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ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.
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ObjectiveTo systematically analyze the typical mental health conditions and psychological disorders of children with intellectual and developmental disabilities (IDD), to construct a mental health service system and psychological interventions to these mental health conditions of children with IDD . MethodsBased on the framework of the World Health Organization Family International Classifications (WHO-FICs), the mental health conditions and related functioning were analyzed, and the mental health service framework and proposed mental health interventions were constructed.There were six main categories of mental health conditions for children with IDDConclusionThis study systematically analyzed the typical mental health status and related psychological functional impairments of children with IDD. Based on the World Health Organization health service system, a mental health service framework for children with IDD was constructed. Referring to the WHO's continuum of health services, a system of psychological intervention methods for children with IDD was established. Furthermore, the WHO-FICs were used to describe and code the functions of children with IDD, and the ICHI-β3 was applied to code and analyze the related psychological interventions. Resultsmood disorders (anxiety and depression), behavioral disorders (disruptive disorders and challenging behaviors, aggressive behaviors), traumatic disorders (post-traumatic stress disorder), mental disorders (schizophrenia), suicide and self-harm, and learning disabilities (developmental learning disabilities, attention deficit hyperactivity disorder). Mental health services for children with IDD involved in six dimensions: leadership and governance, fundraising, human resources, service delivery, mental health technologies, and information and research. Mental health services went through the continuum of health services from prevention, treatment, rehabilitation to health promotion. We delivered mental health services for children with IDD in three aspects: identifying and diagnosing mental health problems or conditions, analyzing the main factors caused mental health problems, and analyzing the environmental factors. Mental health service interventions mainly covered five categories: antidepressants, psychotherapy, stress management training, physical exercise training, healthy lifestyle education, consultation and support. Children with IDD may obtain the mental health services in hospitals, rehabilitation institutions, community and school settings.
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ObjectiveTo investigate rehabilitation competence among trainers and trainees whom participated in the training program entitled National Training Program of Shortage Rehabilitation Physicians (NTPSRP) using World Health Organization rehabilitation competency framework (RCF). MethodsBased on RCF, a questionnaire was developed and administrated through network using Questionnaire Star. All the trainers and trainees who participated in NTPSRP were investigated in September, 2023. ResultsA total of 911 subjects were collected from 27 provinces, including 426 trainers (teachers) and 485 trainees (students). The average age of the teachers was older, with more years of work experience and professional experience in rehabilitation medicine. The degree and professional title of the teachers was also higher. The overall internal consistency reliability of the questionnaire was good (Cronbach's α = 0.988), and all the internal consistency reliability in five fields was good (Cronbach's α > 0.9). The five dimensional structure of RCF in the results was consistent with the prior model established by RCF theory. The self-ratings of all physicians in the five fields were higher than the median level, and was higher in the teachers than in the students [(3.42±0.68) vs. (2.73±0.80), P < 0.001]. Gender and years of experience in rehabilitation medicine were independent factors for the total score of the questionnaire. The total self-rating of female students was 9.65 points lower than that of the male (95%CI 4.386 to 14.914); and one more year in rehabilitation medicine would increase 1.78 points in self-rating (95%CI 1.140 to 2.419). ConclusionThe structure and content of RCF can be used to evaluate the competence of rehabilitation physicians. The teachers and students of NTPSRP are eligible to RCF. RCF-based evaluation can be used to guide the development of continuing education courses for rehabilitation professionals.
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ObjectiveTo systematically analyze the application of World Health Organization rehabilitation competency framework (RCF) and its supporting guidelines in education system of rehabilitation science and curriculum development. MethodsBased on the conceptual framework of RCF and its supporting guidelines, the application of its areas and the modes were analyzed to construct the education system of rehabilitation science with reference to the framework of competency-based clinical medical education. ResultsThe education system of rehabilitation science was developed based on RCF. The competences for specific scenarios in rehabilitation were defined and investigated. A structured system of vocational qualification accreditation and occupational competency standards was constructed, as well as core education system and rehabilitation curricula in rehabilitation science, which helped to train competent rehabilitation workers. ConclusionThe construction of rehabilitation subspecialties, its education system and the development of a curriculum content system based on the RCF is an important way for the development of modern rehabilitation education. RCF theoretical framework and supporting tools provide a standardized and unified method and way for China's rehabilitation science higher education system and professional certification, career access and professional standards for rehabilitation personnel. The quality of rehabilitation science education and the professional development of rehabilitation personnel will also be improved in future.
