rates were significantly lower among rural residents and older adults. Overall satisfaction with assistive devices was relatively high (4.11±0.71). Accessibility of the home environment (B = 0.396, P < 0.001), accessibility of the public environment (B = 0.204, P < 0.001), functional utility of assistive devices (B = 0.204, P < 0.001), and distance to obtain the devices (B < -0.112, P < 0.01) were key factors affecting satisfication toward assistive device use, while the source of payment showed no significant impact (P > 0.05).

Conclusion Significant structural imbalances and group disparities exist in the adaptation of assistive devices among people with dysfunction in China. The phenomenon of multiple functional impairments has not received sufficient attention, and there remains a substantial unmet need for assistive products among non-fitted groups. Although overall satisfaction with assistive devices is high, influencing factors are complex. Continuous improvement of accessibility in both private and public environments, promotion of personalized adaptation services, and optimization of assistive device service networks are essential to enhance adaptation accuracy, sustained use, and subjective well-being among people with dysfunction.

Key words: dysfunction, assistive devices, adaptation level, technology acceptance model, influencing factors

CLC Number:

R496

LIU Chen, DONG Liquan, YAN Mei, JIANG Hua. Evaluation of assistive device adaptation and analysis of influencing factors among people with dysfunction[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(11): 1354-1364.

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References 42

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类别	正在使用对应辅具		未使用对应辅具		合计/n
类别	n	%	n	%	合计/n
移动障碍	640	39.05	999	60.95	1639
视力障碍	3255	68.44	1501	31.56	4756
听力障碍	87	7.17	1127	92.83	1214
沟通障碍	8	1.52	518	98.48	526
记忆障碍	37	2.45	1475	97.55	1512
自理障碍	78	12.19	562	87.81	640

维度	适配情况	居住地		性别		年龄
维度	适配情况	城市	农村	男性	女性	< 18岁	18~60岁	> 60岁
移动障碍	正在使用对应辅具	404	236	299	341	4	78	558
	未使用对应辅具	571	428	425	574	19	191	789
	合计	975	664	724	915	23	269	1347
视力障碍	正在使用对应辅具	2505	750	1576	1679	239	1576	1440
	未使用对应辅具	664	837	638	863	77	463	961
	合计	3169	1587	2214	2542	316	2039	2401
听力障碍	正在使用对应辅具	58	29	50	37	2	16	69
	未使用对应辅具	564	563	540	587	16	176	935
	合计	622	592	590	624	18	192	1004
沟通障碍	正在使用对应辅具	8	0	5	3	1	2	5
	未使用对应辅具	224	294	253	265	29	101	388
	合计	232	294	258	268	30	103	393
记忆障碍	正在使用对应辅具	27	10	13	24	1	7	29
	未使用对应辅具	918	557	567	908	31	278	1166
	合计	945	567	580	932	32	285	1195
自理障碍	正在使用对应辅具	54	24	28	50	2	27	49
	未使用对应辅具	269	293	262	300	19	132	411
	合计	323	317	290	350	21	159	460

项目	n	辅具满意度	F值/t值	P值
移动障碍			8.110^a	< 0.001
没有困难	2026	4.14±0.71
有些困难	451	4.07±0.71
非常困难	95	3.89±0.72
完全不能	31	3.70±0.61
视力障碍			5.520^a	< 0.001
没有困难	250	3.95±0.70
有些困难	2225	4.13±0.71
非常困难	119	4.12±0.63
完全不能	9	3.70±0.73
听力障碍			6.390^a	< 0.001
没有困难	2305	4.13±0.71
有些困难	241	3.96±0.66
非常困难	44	3.87±0.71
完全不能	13	4.05±0.65
沟通障碍			3.320^a	0.019
没有困难	2484	4.12±0.70
有些困难	84	3.94±0.70
非常困难	30	3.84±0.62
完全不能	5	4.06±0.89
记忆障碍			8.447^a	< 0.001
没有困难	2219	4.14±0.71
有些困难	357	3.96±0.65
非常困难	24	3.90±0.49
完全不能	3	3.44±0.38
自理障碍			13.192^a	< 0.001
没有困难	2395	4.14±0.70
有些困难	139	3.82±0.64
非常困难	42	3.83±0.72
完全不能	27	3.83±0.62
年龄			21.700^a	< 0.001
< 18岁	185	4.30±0.64
18~60岁	1206	4.17±0.69
> 60岁	1212	4.02±0.71
性别			-0.930^b	0.353
女	1320	4.10±0.72
男	1283	4.12±0.69
户籍			-1.559^b	0.119
农村	757	4.07±0.70
城市	1846	4.12±0.70

