北京市东城区居家养老辅助器具使用调查
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摘要
目的了解北京市东城区老年人对辅助器具的认知和使用情况、价格接受度、使用满意度、质量问题反馈、依从性和获得方式。方法 2017年4月至12月,选择北京市东城区6个社区166例居家养老老年人,为其评估、适配辅助器具,教会其使用,每半个月回访日常生活活动能力改善状况和对辅助器具的满意度,持续6个月。问卷调查老年人对辅助器具的使用和需求。结果 22%老年人没有使用过辅助器具。正在使用的辅助器具中,移动类占63%,生活护理类占48%,视觉类占44%,听觉类占20%,其他占4%。老年人购买辅具考虑的因素主要有能解决实际问题、质量好、多功能、性价比高等。魁北克辅助科技使用者满意度评估量表评分为(4.04±0.46)分。辅助器具弃用率2%。老年人使用辅助器具常出现的质量问题有组装不牢固/松动(43%)、外观粗糙(27%)、零部件破损(15%)、具有安全隐患(13%)、可靠性差(3%)、尺寸不合适(3%)和强度不够/断裂(3%)。老年人获得辅助器具的方式,80%为自行购买,13%为政府发放,6%为亲友赠送,无租赁方式获取。结论辅助器具能够改善和方便老年人生活。老年人需求最多的是移动、生活、交流和居家辅具,希望选择功能齐全、性价比高、能解决实际问题的辅具。专业的适配、定期的回访和维护可以提高辅助器具满意度,降低弃用率。可推进辅助器具租赁服务,加大实用辅助器具服务技术的推广。
Objective To investigate the awareness, use, price acceptance, satisfaction, feedback on quality problems, compliance and access methods of assistive devices for the old adults in Dongcheng, Beijing.Methods From April to December, 2017, 166 homecare old adults from six communities of Dongcheng, Beijing accept-ed assistive devices after adaption, and were taught how to use. They were followed up once half a month for six months to investigate activities of daily living, satisfaction, awareness and expectation for their assistive devices.Results There were 22% of them never used their assistive devices. For those assistive devices had been used, 62% were mobile products, 48% were homecare products, 44% were visual products, 20% were hearing products, and 4%were other products. The score of Quebec User Evaluation of Satisfaction with Assistive Technology was(4.04±0.46) in total, with 2% abandoning. Practicalness, good quality, multi-function and high performance-cost were the most important factors in mind to buy the assistive products. Common quality problems were infirmness of assembly(43%), rough appearance(27%), damaged parts(15%), hidden danger(13%), unsuitable size(3%),poor reliability(3%) and lack of structural strength(3%). The ways to obtain assistive devices included self-pur-chase(80%), government adaptation(13%), family and friends giving(6%), and lease(0%).Conclusion Assistive devices can improve quality of life for the old adults. They prefer to choosing assistive devices of multi-function, cost-effective, for daily living, communication and homecare. Professional fitting, regular visit and maintenance can increase the satisfaction, and reduce abandonment of assistive devices. Assistive devices leasing service may help to promote the access of assistive devices.
Objective To investigate the awareness, use, price acceptance, satisfaction, feedback on quality problems, compliance and access methods of assistive devices for the old adults in Dongcheng, Beijing.Methods From April to December, 2017, 166 homecare old adults from six communities of Dongcheng, Beijing accept-ed assistive devices after adaption, and were taught how to use. They were followed up once half a month for six months to investigate activities of daily living, satisfaction, awareness and expectation for their assistive devices.Results There were 22% of them never used their assistive devices. For those assistive devices had been used, 62% were mobile products, 48% were homecare products, 44% were visual products, 20% were hearing products, and 4%were other products. The score of Quebec User Evaluation of Satisfaction with Assistive Technology was(4.04±0.46) in total, with 2% abandoning. Practicalness, good quality, multi-function and high performance-cost were the most important factors in mind to buy the assistive products. Common quality problems were infirmness of assembly(43%), rough appearance(27%), damaged parts(15%), hidden danger(13%), unsuitable size(3%),poor reliability(3%) and lack of structural strength(3%). The ways to obtain assistive devices included self-pur-chase(80%), government adaptation(13%), family and friends giving(6%), and lease(0%).Conclusion Assistive devices can improve quality of life for the old adults. They prefer to choosing assistive devices of multi-function, cost-effective, for daily living, communication and homecare. Professional fitting, regular visit and maintenance can increase the satisfaction, and reduce abandonment of assistive devices. Assistive devices leasing service may help to promote the access of assistive devices.
