ABSTRACT
Objective:To investigate and analyze the status and related factors of participation in physical activities for adults with disabilities (AWDs). Methods:A total of 2 302 833 AWDs in 2019 were included. Multiple response was used to analyze the status of participation and logistic regression was used to analyze the related factors. Results:The participative rate of AWDs was low (7.0%), in which, males (7.3%) were higher than females, AWDs aged 18 to 59 years (7.6%) were higher than other ages, AWDs with agricultural household (7.1%), speech disabilities (7.7%), and mild disability (8.6%) were the largest groups. For the reasons for not participating in physical activities, AWDs with agricultural household reported no suitable programs (14.4%), places and facilities (12.3%), which were higher than that with city household. The genders (B = 0.048, P < 0.001), ages (B = 0.178, P < 0.001), household registrations (B = 0.078, P < 0.001) related with participation of physical activities. However, types (Bvision= 0.055, P < 0.01; Bhearing= 0.133, P < 0.001; Bspeech= 0.282, P < 0.001; Bintelligence = -0.159, P < 0.001; Bpsychosis= -0.062, P < 0.01) and severity of disability were more significant (P < 0.001). AWDs with extremely severe disability reported 0.571 times of participation of physical activities than that with mild disability (B = -0.561, OR = 0.571), and AWDs with severe disability reported 0.659 times of that with mild visual disability (B = -0.417, OR = 0.659). Conclusion:The participation rate of AWDs in physical activities is low. Implement physical activities programs would be tailored to the unmet needs of physical activities as AWDs had functioning oriented unmet needs. It proposed to develop individualized and structured physical activities services to promote the participation of disabilities in physical activities.
ABSTRACT
Objective:To explore the characteristics and the influential factors of unmet needs and services development of rehabilitation for people with extremely severe hearing disability (PSHDs). Methods:A total of 90 052 PSHDs were included. Multiple response was used to analyze the characteristics of unmet needs and services of rehabilitation. The structural equation model of the received service and unmet needs of PSHDs was developed. Results:The reporting rate of unmet needs of rehabilitation for PSHDs, from high to low, were assistive devices (61.5%), nursing care (24.1%), medicine (23.4%), functional training (17.6%) and surgery (2.5%). The reporting rate of received service for PSHDs, from high to low, were assistive devices (58.3%), nursing care (24.4%), medicine (22.4%), functional training (22.0%) and surgery (2.2%). Structural Equation Model showed that the more services received, the more needs for cochlear implantation surgery and speech therapy (P < 0.001); the better family income situation, the more needs for cochlear implantation surgery (P < 0.001); and age factor had significant effects on the unmet needs of cochlear implantation surgery and speech therapy (P < 0.001). Conclusion:PSHDs reported unmet needs and received services mainly included assistive devices, nursing care, medicine and functional rehabilitation training. Those PSHDs who had received services would report more demand of unmet needs, supposed that improving the accessibility and coverage of services should be emphasized in the development of rehabilitation services. According to ICF model, on the basis of the characteristics of the unmet needs of PSHDs, it proposed to take measures to implement precise rehabilitation services to improve the quality of services.
ABSTRACT
Objective To explore the unmet needs and service of rehabilitation for Chinese people with disabilities. Methods The unmet needs and services of rehabilitation data from the Second National Sample Survey of Disability and 2006-2016 Statistical Bulletin on the De-velopment of People with disabilities in China issued by China Disabled Persons Federation had been analyzed. Results The unmet needs of rehabilitation for people with disabilities in China were mainly included health care and support, assistive devices, rehabilitation therapy and services, poverty alleviation, accessible facilities, accessible information, and other rehabilitation needs. The highest rate of unmet needs of rehabilitation was in the fields of health care (34.84%) and poverty alleviation (33.25%). There were significant differences in unmet needs of rehabilitation among people with different types of disabilities (χ2=40322.1, P<0.01). For all the types of disabilities, 41.46%had not re-ceived any service and support, 30.45%received health care and support, and 0.55%received accessible information. The main approaches recommended by professionals for people with disabilities were institutional rehabilitation, and community and family based services. The main services recommended by professionals to people with psychiatric (68.18%) or visual disabilities (60.28%) were health care, to people with hearing disability (51.67%) were assistive device, and to people with intellectual (57.36%) and speech disability (47.06%) were rehabil-itation therapy and training. There were significant differences both in rehabilitation approaches and contents among people with different types of disabilities preferred by professionals (χ2=12489.9,χ2=52528.93, P<0.01). Conclusion The unmet needs of rehabilitation for people with different types of disabilities were mainly included health care and assistance, assistive devices, rehabilitation training and services, and poverty alleviation. There were significant differences among people with different types of disabilities. For service delivery, the highest rate was in health care and assistance. The gap between the service and unmet needs of poverty alleviation for people with disabilities in China was the highest. There were significant differences in rehabilitation approaches and contents recommended by professionals among people with different types of disabilities. It was recommended to construct the national and local system of policy support system and rehabilita-tion service governance, to provide precision rehabilitation services based on the unmet needs of rehabilitation, to develop the comprehen-sive rehabilitation service delivery to achieve the goal of rehabilitation for all, and to conduct scientific research on rehabilitation by using International Classification of Functioning, Disability and Health to provide evidence and support for the development of rehabilitation.