Degerstedt Frida, Enberg Birgit, Keisu Britt-Inger, Björklund Martin
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
Umeå Center for Gender Studies, Umeå University, Umeå, Sweden.
Acta Paediatr. 2020 Apr;109(4):774-782. doi: 10.1111/apa.14980. Epub 2019 Sep 30.
The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.
This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up programme, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using chi-square and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.
Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.
The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different geographical regions of Sweden. Knowledge of inequity is crucial in order to address the problem.
本研究旨在从公平性角度，考虑性别、出生国家和地理区域，调查瑞典脑瘫儿童物理治疗干预措施的分布情况。
这项全国性横断面登记研究纳入了2015年参加瑞典国家质量登记处“脑瘫随访计划”（CPUP）的0至18岁脑瘫儿童。使用卡方检验和逻辑回归分析对物理治疗干预措施与性别、出生国家和地理区域之间进行比较并分析关联，同时控制认知水平、运动功能水平、年龄组和主要症状。
在2855名参与者中，2201名（79%）接受了物理治疗。与国外出生的儿童相比，瑞典出生的儿童接受物理治疗的几率高1.60倍（95%置信区间1.10 - 2.33）。物理治疗干预措施的分布在不同地理区域之间存在显著差异。未观察到性别与物理治疗干预措施之间存在关联。
本研究结果表明瑞典对其他国家出生的脑瘫儿童存在护理不公平现象。此外，物理治疗干预措施在瑞典不同地理区域的分布不均衡。了解不公平现象对于解决该问题至关重要。