变量	n	辅具满意度	F值	P值
辅助器具支付主体			3.350	0.003
政府	96	3.85±0.64
非政府组织/慈善机构	16	3.96±0.79
雇主/学校	1	3.00±0.00
保险	3	4.44±0.51
自付	2056	4.12±0.71
家人/朋友	420	4.15±0.70
其他	11	3.85±0.79
辅助器具获取距离			2.660	0.021
< 5 km	2014	4.14±0.71
6~25 km	431	4.03±0.64
26~50 km	50	3.95±0.56
51~100 km	9	4.03±0.73
> 100 km	20	4.31±0.66
不清楚	79	4.00±0.81

因素	r值	P值
家庭环境无障碍水平评价	0.603	< 0.001
公共环境无障碍水平评价	0.549	< 0.001
辅助器具功能效用性评价	0.562	< 0.001

Evaluation of assistive device adaptation and analysis of influencing factors among people with dysfunction

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因素	B	SE	β	t值	P值	95%CI
家庭环境无障碍水平	0.396	0.028	0.303	14.001	< 0.001	0.341~0.452
公共环境无障碍水平	0.204	0.024	0.182	8.335	< 0.001	0.156~0.252
辅助器具功能效用性	0.204	0.027	0.181	7.465	< 0.001	0.150~0.257
辅助器具支付主体
政府	0.035	0.062	0.009	0.560	0.576	-0.087~0.157
非政府组织/慈善机构	0.032	0.159	0.004	0.204	0.838	-0.279~0.343
雇主/学校	-0.070	0.047	-0.002	-1.483	0.138	-0.163~0.023
保险	0.122	0.098	0.006	1.250	0.211	-0.069~0.314
家人/朋友	0.056	0.030	0.029	1.865	0.062	-0.003~0.114
其他	-0.126	0.164	-0.012	-0.771	0.442	-0.447~0.195
辅助器具获取距离
6~25 km	-0.112	0.029	-0.059	-3.894	< 0.001	-0.168~-0.055
26~50 km	-0.203	0.072	-0.039	-2.834	0.005	-0.344~-0.062
51~100 km	0.135	0.176	0.011	0.765	0.445	-0.211~0.481
> 100 km	0.107	0.102	0.013	1.053	0.292	-0.092~0.307
不清楚	0.013	0.076	0.002	0.170	0.865	-0.136~0.162

因素	B	SE	β	t值	P值	95%CI
家庭环境无障碍水平	0.500	0.054	0.392	9.240	< 0.001	0.394~0.607
公共环境无障碍水平	0.165	0.050	0.158	3.322	< 0.001	0.067~0.263
辅助器具功能效用性	0.178	0.052	0.162	3.409	< 0.001	0.075~0.281
辅助器具支付主体
政府	0.141	0.074	0.068	1.911	0.057	-0.004~0.286
非政府组织/慈善机构	0.011	0.197	0.002	0.056	0.955	-0.377~0.399
保险	0.009	0.081	0.001	0.110	0.913	-0.150~0.168
家人/朋友	0.090	0.057	0.053	1.580	0.115	-0.022~0.203
其他	0.188	0.222	0.026	0.851	0.395	-0.247~0.624
辅助器具获取距离
6~25 km	-0.063	0.060	-0.033	-1.056	0.292	-0.181~0.055
26~50 km	-0.200	0.101	-0.046	-1.985	0.048	-0.398~-0.002
51~100 km	-0.584	0.112	-0.033	-5.201	< 0.001	-0.804~-0.363
> 100 km	0.118	0.117	0.019	1.011	0.313	-0.112~0.348
不清楚	-0.030	0132	-0.007	-0.228	0.819	-0.290~0.230

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