浙江省社区康复服务资源的现状调查
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摘要
目的:调查浙江省社区康复现状,为我省社区康复的可持续发展战略提供依据。方法:选择全省11个地区64家社区卫生服务中心及农村乡镇卫生服务中心发放问卷,对社区康复服务部门人力资源状况、开展的主要康复治疗项目、康复站规模及设施等方面进行调查。结果:64家社区共回收有效问卷64份,从调查结果我们可以发现研究生、本科生、大专、中专生分别占5.3%、23.0%、41.1%、30.6%。康复工作人员中康复医师、康复治疗师、全科医师、康复护士分别占25.9%、38.5%、10.5%、27.1%。职称以高级、中级、初级分别占5.3%、34.3%、38.7%。以康复为全职的占36.2%,曾参加康复专科继续教育学习占43.2%。康复治疗(训练)方面主要以上下肢运动能力训练、推拿按摩为主;针对≥65周岁老年人生活及运动方式指导,包括预防跌倒训练、提高老年人心肺(有氧)能力的训练、改善老年肌少症的训练等3个项目所占比例均偏低,分别为20.3%、18.7%、23.4%。社区卫生机构拥有较多的康复硬件是电针仪、远红外治疗仪、轮椅、颈腰牵引床,分别为81.2%、76.5%、73.4%、60.9%。踝关节矫形器、木丁板、PT凳、矫姿镜拥有率最低,分别是29.6%、29.6%、31.2%、32.8%。结论:社区康复在我省得到健康的发展,体系也逐渐完善,但目前仍面临着许多挑战。建议今后我省社区康复服务能力建设过程中将转变社区康复从业人员的服务理念及社区居民的康复意识作为努力方向,重点提高社区康复服务体系中针对老年人及慢病患者的相应服务能力;此外,政策进一步向社区康复倾斜,争取从技术上,资源配备上、人才管理以及中远期规划上保证和提高社区康复应有的质和量,为我省社区康复事业提供一条可持续发展道路。
Objective:To provide evidence for the sustainable development strategy of community rehabilitation through investigating the current situation of community rehabilitation in Zhejiang Province.Methods:Sixty-four community health service centers and rural township health service centers in 11 regions of the province were selected to conduct the questionnaire, which concerned the status of human resources, main rehabilitation programs, scale of rehabilitation station, rehabilitation device, etc.Results:Sixty-four valid questionnaires were collected from 64 communities. According to the survey results, it was found that postgraduate, undergraduate, junior college and secondary school students accounted for 5.3%, 23%, 41.1% and 30.6% respectively. Rehabilitation physicians, rehabilitation therapists, general practitioners and rehabilitation nurses accounted for 25.9%, 38.5%, 10.5% and 27.1% respectively during the total rehabilitation staff. The senior, intermediate and primary professional titles accounted for 5.3%, 34.3% and 38.7% respectively. 36.2% of the rehabilitation staff were full-time, and 43.2% had participated in rehabilitation related continuing education courses. The training of upper and lower extremities and massage were the main treatment methods in the aspect of rehabilitation therapy(training). The constituent ratios of fall prevention training, cardiopulmonary function training and improving sarcopenia training in life-style and exercises guidance of old people aged above 65 were lower, which were 20.3%, 18.7% and 23.4% respectively. The quantity of electroacupuncture apparatus, far-infrared therapeutic apparatus, wheelchair, cervical and lumber traction bed was more than other rehabilitation hardware in community health institutions, which accounted for 81.2%, 76.5%, 73.4% and 60.9% respectively. The number of ankle orthosis wooden board, PT stool and posture correction mirror was the lowest, which accounted for 29.6%, 29.6%, 31.2% and 32.8% respectively.Conclusion: Although the development of community rehabilitation is healthy in our province, and its service system is improved gradually, there are still many challenges to be resolved. We recommend the transforming of the service concept of community rehabilitation practitioners and the rehabilitation consciousness of community residents should be taken as the direction of efforts in the process of building the community rehabilitation service capacity of our province. The corresponding service capacity for the elderly and the patients with slow diseases should be mainly improved during the community rehabilitation service system. In addition, the policy should be further inclined to community rehabilitation to strive to guarantee and improve the quality and quantity of community rehabilitation in terms of technology, resource allocation, talent management and long-term planning, and provide a sustainable development path for the community rehabilitation in our province.
