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探索伊朗卫生系统对残疾人康复服务的障碍:一项定性研究

Exploring Barriers of the Health System to Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study.

作者信息

Abdi Kianoush, Arab Mohammad, Rashidian Arash, Kamali Mohammad, Khankeh Hamid Reza, Farahani Farideh Khalajabadi

机构信息

Ph.D. Student of Health Services Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Professor of Health Management, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Electron Physician. 2015 Nov 20;7(7):1476-85. doi: 10.19082/1476. eCollection 2015 Nov.

Abstract

INTRODUCTION

The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran.

METHODS

This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10.

RESULTS

"Barriers" were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation.

CONCLUSIONS

An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research.

摘要

引言

联合国将健康确定为一项基本人权,但遗憾的是,证据表明残疾人的健康水平往往低于普通人群。这可能与获得服务和项目方面的问题有关。本研究的目的是探讨伊朗卫生系统在为残疾人提供康复服务方面的障碍。

方法

这是一项定性研究,于2014年6月至2015年7月对21名参与者进行了半结构化深入访谈并进行内容分析。数据分析使用MAXQDA 10版本进行。

结果

“障碍”是需要获得康复服务的残疾人面临的最突出挑战。这些障碍被归类为提供康复服务的系统存在缺陷、教育缺陷、残疾人士检测和筛查不足、康复管理缺陷、忽视社会文化因素、可达性困难、身份识别缺失以及康复方面的经济困难这八个概念。

结论

一个有效的康复计划需要达成共识,同时要考虑到解决这些障碍所涉及的长期并发症。了解卫生系统在康复服务方面的障碍需要全面管理,首先应熟悉所有残疾人、提供者、政策制定者和其他受益者。政策制定者将康复服务视为卫生计划的主要部分也是必要的;特别是,他们必须改变对康复服务和项目的监督。因此,政策制定者需要进行全面管理并建议进一步研究。

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