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ObjectiveTo investigate the willingness of rehabilitation patients within an urban medical group to accept downward referrals and analyze the influencing factors. MethodsFrom June to October, 2023, a survey was conducted using a simple random sampling method among neurological and orthopedic rehabilitation patients in hospitals within a specific urban medical group. The 2013 version of the Andersen Model was employed to construct a theoretical framework for the willingness of rehabilitation patients to accept downward referrals and influencing factors. Within this framework, a questionnaire was designed using a 5-point Likert scale, comprising three sections including personal characteristics, environmental features and healthcare service utilization choices, totaling 23 questions. A preliminary survey was conducted, and the questionnaire had underwent reliability and validity testing. ResultsA total of 350 questionnaires were collected, with 314 valid questionnaires. The willingness of rehabilitation patients to accept downward referrals was found to be associated with age, rehabilitation specialties, rehabilitation phases, previous experiences with downward referrals, awareness of and perceptions regarding bidirectional referral policies, and understanding and opinions about the urban medical group (χ2 > 7.755, P < 0.05). The primary influencing factors were rehabilitation specialties, rehabilitation phases, previous experiences with downward referrals and perceptions of the necessity of bidirectional referral policies (P < 0.05). ConclusionRehabilitation specialties, rehabilitation phases, previous experiences with downward referrals and perceptions of the necessity of bidirectional referral policies are the primary factors that influenced the willingness of rehabilitation patients to accept downward referrals. We should formulate targeted and focused improvement measures based on the specific circumstances and key influencing factors of rehabilitation patients within the urban medical group regarding their willingness to accept downward referrals. Continuously enhancing the proportion of patients willingness to accept downward referrals is essential for the effective implementation of bidirectional referral for rehabilitation patients.
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Objective To discover the operating problems through analysis of the financial situations of the rehabilitation institutions. Methods According to the different regions and different levels of rehabilitation institutions, 416 representative institutions from 26 provinc-es, municipalities and autonomous regions were surveyed. Results 329 effective questionnaires were recalled. 57.75%institutions relied on the superior departments in charge of funding, 51.09%institutions were in breakeven state. They were lack of sustainable development pow-er, and the capital expenditure was mainly used for staff salaries and equipment purchase. Conclusion To solve the shortage of funds in the development of rehabilitation institutions, we should establish a long-term mechanism of internal and external compensation.
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Objective To explore the characteristics and relationship among self-esteem, self-control and psychological symptoms of people with disablities, and to investigate the mediating effect of self-control. Methods 598 persons with disabilities, extracted by conve-nience sampling method from January to March, 2015, were assessed with Symptom Checklist 90 (SCL-90), Self-esteem Scale (SES) and the Self-control Scale (SCS) face to face. Results The detection rate of psychological problems of disabled persons was 58.03%. There was significant difference in the scores of SCL-90 among the subjects of different census registers (t=-4.664), disability types (F=5.774), in-come sources (F=5.402) and education levels (F=2.810) (P<0.05). There was significant difference in the score of SCS among different gen-ders (t=2.097), census registers (t=2.661), congenital disability or acquired disability (t=-2.617), disability types (F=5.338) and income sources (F=4.476) (P<0.05). There was significant difference in the score of SES among congenital disability or acquired disability (t=3.652), and different education levels (F=2.443) (P<0.05). The scores of SES (r=-0.179) and SCS (r=-0.396) negatively correlated with the score of SCL-90 (P<0.01), and the scores of SCS positively correlated with SES (r=0.216, P<0.01). SES had significant regression effect on SCL-90 and SCS. Both SES and SCS had significant regression effect on SCL-90 (P<0.01). Conclusion Self-control plays a part of the in-termediary role between self-esteem and psychological symptoms, self-esteem can not only directly affect psychological symptoms, but also affect psychological symptoms through self-control.
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@#The establishment of an efficient performance management system is crucial for a rehabilitation institution. This article discussed the concept of performance, performance management and ways to establish an efficient performance management system.
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@#How to give full play to the advantages of rehabilitation institutions, and to improve service quality and administration efficiency are some of the complex issues faced by the high-level administrators of rehabilitation institutions. This paper studied a total of 67 institutions to investigate the operation and management model of rehabilitation institutions in China, as well as their advantages and disadvantages.
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How to give full play to the advantages of rehabilitation institutions, and to improve service quality and administration effi-ciency are some of the complex issues faced by the high-level administrators of rehabilitation institutions. This paper studied a total of 67 in-stitutions to investigate the operation and management model of rehabilitation institutions in China, as well as their advantages and disadvan-tages.
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The establishment of an efficient performance management system is crucial for a rehabilitation institution. This article dis-cussed the concept of performance, performance management and ways to establish an efficient performance management system.
