新疆维吾尔自治区南疆地区脑卒中康复适宜技术推广分析

• 作者： 杜玉英 ¹ 王彩玲 ² 崔森林 ³ 雷蕾 ⁴ 王艳萍 ⁵ 宋学琴 ⁶ 韩淑琴 ⁷ 张艳梅 ⁸ 王宝兰 ¹ 黄海霞 ¹ 陈祢 ¹ 严会荣 ¹ 李冬 ¹ 张晶晶 ¹ 任钰 ¹
• 作者单位：
  1.  830011 新疆维吾尔自治区乌鲁木齐市，新疆医科大学第一附属医院康复医学科

  2.  844700 新疆维吾尔自治区喀什地区莎车县人民医院康复医学科

  3.  844200 新疆维吾尔自治区喀什地区疏勒县人民医院康复医学科

  4.  845350 新疆维吾尔自治区克孜勒苏柯尔克孜自治州人民医院康复医学科

  5.  844999 新疆维吾尔自治区喀什地区叶城县人民医院康复医学科

  6.  844599 新疆维吾尔自治区喀 什地区英吉沙县人民医院康复医学科

  7.  844400 新疆维吾尔自治区喀什地区岳普湖县人民医院康复医学科

  8.  844207 新疆维吾尔自治区喀什地区麦盖提县人民医院康复医学科
• 提交时间：2023-06-08

摘要: 背景　 面向农村和城市社区推广卫生适宜技术，是提高基层医疗卫生机构技术水平和服务能力的重要措施，新疆医科大学第一附属医院在新疆维吾尔自治区南疆地区开展了卫生适宜技术推广工作。目的　 评价在新疆维吾尔自治区南疆地区推广脑卒中康复适宜技术的效果，了解新疆维吾尔自治区南疆地区康复工作人员对脑卒中康复适宜技术推广方式的需求情况及希望通过参加脑卒中康复适宜技术推广项目达成的目标，为卫生健康行政部门深入推进康复适宜技术推广工作提供依据。方法　 于2018年7月，采用多阶段抽样法，以新疆维吾尔自治区南疆地区8个深度贫困县为样本来源地，选取来自样本来源地8家人民医院康复医学科、各人民医院所辖乡镇卫生院和社区卫生服务中心的康复工作人员，以及残联、民政系统和其他康复机构的康复工作人员为研究对象，向其推广脑卒中康复适宜技术后，采用自设问卷对其进行调查。比较参加脑卒中康复适宜技术推广项目前（2018-01-01至2018-06-30）和参与后（2020-07-01至2020-12-31）人民医院康复医学科月均门诊量、住院量及治疗收入。结果　 于2018-07-15至2020-06-30开展脑卒中急性期、亚急性期、恢复期康复适宜技术，以及脑卒中社区和家庭康复适宜技术推广工作，推广的适宜技术涉及的内容包括运动功能康复训练、功能性电刺激、强制性运动疗法（CIMT）、镜像疗法、脑卒中患者吞咽障碍管理及康复训练、脑卒中患者日常生活活动能力训练及康复护理等。共回收有效问卷384份。384名康复工作人员中，63.3%（243/384）认为适宜技术在区（县）内推广、应用很有意义；46.1%（177/384）认为项目在当地非常适用；37.5%（144/384）认为所在医疗机构稍加完善相关条件即可开展此项技术；46.9%（180/384）认为此适宜技术推广项目在技能操作上的难易程度为容易；通过培训，42.2%（162/384）表示对此项技术有所了解，还需再学习和接受培训。参加脑卒中康复适宜技术推广项目后与参与前相比，人民医院康复医学科月均门诊量、月均治疗收入明显增高（P<0.05）。在脑卒中康复适宜技术推广方式方面，康复工作人员对实操培训的需求最高〔63.0%（242/384）〕，对教学查房的需求最低〔19.8%（76/384）〕。期望通过参加脑卒中康复适宜技术推广项目提高操作能力〔77.1%（296/384）〕、理论水平〔65.6%（252/384）〕者占比分别位居第1、2位。结论　 脑卒中康复适宜技术推广工作取得明显成效。南疆地区脑卒中患者康复需求巨大，而南疆地区整体的康复医疗服务能力远不能满足社会需求。可通过加强卫生适宜技术推广，鼓励康复工作人员参加进修、培训，积极开展远程医疗服务，加快推进医联体建设等一系列举措，切实提高南疆地区康复医疗水平。

