Xia Cong, Wei Ting, Shao Ping, Tang Qi, Zheng HongYing, Sun Mei, Chen Gang, Lu Jun
School of Health Management, Anhui Medical University, Hefei, Anhui Province, 230000, China.
School of Public Health, Fudan University, Shanghai, 200032, China.
BMC Public Health. 2025 Feb 15;25(1):631. doi: 10.1186/s12889-025-21907-0.
Continuance utilization of rehabilitation services among children with disabilities is not optimal. However, little is known about the factors that influence whether rehabilitation is continued. Therefore, a cross-sectional study was conducted in a sample of family caregivers in China to explore the relationship between perceived rehabilitation benefit, expectation, satisfaction, self-efficacy, continuance intention and continuance behavior.
A total of 368 family caregivers of children with disabilities were recruited from rehabilitation institutions through the convenience sampling method in Shanghai and Kunshan, China. We developed a research model that drives continuance utilization of rehabilitation services and proposed 13 research hypotheses based on the Expectation Disconfirmation Theory (EDT) and the extended Expectation-Conformation Model of Information System Continuance (extended ECM-ISC model). A structure equation model was built to test the hypotheses.
Among the 13 research hypotheses we proposed, 11 of them were supported. The results suggest that family caregivers' continuance intention of taking children with disabilities for rehabilitation services was associated with their continuance behavior. Satisfaction and self-efficacy were associated with continuance intention. Perceived rehabilitation benefit and expectation were associated with satisfaction. Expectation was associated with perceived rehabilitation benefit. Furthermore, we found that perceived rehabilitation benefit was positively associated with continuance behavior from three different paths, whereas expectation had an indirect correlation with continuance behavior via the sequential mediation variables of satisfaction and continuance intention. In addition, satisfaction and self-efficacy were found to have a significant indirect correlation with continuance behavior via continuance intention.
Based on these findings, improvements in perceived rehabilitation benefit, expectation, self-efficacy, satisfaction, and continuance intention are the important issues contributing to the enhancement of continuance utilization of rehabilitation services among children with disabilities.
残疾儿童康复服务的持续利用率并不理想。然而，对于影响康复服务是否持续的因素却知之甚少。因此，在中国对家庭照顾者样本进行了一项横断面研究，以探讨感知康复效益、期望、满意度、自我效能感、持续意愿和持续行为之间的关系。
通过便利抽样法，在中国上海和昆山的康复机构招募了368名残疾儿童的家庭照顾者。我们构建了一个驱动康复服务持续利用的研究模型，并基于期望不一致理论（EDT）和信息系统持续使用的扩展期望确认模型（扩展ECM-ISC模型）提出了13个研究假设。建立了结构方程模型来检验这些假设。
在我们提出的13个研究假设中，有11个得到了支持。结果表明，家庭照顾者带残疾儿童接受康复服务的持续意愿与其持续行为相关。满意度和自我效能感与持续意愿相关。感知康复效益和期望与满意度相关。期望与感知康复效益相关。此外，我们发现感知康复效益从三条不同路径与持续行为呈正相关，而期望通过满意度和持续意愿的顺序中介变量与持续行为存在间接关联。此外，发现满意度和自我效能感通过持续意愿与持续行为存在显著的间接关联。
基于这些发现，提高感知康复效益、期望、自我效能感、满意度和持续意愿是促进残疾儿童康复服务持续利用率提高的重要问题。
