对乌克兰与战争相关的康复需求和差距的定性评估。
A qualitative assessment of war-related rehabilitation needs and gaps in Ukraine.
作者信息
Lawry Lynn Lieberman, Korona-Bailey Jessica, Hamm Tiffany E, Maddox John, Janvrin Miranda, Juman Luke, Berezyuk Oleh, Smolinski George, Brim William, Koehlmoos Tracey Perez
机构信息
Uniformed Services University, 4301 Jones Bridge Rd, Bethesda, MD, 20814-4799, USA.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Bethesda, MD, 20817, USA.
出版信息
J Health Popul Nutr. 2025 May 29;44(1):175. doi: 10.1186/s41043-025-00912-4.
BACKGROUND
Ukraine's Ministry of Health formally recognized rehabilitation as an essential component of universal health coverage in 2020. However, services remain fragmented and under-resourced, particularly following the full-scale invasion by the Russian Federation in February 2022. Widespread injuries due to trench warfare, drones, and large-scale ground combat have placed unprecedented strain on the Ukrainian trauma and rehabilitation systems, which continue to lack a cohesive national strategy. This study aimed to (1) assess the trauma and rehabilitation system in Ukraine during the ongoing conflict; (2) identify current needs, gaps, and opportunities for strengthening rehabilitation services; and (3) inform national and international stakeholders-including the United States and NATO-about urgent priorities to support Ukraine's rehabilitation infrastructure, reintegration pathways, and gender-sensitive care delivery.
METHODS
We conducted 36 qualitative key informant interviews across all NATO levels of care using an adapted Global Trauma System Evaluation Tool. Thematic analysis focused on rehabilitation-related domains.
RESULTS
Respondents highlighted shortages in staff, equipment, and mental health integration. Rehabilitation remains unevenly implemented, with better access for military versus civilian patients. Care for survivors of conflict-related sexual violence and support for women's equitable access were consistently cited gaps.
CONCLUSIONS
Ukraine's growing burden of war-related injuries necessitates urgent investment in a coordinated national rehabilitation strategy. Priorities include workforce development, equipment supply, mental health integration, and inclusive care models that address the needs of women and conflict related sexual violence survivors. Evidence-based rehabilitation, supported by validated training for clinicians, is essential for long-term recovery, societal reintegration, and national resilience.
背景
乌克兰卫生部于2020年正式承认康复是全民健康覆盖的重要组成部分。然而，服务仍然分散且资源不足，特别是在2022年2月俄罗斯联邦全面入侵之后。堑壕战、无人机和大规模地面战斗造成的广泛伤害给乌克兰的创伤和康复系统带来了前所未有的压力，该系统仍然缺乏一个连贯的国家战略。本研究旨在：（1）评估冲突期间乌克兰的创伤和康复系统；（2）确定加强康复服务的当前需求、差距和机会；（3）向包括美国和北约在内的国家和国际利益相关者通报支持乌克兰康复基础设施、重新融入社会途径和性别敏感护理服务的紧迫优先事项。
方法
我们使用经过改编的全球创伤系统评估工具，在北约所有护理层面进行了36次定性关键 informant访谈。主题分析集中在与康复相关的领域。
结果
受访者强调了人员、设备和心理健康整合方面的短缺。康复的实施仍然不均衡，军事患者比平民患者更容易获得康复服务。与冲突相关的性暴力幸存者的护理以及对妇女平等获得服务的支持一直被认为是差距所在。
结论
乌克兰与战争相关的伤病负担日益加重，因此需要紧急投资制定一项协调一致的国家康复战略。优先事项包括劳动力发展、设备供应、心理健康整合以及满足妇女和与冲突相关的性暴力幸存者需求的包容性护理模式。在经过验证的临床医生培训支持下的循证康复对于长期康复、社会重新融入和国家复原力至关重要。
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