Abstract: Background　Promoting appropriate health technology to rural and urban communities is an important measure to improve the technical level and service capacity of primary care institutions. The First Affiliated Hospital of Xinjiang Medical University carried out the promotion of appropriate health technology in southern Xinjiang of Xinjiang Uygur Autonomous. Objective　To evaluate the effect of appropriate technology promotion for stroke rehabilitation in Southern Xinjiang of Xinjiang Uygur Autonomous Region，understand the needs of rehabilitation workers in Southern Xinjiang of Xinjiang Uygur Autonomous Region for appropriate technology promotion for stroke rehabilitation and the goals they hope to achieve by participating in appropriate technology promotion for stroke rehabilitation projects，providing a basis for health administrative departments to implement appropriate rehabilitation technology promotion work. Methods　The rehabilitation workers from the rehabilitation medicine departments of 8 people's hospitals，affiliated township health centers and communities health centers，federation of the disabled，civil affairs system and other rehabilitation institutions in 8 deep poverty-stricken counties which were considered as sample source sites by using a multi-stage sampling method in July 2018. The appropriate technology promotion for stroke rehabilitation was performed followed by a investigation by using self-designed questionnaire. The monthly outpatient volume，hospitalization volume and treatment income of the rehabilitation medicine department of people's hospitals before（January 1，2018 to June 30，2018）and after participation（July 1，2020 to December 31，2020）in technology promotion for stroke rehabilitation projects were compared. Results　The appropriate technology promotion for stroke rehabilitation in acute，subacute and convalescent stages，as well as community and family rehabilitation of stroke was performed from January 1，2018 to June 30，2018，involving motor function rehabilitation training，functional electrical stimulation，mandatory exercise therapy techniques，constraint induced movement therapy（CIMT），mirror therapy，management and rehabilitation training of dysphagia，daily living activities training and rehabilitation care of stroke patient. A total of 384 valid questionnaires were collected. Among the 384 rehabilitation workers, 63.3%（243/384）identified the appropriate technology promotion within districts（counties）as very meaningful；46.1%（177/384）thought the project was very applicable in their local area；37.5%（144/384）believed that the technology for stroke rehabilitation can be carried out in their medical institutions with a slight improvement of the relevant conditions；46.9%（180/384）believed that the difficulty level of the appropriate technology promotion project was easy in terms of operation skills；after the training，42.2%（162/384）claimed to be knowledgeable about the technology and need to learn and receive further training. The monthly outpatient volume and monthly treatment income of the rehabilitation medicine department of people's hospitals after participating in stroke rehabilitation technology promotion projects increased significantly compared with before participation（P<0.05）. In terms of technology promotion for stroke rehabilitation，rehabilitation workers have the highest demand for practical training〔63.0%（242/384）〕，and the lowest demand for teaching rounds〔19.8%（76/384）〕. The percentages of workers who expected to improve operational ability〔77.1%（296/384）〕and theoretical level 〔65.6%（252/384）〕by participating in the appropriate technology promotion for stroke rehabilitation project ranked 1st and 2nd，respectively. Conclusion　The promotion work of appropriate technology for stroke rehabilitation has achieved significant results. At present，there is a huge demand for rehabilitation of stroke patients in southern Xinjiang，but the overall rehabilitation medical service capacity is far from meeting the social needs. A series of initiatives can be taken to effectively improve the level of rehabilitation therapy in southern Xinjiang，including strengthening the promotion of appropriate health technology，encouraging rehabilitation workers to participate in further education and training，actively carrying out telehealth services，and accelerating the construction of medical associations.

• 分类： 医学、药学 >> 预防医学与公共卫生学
• 引用： ChinaXiv:202306.00067 (或此版本 ChinaXiv:202306.00067V1)
  DOI:10.12114/j.issn.1007-9572.2022.0099
  CSTR:32003.36.ChinaXiv.202306.00067.V1
• 推荐引用方式： 杜玉英,王彩玲,崔森林,雷蕾,王艳萍,宋学琴,韩淑琴,张艳梅,王宝兰,黄海霞,陈祢,严会荣,李冬,张晶晶,任钰.(2023).新疆维吾尔自治区南疆地区脑卒中康复适宜技术推广分析.中国全科医学.doi:10.12114/j.issn.1007-9572.2022.0099 (点此复制)