Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; Research Methods Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
Arch Phys Med Rehabil. 2019 Sep;100(9):1648-1654.e9. doi: 10.1016/j.apmr.2019.02.002. Epub 2019 Mar 7.
To explore the relationships between wheelchair services received during wheelchair provision and positive outcomes for users of wheelchairs.
Secondary analysis of cross-sectional data.
Urban and periurban communities in Kenya and the Philippines.
Adult basic manual wheelchair users (N=852), about half of whom reported having received some wheelchair services with the provision of their current wheelchairs.
Not applicable.
Participants completed a survey that included questions related to demographic, clinical, and wheelchair characteristics. The survey also included questions about the past receipt of 13 wheelchair services and 4 positive outcomes for users of wheelchairs. The relationships between individual services received and positive outcomes were assessed using logistic regression analyses. In addition to assessing individual services and outcomes, we analyzed a composite service score (the total number of services received) and a composite outcome score (≥3 positive outcomes).
The top 3 individual services from the perspective of relationships with the composite outcome score were "provider did training" (P=.0009), "provider assessed wheelchair fit while user propelled the wheelchair" (P=.002), and "peer group training received" (P=.033). The composite service score was significantly related to "daily wheelchair use" (P<.0001), "outdoor unassisted wheelchair use" (P<.0001), "high performance of activities of daily living" (P=.046) and the composite outcome score (P=.005), but not to the "absence of serious falls" (P=.73).
The receipt of wheelchair services is associated with positive outcomes for users of wheelchairs, but such relationships do not exist for all services and outcomes. These findings are highly relevant to ongoing efforts to optimize wheelchair service delivery.
探索在提供轮椅过程中接受的轮椅服务与轮椅使用者的积极结果之间的关系。
横断面数据的二次分析。
肯尼亚和菲律宾的城市和城郊社区。
成人基本手动轮椅使用者（N=852），其中约一半报告在提供当前轮椅时接受了一些轮椅服务。
不适用。
参与者完成了一项调查，其中包括与人口统计学、临床和轮椅特征相关的问题。该调查还包括过去接受 13 项轮椅服务和 4 项轮椅使用者积极结果的相关问题。使用逻辑回归分析评估了个体服务的接受与积极结果之间的关系。除了评估个体服务和结果外，我们还分析了综合服务评分（接受服务的总数）和综合结果评分（≥3 项积极结果）。
从与综合结果评分的关系角度来看，前 3 项个体服务是“提供者进行培训”（P=.0009）、“提供者在用户推动轮椅时评估轮椅适配性”（P=.002）和“接受同伴群体培训”（P=.033）。综合服务评分与“日常轮椅使用”（P<.0001）、“户外无辅助轮椅使用”（P<.0001）、“日常生活活动的高表现”（P=.046）和综合结果评分（P=.005）显著相关，但与“无严重跌倒”（P=.73）无关。
接受轮椅服务与轮椅使用者的积极结果相关，但并非所有服务和结果都存在这种关系。这些发现与正在进行的优化轮椅服务提供的努力密切相关。
