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Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11
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Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11

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  • 1. 中期考核 研究生:朱杰 导师 :励建安 教授 A new institutional based rehabilitation model after the Sichuan earthquake in China Xia Zhang, MD, PhD candidate Mentor: Jianan Li Nanjing Medical University, Nanjing, China Caring For Children Foundation, Hongkong, China
  • 2.  
  • 3. <ul><li>M county </li></ul><ul><li>21 townships, 500,000 residents </li></ul><ul><li>11,000 people died </li></ul><ul><li>60 KM to the epicenter </li></ul><ul><li>Mountainous area </li></ul>Baseline: on site investigation in M, S and J county in 2008 Follow-up: Re-evaluation in M, S and A county in 2010 IBR, CBR, surgery and training programs
  • 4. NHV Model NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Physiatrician PT/Nurse Rehab equipment Earthquake Survivors Cooperation in NGOs, Health departments and rehabilitation Volunteers
  • 5. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital NHV Model
  • 6. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau NHV Model
  • 7. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau Handicap International NHV Model
  • 8. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau Handicap International Disabled Person’s Federation NHV Model
  • 9. Demography data Injury classification Rehab needs Physical function Mental health Social integration NHV Model 2008 Baseline 2010 Follow-up M county
  • 10. M county VS A county S county VS VS NHV Model 2008 Baseline 2010 Follow-up
  • 11. Medical outcome in M county—ADL
  • 12. Medical outcome in M county—ADL
  • 13. Functional recovery in SCIs 0.127 -1.58 344±80.8 322±87.0 CHART 0.039 -2.18 35.9±8.2 39.2 ±8.0 PTSD 0.011 -1.66 71.4±10.2 68.3±12 WHOQOL 0.000 -5.01 9.6±8.2 5.8±7.0 WSCI II walking index 0.002 -3.37 81.9±18.7 71.2±25.8 ADL SCI P value Paired t test Follow-up Baseline Outcome Diagnosis
  • 14. Functional recovery in SCIs 0.127 -1.58 344±80.8 322±87.0 CHART 0.039 -2.18 35.9±8.2 39.2 ±8.0 PTSD 0.011 -1.66 71.4±10.2 68.3±12 WHOQOL 0.000 -5.01 9.6±8.2 5.8±7.0 WSCI II walking index 0.002 -3.37 81.9±18.7 71.2±25.8 ADL SCI P value Paired t test Follow-up Baseline Outcome Diagnosis
  • 15. Comparison between M-S county and M-A county M county S county A county ADL 91.1±10.5 87.3±16.5 91.2±11.8 LSQ 55.7±16.5 33.6±9.80 50.0±9.86 SF-36 54.9±16.1 51.9±13.1 54.9±16.8 PCL-C 34.2±10.6 39.3±9.43 33.6±9.80
  • 16. Comparison in M-A county Mianzhu Shifang Anxian P ADL 91.1±10.5 42.1±46.3 93.3±14.2 LSQ 47.3±9.65 50.3±9.53 44.8±8.26 SF-36 54.9±16.1 51.9±13.1 54.9±16.8 PTSD 35.6±10.0 34.3±10.1 39.3±9.60 M county S county A county P ADL 91.1±10.5 87.3±16.5 91.2±11.8 0.113 LSQ 55.7±16.5 33.6±9.80 50.0±9.86 0.068 SF-36 54.9±16.1 51.9±13.1 54.9±16.8 0.172 PCL-C 34.2±10.6 39.3±9.43 33.6±9.80 0.603