引文
[1]ISO 9999:2016 Assistive products for persons with disabili-ty-Classification and terminology[EB/OL].(2018-06-16).https://www.iso.org/obp/ui/#iso:std:iso:9999:ed-6:v1:en
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[3]朱图陵.康复工程与辅助技术的基本概念与展望[J].中国康复理论与实践,2017,23(11):1330-1335.
[4]朱图陵,金德闻.辅助器具与辅助技术[J].中国康复医学杂志,2006,21(3):252-254.
[5]罗椅民,师昉,纪树荣.老年辅助器具与辅助技术在养老康复中的应用进展[J].中国康复医学杂志,2016,31(7):813-816.
[6]Cook A M,Polgar J M.Assistive Technologies:Principles and Practice[M].4th ed.St.Louis,Missouri:Elsevier Health Sci-ences,2015.
[7]Federici S,Scherer M J,Borsci S.An ideal model of an assis-tive technology assessment and delivery process[J].Technol Disabil,2014,26:27-38.
[8]朱图陵,范佳进,张翔.基于现代残疾观ICF和WRD认识辅助器具[J].中国康复,2013,28(6):471-473.
[9]朱图陵,范佳进,黄河,等.残疾人无障碍环境评定[J].中国康复理论与实践,2013,19(5):489-492.
[10]朱图陵,王保华.论残疾、无障碍环境与辅助器具[J].残疾人研究,2016(3):37-42.
[11]Cho H Y,MacLachlan M,Clarke M,et al.Accessible home environments for people with functional limitations:a systemat-ic review[J].Int J Environ Res Public Health,2016,13(8).pii:E826.
[12]Clarke P J.The role of the built environment and assistive de-vices for outdoor mobility in later life[J].J Gerontol B Psychol Sci Soc Sci,2014,69(1):S8-S15.
[13]赖卿,李高峰,唐艳军,等.双腕掌离断者的辅助器具适配个案实践--基于ICF框架的应用研究[J].中国康复理论与实践,2014,20(6):522-526.
[14]郑飞雪,贝维斯.辅具适配和环境改造在残疾人社区康复中的实践及启示[J].中国康复,2014,29(5):396-398.
[15]师昉,王龙,吕泽平,等.辅助器具的适配评估服务[J].中华物理医学与康复杂志,2015,37(4):312-313.
[16]刘旋,陈振声,王保华,等.肢残儿童四类辅助器具满意度调查[J].中国康复理论与实践,2013,19(5):418-420.
[17]张旭,陈功.老龄化背景下的康复辅助器具利用与需求研究进展[J].中国康复理论与实践,2016,22(11):1350-1353.
[18]张文娟,谭文静.中国老年人辅助器具的使用行为分析[J].人口与发展,2016,22(3):100-112,70.
[19]师昉,张广为,彭娜,等.北京市300例肢体残障者辅助器具适配情况研究[J].中国伤残医学,2013,21(6):78-79.
[20]毕琪,宋毓,季敏,等.上海市辅助器具适配对残疾人室内外活动能力影响的调查[J].中国康复理论与实践,2015,21(7):766-769.
[21]Gell N M,Wallace R B,LaCroix A Z,et al.Mobility device use in older adults and incidence of falls and worry about fall-ing:Findings from the 2011-2012 National Health and Aging Trends Study[J].J Am Geriatr Soc,2015,63(5):853-859.