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@#Based on the conception and character of core competency, this paper analyzed the core competency in rehabilitation organization and suggested some strategy.
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@#Objective To investigate the status of the establishment and service of the rehabilitation departments in comprehensive hospitals in China mainland.Methods A questionnaire survey was conducted in 240 comprehensive hospitals with different grades distributed in the capital city of 31 provinces, autonomous regions, and municipality cities in China mainland in a stratified sampling way. The contents investigated are the settings of rehabilitation departments, the performances of the rehabilitation services, the staffing of the rehabilitation workers and the problems faced in rehabilitation. Then, statistical analysis were done between the developed eastern regions and economically less developed middle-western regions, as well as different grades of comprehensive hospitals. Results In total, 216 valid questionnaires were collected (72 tertiary hospitals, 72 secondary hospitals and 72 primary hospitals), and there are no statistically difference between eastern regions and middle-western regions(P=0.61). About 69% of the hospitals surveyed have built up the rehabilitation departments, and there are no statistically difference between different regions (P=0.30). As far as the performance of the rehabilitation services are concerned, 97.2% of them have carried out rehabilitation service, 60% of them can satisfy the demands of the patients, and there are no difference between the different grades and between the eastern and middle-western regions(P>0.05). In addition, 76.4% of them have rehabilitation doctors, 68.4% have physiotherapists(PT), 52.3% have traditional Chinese medicine doctors, 50.5% have occupational therapists(OT), 36.9% have speech therapists(ST), 17.8% have psychologists, and only 2.3% have social workers. The staff status on PT, OT and ST of the hospitals in eastern regions are significantly better than that in middle-western regions(P<0.01), and the staff status on rehabilitation doctors, PT, OT, ST and psychologists in the tertiary hospitals are significantly better than that in the secondary hospitals and primary hospitals(P<0.01). Finally, the first five problems the rehabilitation department faced are following: short of professional workers(63.9%), lack of training areas(51%), lack of modern rehabilitation service management system (50.5%), out-of-date equipments(49.5%) and low fees of rehabilitation treatment(49.1%). Conclusion Many problems exists in the rehabilitation departments of comprehensive hospitals, such as the development of rehabilitation departments, the professional workers, the quality and width of the service, the efficient use of rehabilitation resources, rehabilitation management and profession permission, the relative policies and regulations, personnel training and so on. Therefore, the government should enhance to put the supported policies into practice, and reinforce investment to the comprehensive hospitals, in particular, enhance the support of the comprehensive hospitals in middle-western regions, as well as the primary hospitals and the secondary hospitals, all of which will play a much more efficient role in rehabilitation for the disabled in the comprehensive hospitals.
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@#ObjectiveTo explore the effect of marriage on the life satisfaction and mood of the spinal cord injury couple survived after Tangshan earthquake.Methods40 SCI patients (20 married and 20 unmarried) who were survived after Tangshan earthquake were investigated with 20 from married family (10 male and 10 female) and 20 from unmarried family (10 male and 10 female). The contents of investigation included life satisfaction, quality of life, anxiety and depression.Results The married group had significantly more satisfied with their life and less anxiety than the unmarried group. But there were no differences in evaluation of life quality and depression between two groups.Conclusion The marriage can improve the life satisfaction and psychological health of the SCI patients survived after Tangshan earthquake.
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@#ObjectiveTo investigate the living condition of patients with spinal cord injury (SCI) after Tangshan earthquake.MethodsA questionnaire was designed for the investigation with 41 items including resident environment, income, mood, etc. The faculty of surveillance was composed of trained professionals. 1261 SCI patients living in Tangshan at present, 420 of which live in the sanatoriums and others live in the common families. The patients of four sanatoriums were chosen randomly from fourteen sanatoriums to be investigated in detail, and patients in the common families in two communities, one from city, another from countryside, were also chosen. This investigation was performed in 2003.The results are compared with that of 1988' survey.ResultsGreat improvements in the living condition of SCI patients in Tangshan were shown by the comparison of these two surveys, they were mainly in: the progress in the housing environments (100% SCI patients now live in the specially designed reconstructed houses); better medical services provided (the ratio of wheelchair available from 38.1% to 100%); the majority of the patients in acceptance stage of their disability; the increase of income (21.1% takes up various occupation) with a vigorous spare time; decrease in the common complications with SCI patients; although uremia was still the first death cause of the SCI patients, the percentage was decreased apparently; cardiovascular accident had a higher percentage in the death cause(the second leading cause), implies that the death cause of the SCI survivors had approached the normal person.ConclusionThe improvements reflect the social progress in China. However, still there are some problems to be remained for further solution: the ratio of employment is low; the insurance of living and medical rehabilitation needs further improvement.