UASSIGNED:(1)描述来自中国的脊髓损伤(SCI)患者所经历的环境障碍和参与限制,(2)检查病变特征和参与限制之间的关联,考虑到环境障碍的中介作用,(3)确定对参与影响最大的环境障碍。
未经评估:横断面研究。这项研究是国际脊髓损伤调查(InSCI)的一部分。
未经批准:社区,江苏省和四川省,中国。
未经批准:SCI1355人。
UNASSIGNED:不适用。
UNASSIGNED:参与限制是根据模型残疾调查中的项目进行测量的,环境壁垒是用Nottwil环境因素清单简表测量的。
UNASSIGNED:参与者经历了五个(IQR1-9)环境障碍和五个(IQR0-9)参与限制的中位数。报告的环境障碍主要与气候有关,资源和可访问性不足,参与限制主要发生在使用公共交通工具上,照顾别人,和到达的地方。在调整后的零膨胀泊松模型中,严重损伤患者报告了更多的环境障碍(完全损伤:IRR=1.31,95CI=[1.24,1.38])和参与限制(四肢瘫痪:IRR=1.15,95CI=[1.10,1.21];完全损伤:IRR=1.25,95CI=[1.18,1.31]).此外,环境障碍(IRR=1.07,95CI=[1.06,1.08])是参与限制的重要预测因子,部分介导了病变完整性与参与限制的关联.与公共场所无障碍相关的障碍(IRR=1.47,95CI=[1.33,1.62]),访问房屋(IRR=1.32,95CI=[1.21,1.44]),长途运输(IRR=1.11,95CI=[1.04,1.20]),通信设备(IRR=1.07,95CI=[1.01,1.15])和国家服务(IRR=1.10,95CI=[1.02,1.19])对参与的负面影响最大。
未经评估:在中国,SCI患者的社会参与受到严重限制。消除环境障碍将是解决这一问题的计划的重要组成部分。
(1) to describe environmental barriers and participation restrictions experienced by people with spinal cord injury (SCI) from
China, (2) to examine associations between lesion characteristics and participation restrictions, considering a mediating role of environmental barriers, (3) to identify those environmental barriers that have the largest influence on participation.
Cross-sectional study. This study is part of the International Spinal Cord Injury Survey (InSCI).
Community, Jiangsu and Sichuan Province,
China.
1355 persons with SCI.
Not applicable.
Participation restrictions were measured with items from the Model Disability Survey, Environmental Barriers were measured with the Nottwil Environmental Factors Inventory-Short Form.
Participants experienced a median of five (IQR 1-9) environmental barriers and five (IQR 0-9) participation restrictions. Environmental barriers were mainly reported in relation to climate, insufficient resources and accessibility, and participation restrictions mainly occurred in using public transportation, taking care of others, and getting to places. In an adjusted zero-inflated Poisson model, people with more severe injuries reported a greater number of environmental barriers (complete injury: IRR = 1.31, 95%CI = [1.24,1.38]) and participation restrictions (tetraplegia: IRR = 1.15, 95%CI = [1.10,1.21]; complete injury: IRR = 1.25, 95%CI = [1.18,1.31]). Moreover, environmental barriers (IRR = 1.07, 95%CI = [1.06,1.08]) were a significant predictor of participation restrictions and partially mediated the association of lesion completeness with participation restrictions. Barriers related to accessibility of public places (IRR = 1.47, 95%CI = [1.33,1.62]), accessing homes (IRR = 1.32, 95%CI = [1.21,1.44]), long distance transportation (IRR = 1.11, 95%CI = [1.04,1.20]), communication devices (IRR = 1.07, 95%CI = [1.01,1.15]) and state services (IRR = 1.10, 95%CI = [1.02,1.19]) had the greatest negative impact on participation.
Social participation of people with SCI is seriously restricted in
China. Removing environmental barriers will be an important element of programs to address this problem.