[22]朱图陵.辅助技术在老年人康复中的应用[J].中国康复理论与实践,2017,23(8):971-975.
[23]路微波,吴毅,余征,等.社区专业人员介入对脑卒中患者辅助器具适配的影响[J].中国康复,2016,31(3):187-189.
[24]张晶,王斌全,魏绍辉.脑卒中失能老年人中后期ADL能力及辅助器具使用现状调查[J].国际护理学杂志,2017,36(8):1034-1038.
[25]李奎成,曹海燕,刘晓艳,等.严重功能障碍住院患者康复辅助器具应用调查[J].中国康复,2013,28(4):278-280.
[26]吴英黛.辅具评估专业技术手册[M].北京:华夏出版社,2009.
[27]田壮,宋毓,金荣,等.上海市残疾人辅助器具组合适配评估结果分析[J].中国康复理论与实践,2016,22(2):221-226.
[28]Chu L,Vella J.Assistive Device Abandonment with in the Geriatric Population[R].Ann Arbor:Touro College,2001.
[29]钟磊.发展我国辅助器具租借服务初探[J].中国康复理论与实践,2012,18(7):688-690.
[30]李叶,闫振华.我国辅助器具供应量的变化及原因分析[J].中国康复理论与实践,2009,15(11):1089-1090.
[31]Smith R O,Scherer M J,Cooper R,et al.Assistive technolo-gy products:a position paper from the first Global Research,In-novation,and Education on Assistive Technology(GREAT)summit[J].Disabil Rehabil Assist Technol,2018,2018,13(5):473-485.
[32]雷巍.国外新型辅助产品的发展[J].中国康复理论与实践,2013,19(5):404-406.
[33]屠其雷.辅助器具在养老机构康复护理中的探索与实践[J].社会福利(理论版),2014(1):36-38.
[34]Mansouri N,Goher K,Hosseini S E.Ethical framework of assistive devices:review and reflection[J].Robotics Biomim,2017,4(1):19.
[35]赖卿,李高峰,方新,等.ICF视野下康复辅助器具技术专业人才培养体系建设[J].中国康复理论与实践,2018,24(3):367-372.
[36]方新,李高峰,熊宝林,等.康复辅助器具服务模式与人才队伍建设[J].中国康复医学杂志,2018,33(2):211-214.
[2]李高峰,朱图陵.老年人辅助器具应用[M].北京:北京大学出版社,2013.
[3]朱图陵.康复工程与辅助技术的基本概念与展望[J].中国康复理论与实践,2017,23(11):1330-1335.
[4]朱图陵,金德闻.辅助器具与辅助技术[J].中国康复医学杂志,2006,21(3):252-254.
[5]罗椅民,师昉,纪树荣.老年辅助器具与辅助技术在养老康复中的应用进展[J].中国康复医学杂志,2016,31(7):813-816.
[6]Cook A M,Polgar J M.Assistive Technologies:Principles and Practice[M].4th ed.St.Louis,Missouri:Elsevier Health Sci-ences,2015.
[7]Federici S,Scherer M J,Borsci S.An ideal model of an assis-tive technology assessment and delivery process[J].Technol Disabil,2014,26:27-38.
[8]朱图陵,范佳进,张翔.基于现代残疾观ICF和WRD认识辅助器具[J].中国康复,2013,28(6):471-473.
[9]朱图陵,范佳进,黄河,等.残疾人无障碍环境评定[J].中国康复理论与实践,2013,19(5):489-492.
[10]朱图陵,王保华.论残疾、无障碍环境与辅助器具[J].残疾人研究,2016(3):37-42.
[11]Cho H Y,MacLachlan M,Clarke M,et al.Accessible home environments for people with functional limitations:a systemat-ic review[J].Int J Environ Res Public Health,2016,13(8).pii:E826.
[12]Clarke P J.The role of the built environment and assistive de-vices for outdoor mobility in later life[J].J Gerontol B Psychol Sci Soc Sci,2014,69(1):S8-S15.