Objective:To provide evidence for the sustainable development strategy of community rehabilitation through investigating the current situation of community rehabilitation in Zhejiang Province.Methods:Sixty-four community health service centers and rural township health service centers in 11 regions of the province were selected to conduct the questionnaire, which concerned the status of human resources, main rehabilitation programs, scale of rehabilitation station, rehabilitation device, etc.Results:Sixty-four valid questionnaires were collected from 64 communities. According to the survey results, it was found that postgraduate, undergraduate, junior college and secondary school students accounted for 5.3%, 23%, 41.1% and 30.6% respectively. Rehabilitation physicians, rehabilitation therapists, general practitioners and rehabilitation nurses accounted for 25.9%, 38.5%, 10.5% and 27.1% respectively during the total rehabilitation staff. The senior, intermediate and primary professional titles accounted for 5.3%, 34.3% and 38.7% respectively. 36.2% of the rehabilitation staff were full-time, and 43.2% had participated in rehabilitation related continuing education courses. The training of upper and lower extremities and massage were the main treatment methods in the aspect of rehabilitation therapy(training). The constituent ratios of fall prevention training, cardiopulmonary function training and improving sarcopenia training in life-style and exercises guidance of old people aged above 65 were lower, which were 20.3%, 18.7% and 23.4% respectively. The quantity of electroacupuncture apparatus, far-infrared therapeutic apparatus, wheelchair, cervical and lumber traction bed was more than other rehabilitation hardware in community health institutions, which accounted for 81.2%, 76.5%, 73.4% and 60.9% respectively. The number of ankle orthosis wooden board, PT stool and posture correction mirror was the lowest, which accounted for 29.6%, 29.6%, 31.2% and 32.8% respectively.Conclusion: Although the development of community rehabilitation is healthy in our province, and its service system is improved gradually, there are still many challenges to be resolved. We recommend the transforming of the service concept of community rehabilitation practitioners and the rehabilitation consciousness of community residents should be taken as the direction of efforts in the process of building the community rehabilitation service capacity of our province. The corresponding service capacity for the elderly and the patients with slow diseases should be mainly improved during the community rehabilitation service system. In addition, the policy should be further inclined to community rehabilitation to strive to guarantee and improve the quality and quantity of community rehabilitation in terms of technology, resource allocation, talent management and long-term planning, and provide a sustainable development path for the community rehabilitation in our province.
引文
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[3] 张诗敏,杜雪平,胡海鹰.社区康复工作现状及对策研究[J].中国全科医学,2011,14(25):2918-2920.
[4] 周国瑾,刘翠,王萌,等.浅谈医学生开展社区康复实践活动的方法及意义[J].健康导报:医学版,2015(10):265-265.
[5] 中国残疾人联合会,国家卫生和计划生育委员会,国务院扶贫开发领导小组办公室.残疾 人精 准康 复服 务行 动实 施方 案[EB/OL].http://www.cdpsn.org.cn/policy/dt104l44602.htm,2016-06-02.
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[9] 景秀.老年慢性病患者门诊跌倒预防中实施健康指导护理干预的效果[J].实用医技杂志,2016,23(4):446-447.
[10] 胡岢.听力残疾儿童的早期干预[J].中国听力语言康复科学杂志,2004(1):48-50.
[11] 梁秀峰,李润琴.浅谈社区服务中心对21例老年患者的护理[J].中华现代护理学杂志,2007,15(21):36-38.
[12] 杨剑.健康教育及管理在社区老年慢性病防治中的应用与效果[J].中国当代医药,2016,23(19):192-194.
[13] 卓大宏.进入21世纪的社区康复[J].中国康复医学杂志,2000,15(6):327-329.
