Kent R M, Chandler B J, Barnes M P
Rheumatology and Rehabilitation Research Unit, University of Leeds, UK.
Clin Rehabil. 2000 Oct;14(5):481-90. doi: 10.1191/0269215500cr350oa.
To describe service use and unmet needs of disabled people in a rural environment, given well-recognized difficulties in providing equitable services to a widely-spread population, availability of transport and the presence of discrepancies in wealth.
Disabled people registered with a single rural general practice, identified by postal questionnaire.
All 3462 households were screened using the Office of Population, Censuses and Surveys (OPCS) disability screening questionnaire. An 86% response rate was achieved. Seventy-four people aged 16-65 and 69 people aged 66-75 were interviewed by a rehabilitation physician. Fifty-five people aged 76+ were interviewed. Disability was assessed using the OPCS scales of disability, Barthel Index, and Hospital Anxiety and Depression Scale.
Thirty per cent (43) of those aged 16-75 received assistance for their personal activities of daily living (ADLs), and 98% (140) required assistance for extended ADLs (taken from the OPCS surveys criteria). There was no difference in either disability or dependency by age group. Fifty-three per cent of this group had domestic adaptations, 75% had disability aids. Those aged 16-75 had significantly fewer aids and adaptations, less home care, care management, respite, district nursing and chiropody services than people over 75. Equipment was provided by statutory services less frequently and fewer carers were salaried. The rehabilitation physician assessed them as needing more occupational therapy, physiotherapy and chiropody. Thirty per cent saw their GP monthly and 45% attended hospital.
Unmet need was assessed as greater in the younger group. Elderly people are possibly more visible to service providers with better recognition of need. There is no evidence of a relationship between medical surveillance and identification of rehabilitation needs. Those with greater degrees of disability require more interlinked and organized services.
鉴于在为广泛分布的人群提供公平服务、交通便利性以及财富差异方面存在公认的困难，描述农村地区残疾人的服务使用情况和未满足的需求。
通过邮政问卷调查确定，在一个农村全科诊所登记的残疾人。
使用人口普查与调查办公室（OPCS）的残疾筛查问卷对所有3462户家庭进行筛查。回复率达到86%。一名康复医生对74名16 - 65岁的人和69名66 - 75岁的人进行了访谈。对55名76岁及以上的人进行了访谈。使用OPCS残疾量表、巴氏指数和医院焦虑抑郁量表对残疾情况进行评估。
16 - 75岁的人群中，30%（43人）在日常生活活动（ADL）方面获得了帮助，98%（140人）在扩展的ADL方面（根据OPCS调查标准）需要帮助。不同年龄组在残疾或依赖程度上没有差异。该组中有53%进行了家庭改造，75%拥有残疾辅助器具。16 - 75岁的人拥有的辅助器具和进行的家庭改造明显少于75岁以上的人，接受的家庭护理、护理管理、临时护理、社区护理和足疗服务也更少。法定服务提供设备的频率较低，领取薪水的护理人员较少。康复医生评估他们需要更多的职业治疗、物理治疗和足疗服务。30%的人每月看全科医生，45%的人住院治疗。
评估显示年轻人群中未满足的需求更大。服务提供者可能更容易看到老年人，对他们需求的认识也更好。没有证据表明医疗监测与康复需求的识别之间存在关联。残疾程度较高的人需要更相互关联和有组织的服务。