[13]赖卿,李高峰,唐艳军,等.双腕掌离断者的辅助器具适配个案实践--基于ICF框架的应用研究[J].中国康复理论与实践,2014,20(6):522-526.
[14]郑飞雪,贝维斯.辅具适配和环境改造在残疾人社区康复中的实践及启示[J].中国康复,2014,29(5):396-398.
[15]师昉,王龙,吕泽平,等.辅助器具的适配评估服务[J].中华物理医学与康复杂志,2015,37(4):312-313.
[16]刘旋,陈振声,王保华,等.肢残儿童四类辅助器具满意度调查[J].中国康复理论与实践,2013,19(5):418-420.
[17]张旭,陈功.老龄化背景下的康复辅助器具利用与需求研究进展[J].中国康复理论与实践,2016,22(11):1350-1353.
[18]张文娟,谭文静.中国老年人辅助器具的使用行为分析[J].人口与发展,2016,22(3):100-112,70.
[19]师昉,张广为,彭娜,等.北京市300例肢体残障者辅助器具适配情况研究[J].中国伤残医学,2013,21(6):78-79.
[20]毕琪,宋毓,季敏,等.上海市辅助器具适配对残疾人室内外活动能力影响的调查[J].中国康复理论与实践,2015,21(7):766-769.
[21]Gell N M,Wallace R B,LaCroix A Z,et al.Mobility device use in older adults and incidence of falls and worry about fall-ing:Findings from the 2011-2012 National Health and Aging Trends Study[J].J Am Geriatr Soc,2015,63(5):853-859.
[22]朱图陵.辅助技术在老年人康复中的应用[J].中国康复理论与实践,2017,23(8):971-975.
[23]路微波,吴毅,余征,等.社区专业人员介入对脑卒中患者辅助器具适配的影响[J].中国康复,2016,31(3):187-189.
[24]张晶,王斌全,魏绍辉.脑卒中失能老年人中后期ADL能力及辅助器具使用现状调查[J].国际护理学杂志,2017,36(8):1034-1038.
[25]李奎成,曹海燕,刘晓艳,等.严重功能障碍住院患者康复辅助器具应用调查[J].中国康复,2013,28(4):278-280.
[26]吴英黛.辅具评估专业技术手册[M].北京:华夏出版社,2009.
[27]田壮,宋毓,金荣,等.上海市残疾人辅助器具组合适配评估结果分析[J].中国康复理论与实践,2016,22(2):221-226.
[28]Chu L,Vella J.Assistive Device Abandonment with in the Geriatric Population[R].Ann Arbor:Touro College,2001.
[29]钟磊.发展我国辅助器具租借服务初探[J].中国康复理论与实践,2012,18(7):688-690.
[30]李叶,闫振华.我国辅助器具供应量的变化及原因分析[J].中国康复理论与实践,2009,15(11):1089-1090.
[31]Smith R O,Scherer M J,Cooper R,et al.Assistive technolo-gy products:a position paper from the first Global Research,In-novation,and Education on Assistive Technology(GREAT)summit[J].Disabil Rehabil Assist Technol,2018,2018,13(5):473-485.
[32]雷巍.国外新型辅助产品的发展[J].中国康复理论与实践,2013,19(5):404-406.
[33]屠其雷.辅助器具在养老机构康复护理中的探索与实践[J].社会福利(理论版),2014(1):36-38.
[34]Mansouri N,Goher K,Hosseini S E.Ethical framework of assistive devices:review and reflection[J].Robotics Biomim,2017,4(1):19.
[35]赖卿,李高峰,方新,等.ICF视野下康复辅助器具技术专业人才培养体系建设[J].中国康复理论与实践,2018,24(3):367-372.
[36]方新,李高峰,熊宝林,等.康复辅助器具服务模式与人才队伍建设[J].中国康复医学杂志,2018,33(2):211-214.