[14] 陈伟伟,高润霖,刘力生,等.中国心血管病报告2017概要.中国循环杂志.2018,33:1-8.
[15] 吕淑荣,俞浩,苏健,等.膳食模式与心脑血管病死亡风险关系的巢式病例-对照研究[J].中华预防医学杂志,2016,50(10):912-913.
[16] 李益平,简雅娟,郝福春,等.社区康复人员康复培训课程开发路径的研究[J].继续医学教育,2018(1):1-2.
[17] 张晶晶,李云,陈园,等.基于社区康复服务现状调查分析的发展策略研究[J].中国康复医学杂志,2017,32(1):78-81.
[18] 廖利民.加强康复医学专业研究生的科研能力培养[J].中国康复理论与实践,2016,22(5):618-620.
[19] 李晓檬,李娅铃,姜嘉嘉,等.浙江省三级综合性医院康复医学科设置现状调查[J].中国康复,2017,32(1):65-66.
[20] 张小年,张兆峰,杜晓霞.加强康复医学生心身医学教育[J].北京医学,2017(5):543-544.康复教育
[2] 张金明,赵悌尊.国际社区康复发展趋势及对我国社区康复工作的思考[J].中国康复理论与实践,2011,2(3):184-186.
[3] 张诗敏,杜雪平,胡海鹰.社区康复工作现状及对策研究[J].中国全科医学,2011,14(25):2918-2920.
[4] 周国瑾,刘翠,王萌,等.浅谈医学生开展社区康复实践活动的方法及意义[J].健康导报:医学版,2015(10):265-265.
[5] 中国残疾人联合会,国家卫生和计划生育委员会,国务院扶贫开发领导小组办公室.残疾 人精 准康 复服 务行 动实 施方 案[EB/OL].http://www.cdpsn.org.cn/policy/dt104l44602.htm,2016-06-02.
[6] 高启胜,沈清,陈定湾,等.浙江省基层医疗服务能力现状分析[J].中华医院管理杂志,2017,33(2):106-109.
[7] 王国敬.浙江省基层医疗卫生机构综合改革现状分析及对策研究[J].中国农村卫生,2012(2):59-62.
[8] 李祥华.社区康复服务的功能与现状[J].社区医学杂志,2011,11(2):3-4.
[9] 景秀.老年慢性病患者门诊跌倒预防中实施健康指导护理干预的效果[J].实用医技杂志,2016,23(4):446-447.
[10] 胡岢.听力残疾儿童的早期干预[J].中国听力语言康复科学杂志,2004(1):48-50.
[11] 梁秀峰,李润琴.浅谈社区服务中心对21例老年患者的护理[J].中华现代护理学杂志,2007,15(21):36-38.
[12] 杨剑.健康教育及管理在社区老年慢性病防治中的应用与效果[J].中国当代医药,2016,23(19):192-194.
[13] 卓大宏.进入21世纪的社区康复[J].中国康复医学杂志,2000,15(6):327-329.
[14] 陈伟伟,高润霖,刘力生,等.中国心血管病报告2017概要.中国循环杂志.2018,33:1-8.
[15] 吕淑荣,俞浩,苏健,等.膳食模式与心脑血管病死亡风险关系的巢式病例-对照研究[J].中华预防医学杂志,2016,50(10):912-913.
[16] 李益平,简雅娟,郝福春,等.社区康复人员康复培训课程开发路径的研究[J].继续医学教育,2018(1):1-2.
[17] 张晶晶,李云,陈园,等.基于社区康复服务现状调查分析的发展策略研究[J].中国康复医学杂志,2017,32(1):78-81.
[18] 廖利民.加强康复医学专业研究生的科研能力培养[J].中国康复理论与实践,2016,22(5):618-620.
[19] 李晓檬,李娅铃,姜嘉嘉,等.浙江省三级综合性医院康复医学科设置现状调查[J].中国康复,2017,32(1):65-66.
[20] 张小年,张兆峰,杜晓霞.加强康复医学生心身医学教育[J].北京医学,2017(5):543-544.康复教育