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...
 
<ul><li>M county </li></ul><ul><li>21 townships, 500,000 residents  </li></ul><ul><li>11,000 people died  </li></ul><ul><l...
NHV Model NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Physiatricia...
NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital NHV Model
NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health ...
NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health ...
NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health ...
Demography data Injury classification Rehab needs Physical function Mental health Social integration NHV Model 2008 Baseli...
M  county VS A county S county VS VS NHV Model 2008 Baseline 2010 Follow-up
Medical outcome in M county—ADL
Medical outcome in M county—ADL
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 ...
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 ...
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...
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-3...
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-3...
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 count...
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 count...
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 count...
Economic outcome Average cost: 4,350 yuan
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...
5 Physiatricians 6 Physical Therapists 6 Rehabilitation Nurses 50 Patient Wards
 
Long term mechanism—cooperation in the future 3 years <ul><li>No-fee rehabilitation treatments for earthquake survivors an...
 
Based on the earthquake survivors government and non-government IBR and CBR
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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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Zhang a new institutional based rehab model after the sichuan eq in china crdr.disaster.symp.isprm11

  1. 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
  3. 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
  4. 5. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital NHV Model
  5. 6. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau NHV Model
  6. 7. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau Handicap International NHV Model
  7. 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
  8. 9. Demography data Injury classification Rehab needs Physical function Mental health Social integration NHV Model 2008 Baseline 2010 Follow-up M county
  9. 10. M county VS A county S county VS VS NHV Model 2008 Baseline 2010 Follow-up
  10. 11. Medical outcome in M county—ADL
  11. 12. Medical outcome in M county—ADL
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 21. Economic outcome Average cost: 4,350 yuan
  21. 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>
  22. 23. 5 Physiatricians 6 Physical Therapists 6 Rehabilitation Nurses 50 Patient Wards
  23. 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>
  24. 27. Based on the earthquake survivors government and non-government IBR and CBR

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