重庆市残疾人家庭医生签约康复服务能力现状分析

Analysis of the current situation of rehabilitation service competency contracted family doctor services by disabled in chongqing

目的:了解重庆市残疾人家庭医生团队的康复服务能力现状,为残疾人家庭医生团队康复服务能力的提升提供可行性建议。方法:基于世界卫生组织(WHO)《健康服务体系中的康复:行动指南》配套工具“康复现状系统评估配套工具-康复信息收集模板”,按照重庆市残疾人联合会的相关要求,对重庆市11个区县的187位家庭医生团队成员进行问卷调查,对数据进行描述性分析。结果:参与调查的家庭医生团队成员中,团队内有护理人员(93.05%)、全科医生(84.49%)、公卫医生(82.35%)和乡村医生(74.87%)的占比较高,有康复医生(29.95%)和康复治疗师(16.58%)的较少;从年龄段看,18~30岁(34.48%)和31~40岁(37.97%)人数较多;从学历看,本科生最多占比高达60.96%。从有效收回的172份问卷分析来看,各残疾类别开展较多的为支持性服务中的康复知识培训、心理辅导、康复咨询,其中盲人和低视力分别为40.70%和52.33%、精神残疾为53.49%、智力残疾为60.47%、听力残疾为33.72%,肢体残疾为50%;且未开展任何服务的比例也较高,其中视力残疾为35.47%、精神残疾为30.23%、智力残疾为26.16%、听力残疾为38.37%,肢体残疾为26.16%;各残疾类别未开展原因说明栏信息中,与“专业技术能力或专业知识不足”相关的条目均最多,其中视力残疾29条(共52条)、精神残疾25条(共39条)、智力残疾26条(共43条)、听力残疾28条(共62条),肢体残疾24条(共40条)。结论:目前残疾人家庭医生团队大多缺少康复医生和康复治疗师,缺乏康复知识和专业技术,提供的康复服务项目主要以支持性服务为主;基于WHO初级卫生保健政策和我国《十四五残疾人保障和发展规划》,在缺乏康复专业人员的情况下,可以对家庭医生团队进行康复服务能力的培训。

Objective:Understand the current situation of rehabilitation services provided by the disabled family doctor team in Chongqing,and provide feasible suggestions for improving the rehabilitation service capabilities of the disabled family doctor team.Methods:Based on World Health Organization Rehabilitation in Health Systems:Template for Rehabilitation Information Collection(TRIC):a tool accompanying the Systematic Assessment of Rehabilitation Situation(STARS),according to the relevant requirements of the Chongqing Disabled Persons’Federation,a questionnaire survey was conducted on 187 family doctor team members from 11 districts and counties in Chongqing,and the data were descriptively analyzed.Results:Among the members of the family doctor team participating in the survey,a relatively high proportion was nurses(93.05%),general practitioners(84.49%),public health doctors(82.35%),and rural doctors(74.87%),with fewer having rehabilitation doctors(29.95%)and rehabilitation therapists(16.58%).There were more people aged 18~30(34.48%)and 31~40(37.97%)years old.The proportion of undergraduate was as high as 60.96%.From the analysis of 172 effective questionnaires,the rehabilitation services were mostly supportive services.Among them,visual disability accounted for 52.33%,mental disability for 53.49%,intellectual disability for 60.47%,hearing disability for 33.72%,and physical disability for 50%.The proportion of services not provided was also high.Among them,visual disability accounted for 35.47%,mental disability for 30.23%,intellectual disability for 26.16%,hearing disability for 38.37%,and physical disability for 26.16%;The most entries were related to“insufficient professional technical ability or professional knowledge”in the reason explanation for not execu-ting.Among them,visual disability was accounted for 29(52 in total),mental disability for 25(39 in total),intellectual disability for 26(43 in total),hearing disability for 28(62 in total),and physical disability for 24(40 in total).Conclusion:At present,the team of disabled family doctors mostly lacks rehabilitation doctors and therapists,lacks rehabilitation knowledge and professional skills,and the rehabilitation services provided are mainly supportive services.Based on the WHO primary health care policy and China’s 14th Five Year Plan for the Protection and Development of Persons with Disabilities,in the absence of rehabilitation professionals,family doctor teams can be trained in rehabilitation service competency.