  • 17. Comparison in M-S county Mianzhu Shifang Anxian P ADL 91.1±10.5 42.1±46.3 93.3±14.2 LSQ 47.3±9.65 50.3±9.53 44.8±8.26 SF-36 54.9±16.1 51.9±13.1 54.9±16.8 PTSD 35.6±10.0 34.3±10.1 39.3±9.60 M county S county A county P ADL 91.1±10.5 87.3±16.5 91.2±11.8 0.003 LSQ 55.7±16.5 33.6±9.80 50.0±9.86 0.002 SF-36 54.9±16.1 51.9±13.1 54.9±16.8 0.027 PTSD 34.2±10.6 39.3±9.43 33.6±9.80 0.000
  • 18. Economic outcome-average cost 1696 Total 858 191 647 132 P county 130 D county 67 35 92 J county 24 81 Z county 70 B county 226 3 97 A county 303 59 377 M county Surgery Outpatient Inpatient Site
  • 19. Economic outcome-average cost 1696 Total 858 191 647 132 P county 130 D county 67 35 92 J county 24 81 Z county 70 B county 226 3 97 A county 303 59 377 M county Surgery Outpatient Inpatient Site
  • 20. Economic outcome-average cost 1696 Total 858 191 647 132 P county 130 D county 67 35 92 J county 24 81 Z county 70 B county 226 3 97 A county 303 59 377 M county Surgery Outpatient Inpatient Site
  • 21. Economic outcome Average cost: 4,350 yuan
  • 22. Research outcome 地震伤员康复需求调查报告 2011-01-08 <ul><li>张霞,卞荣,励建安等;四川江油地震伤员康复状况分析;中国康复医学杂志; 2009,24 ( 1 ): 5-8. </li></ul><ul><li>刘守国,艾金飞,张霞,励建安等;四川省北川中学地震伤员康复状况调查分析;中国康复医学杂志; 2009,24 ( 8 ): 680-3. </li></ul><ul><li>肖明月,刘守国,张霞,励建安等;绵竹地震伤员职业需求康复现状的调查与分析 ;中华物理医学与康复杂志; 2010 ( 11 ): 657-658. </li></ul><ul><li>李勇强,励建安,张霞等;四川地震脊髓损伤康复医疗状况分析;中华物理医学与康复杂志; 2010 ( 10 ): 488-492. </li></ul><ul><li>肖明月,刘守国,励建安,张霞等;绵竹地震胫腓骨骨折伤员功能恢复的影响因素分析;中国康复医学杂志; 2011 年 1 月发表 </li></ul><ul><li>刘守国,励建安,王红星,张霞等;四川绵竹地震伤员社区康复需求调查;中华物理医学与康复杂志;已收稿; </li></ul><ul><li>陈思婧,张霞,励建安等;绵竹脊髓损伤地震伤员生存质量和抑郁状态分析;中华物理医学与康复; </li></ul><ul><li>李咏雪,张霞,励建安等;地震骨折伤员慢性疼痛的相关因素及与生存质量的关系;中华物理医学与康复,已收稿; </li></ul><ul><li>张霞,陈思婧,胡筱蓉,励建安等;医疗康复对四肢骨不连地震伤员生活质量的影响;中华物理医学与康复;已投稿; </li></ul><ul><li>胡筱蓉,张霞,励建安等;四川绵竹脊髓损伤伤员回归社区后功能变化; </li></ul><ul><li>Yongqiang Li, Yin Liu, Sijing Chen, Xia Zhang, Jianan Li; Outcome of medical rehabilitation for 51 Sichuan earthquake victims with SCI; Spinal; </li></ul><ul><li>Mingyue Xiao, Jianan Li, Xia Zhang; Factors affecting functional outcome of Sichuan earthquake survivors with tibial shaft fractures: a follow-up study; Journal of Rehabilitation Medicine. </li></ul>
  • 23. 5 Physiatricians 6 Physical Therapists 6 Rehabilitation Nurses 50 Patient Wards
  • 24.  
  • 25. Long term mechanism—cooperation in the future 3 years <ul><li>No-fee rehabilitation treatments for earthquake survivors and low-income patients </li></ul><ul><li>Capacity building of MZ hospital </li></ul><ul><li>CBR programs for MZ earthquake survivors </li></ul>
  • 26.  
  • 27. Based on the earthquake survivors government and non-government IBR and CBR

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