Chinese Journal of Rehabilitation Theory and Practice ›› 2025, Vol. 31 ›› Issue (7): 802-811.doi: 10.3969/j.issn.1006-9771.2025.07.007

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Development of a needs assessment tool for grading care services for adults with disabilities in welfare institutions

SUN Jiayao1, MA Chunhua2, LÜ Jun1,3,4(), TANG Qi1,3(), SHAO Zhimin5, HU Kangning1, HUANG Haoying2, HUANG Aihua2   

  1. 1. School of Public Health, Fudan University, Shanghai 200433, China
    2. Second Social Welfare Institute of Shanghai, Shanghai 202158, China
    3. China Research Center on Disability, Fudan University, Shanghai 200032, China
    4. National Clinical Research Center for Geriatrics, Shanghai 200040, China
    5. Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
  • Received:2025-04-27 Revised:2025-05-08 Published:2025-07-25 Online:2025-07-30
  • Contact: LÜ Jun, E-mail: lujun@shmu.edu.cn; TANG Qi, E-mail: tangqi@fudan.edu.cn
  • Supported by:
    Shanghai Municipal Civil Affairs Bureau Research Project(MZKT-2024-01-23);Tang Zhongying Foundation(C32-0201-2401);China Disabled Persons' Federation 2024 Disability Service Standard Development Plan;National Social Science Foundation of China (Major)(17ZDA078)

Abstract:

Objective To develop a tool for assessing the needs for care services for adults with disabilities in welfare institutions, and formulate criteria for classifying care needs.

Methods Based on the theory of the International Classification of Functioning, Disability and Health, the core contents of domestic and international care service assessment standards were analysed, and the first draft of the assessment tool was formed integrating with the current practice of welfare institutions. A total of eleven experts in the field of care services validated the first draft, and the assessment tool was revised according to the experts' opinions. From May to June, 2024, 340 adults with disabilities from Second Social Welfare Institute of Shanghai were graded to analyze the reliability and validity of the assessment tool. And then, 1 046 subjects from Second Social Welfare Institute of Shanghai were graded using the assessment tool, and the scoring intervals for the five levels of care were determined using cluster analysis.

Results The assessment tool included four first-level dimensions, eleven second-level dimensions, 39 third-level dimensions and 43 indicators. The coefficients of variation of each dimension and indicator were less than 0.25 for expert validation, while the average score of the importance of each indicator was above 4.63, with a full score rate more than 0.86. The overall Cronbach's α coefficient was 0.956, the test-retest reliability was 0.997, and the content validity index of each indicator was 0.83 to 1.00. The exploratory factor analysis extracted four common factors, with a cumulative variance contribution of 86.679%; the loading coefficients of indicators were 0.675 to 0.878, and the correlation coefficients among the dimensions were 0.325 to 0.476. Cluster analysis determined the level of institutional care needs as level 1 (severe), level 2 (medium-heavy), level 3 (medium), level 4 (light-moderate), and level 5 (light).

Conclusion The needs assessment tool for care services for adults with disabilities in welfare institutions developed in this study is good in reliability and validity, and can be used in guiding the care services provided for people with disabilities more efficient and targeted.

Key words: adults, people with disabilities, institutional care, assessment tools, grading care needs, reliability, validity

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