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马来西亚社区脊髓损伤患者医疗服务利用情况及服务满意度的路径分析

A path analysis of the healthcare utilization and services satisfaction among community-dwelling individuals with spinal cord injury in Malaysia.

作者信息

Zainudin Muhamad F, Hashim Natiara M, Zohdi Wan N W M, Hasnan Nazirah, Engkasan Julia P

机构信息

Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.

Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.

出版信息

J Rehabil Med. 2025 Feb 25;57:jrm40621. doi: 10.2340/jrm.v57.40621.

Abstract

PURPOSE

To explore healthcare utilization patterns and healthcare services satisfaction among individuals with spinal cord injury in Malaysia.

METHODS

This cross-sectional study utilized the International Spinal Cord Injury (InSCI) Community Survey and involved 8 hospitals and 1 spinal cord injury organization. A total of 285 participants met the inclusion criteria. Subsequently, 6/11 sections of the InSCI questionnaire were analysed through a path analysis.

RESULTS

The 3 most utilized healthcare providers reported were physical and rehabilitation medicine specialists (76.5%), physiotherapists (36.8%), and primary care physicians (27.4%). The top 3 most severe health problems reported were sexual dysfunction, muscle spasm and spasticity, and contractures. Healthcare services satisfaction was high. Health problems predicted healthcare utilization (β = 0.443), while activity limitation and participation restriction predicted healthcare services satisfaction (β = -0.202). The activity limitation and participation restriction in male participants was moderated by the spinal cord injury severity (B = 2.330, p  <  0.001) and health problems (B = 0.550, p < 0.001).

CONCLUSIONS

Individuals with spinal cord injury in Malaysia rely heavily on physical and rehabilitation medicine specialists, highlighting accessibility challenges due to the centralized specialized rehabilitation services. Sexual dysfunction remains a significant yet under-addressed health concern. Despite these issues, satisfaction with healthcare services is high.

摘要

目的

探讨马来西亚脊髓损伤患者的医疗服务利用模式及对医疗服务的满意度。

方法

本横断面研究采用国际脊髓损伤(InSCI)社区调查问卷,涉及8家医院和1个脊髓损伤组织。共有285名参与者符合纳入标准。随后,通过路径分析对InSCI问卷的6/11部分进行了分析。

结果

报告使用最多的3类医疗服务提供者为物理和康复医学专家(76.5%)、物理治疗师(36.8%)和初级保健医生(27.4%)。报告的最严重的3个健康问题为性功能障碍、肌肉痉挛和挛缩。对医疗服务的满意度较高。健康问题可预测医疗服务利用情况(β = 0.443),而活动受限和参与受限可预测对医疗服务的满意度(β = -0.202)。男性参与者的活动受限和参与受限受脊髓损伤严重程度(B = 2.330,p < 0.001)和健康问题(B = 0.550,p < 0.001)的调节。

结论

马来西亚的脊髓损伤患者严重依赖物理和康复医学专家,这凸显了由于集中式专业康复服务而导致的可及性挑战。性功能障碍仍然是一个重大但未得到充分解决的健康问题。尽管存在这些问题,但对医疗服务的满意度较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b943/11877857/ccd3be136282/JRM-57-40621-g001.jpg

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