Zhongguo quanke yixue (Sep 2023)
Analysis of Appropriate Technology Promotion for Stroke Rehabilitation in Southern Xinjiang
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. Objective To evaluate the effect of appropriate technology promotion for stroke rehabilitation in southern Xinjiang, understand the needs of rehabilitation workers in southern Xinjiang 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.
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