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@#Objective To discuss the paradigm and contents of rehabilitation psychology using bio-psycho-social model of functioning, disability and health of International Classification of Functioning, Disability and Health (ICF). Methods In perspectives of rehabilitation sciences and psychological sciences, paradigm and contents of modern rehabilitation psychology with the functioning framework of ICF were constructed in accordance with the development of modern rehabilitation science. Results A holistic rehabilitation model was constructed based on ICF, involving the body, mind and environment. Based on the functional model of ICF, the main contents of modern rehabilitation psychology were not only related to the function and structure of the body, but also related to the activities and participation, and emphasized the interaction with environment. The modern rehabilitation psychology would not only research about the physical dysfunction, but also the intervention of activity and environment. Based on ICF, common terminology and coding methods might be used to enable rehabilitation psychologists to communicate with relevant professionals in the multidisciplinary and interdisciplinary field of rehabilitation. Conclusion Constructing the theoretical framework and research paradigm of modern rehabilitation psychology based on ICF can form the system of rehabilitation psychology integrated with psychological science and rehabilitation science.
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@#Objective To systematically research the policies and core contents of World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) documents on policies, guidelines and standards for health-promoting schools and health services. Methods These policy documents included Making Every School a Health-promoting School: Implementation Guidelines, WHO Guidelines on School Health Services, and Making Every School a Health Promoting School Global Standards and Indicators, which construct a conceptual and policies framework for health-promoting schools. In perspective of health service system, this study systematically explored the policies, guidelines and standards of WHO and UNESCO on health-promoting schools and health services, as well as the role of health-promoting school component systems in promoting the health of children and how physical activity can be an important area of health-promoting schools. Results The Health Promoting Schools Initiative is an important area of research for the WHO health services. Making Every School a Health-promoting School: Implementation Guidelines primarily serves students aged five to 19, teachers and other staff in schools. WHO Guidelines on School Health Services cover a variety of activity types including health promotion, health education, preventive interventions, clinical assessment and health services management. Making Every School a Health Promoting School Global Standards and Indicators covers eight global criteria and thirteen specific areas in the areas of policy resources, curriculum and environment, and community engagement. Conclusion WHO and UNESCO have proposed a series of policies related to building health-promoting schools, which focus on child health and advocate the promotion of child and adolescent health, public health, education, social and economic development through schools to achieve the goal of safeguarding the health rights of children and adolescents and meeting health needs. Following the WHO Guidelines on School Health Services and Making Every School a Health Promoting School Global Standards and Indicators, it proposed to incorporate educational and physical education tools into the school health service system.
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@#Objective To systematically analyze the World Health Organization Rehabilitation Competency Framework (RCF) theoretical framework, methodology and its application in the field of rehabilitation.Methods We systematically analyzed RCF conceptual framework and key characteristics, and discussed how to apply the RCF in the fields of human resource planning, education program and curriculum system, and vocational competency standards and certification criteria for rehabilitation human resources.Results The RCF encompasses five domains, naming practice, professionalism, learning and development, management and leadership, and research. Rehabilitation professionals' performance is the result of the interaction of their core values and beliefs, competencies, activities, knowledge, and skills. The RCF can be used to plan rehabilitation human resources, establish competency-based rehabilitation education programs and curriculum systems, and develop competency certification standards and licensure accreditation standards.Conclusion This study analyzed background, content and implementation framework of RCF, and systematically discussed the theories and methods related to how to use the RCF to construct national rehabilitation human resources development plans, develop rehabilitation education programs and curriculum systems based on the RCF, and establish certification and assessment standards for rehabilitation human resources.
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@#Objective To analyze theoretical frameworks, definitions, terminology and measurements of disability using International Classification of Functioning, Disability and Health (ICF), and United Nations Convention on the Rights of Persons with Disabilities (CRPD), to provide a scientific basis for developing definition, classification and measurements to meet international standards.Methods Content analysis had been conducted for the definitions and measurements of disability issued by international organizations using the ICF terminology and code and the definitions of disability and people with disability by CRPD.Results The core concepts and content had been reviewed using the ICF terminology and code, and the definitions of disability and people with disability by CRPD. The contents of definitions of disability proposed by international organizations cover all components of ICF. The contents of standardized disability measurements issued by United Nations or World Health Organization cover all components of ICF and map to CRPD definitions of disability and people with disability as the framework, classification, terminology and coding system had been adopted for the development.Conclusion The definition and measurements had been developed using ICF and CRPD framework, terminology, and coding system of disability. The framework and standard of disability had been constructed. The standard of disability data will implement in the fields of health, rehabilitation, education, employment, community and social services for people with disability to promote data exchange across sectors.
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@#Objective To establish theoretical framework, content, and standard of disability data using International Classification of Functioning, Disability and Health (ICF). Methods The structure and content of the Disability Survey Project Form by Washington Group on Disability Statistics, World Health Organization Disability Assessment Schedule 2.0, Model Disability Survey developed by World Health Organization and ICF Core Set (General) were analyzed with ICF categories and coding. Results The sturcture and contents of disability measurements has been developed and analysed using ICF.Conclusion The framework, content and data standard had been developed.
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@#As a standard framework of disability definition and measurement, International Classification of Functioning, Disability and Health (ICF) is widely used in disability statistics. This paper reviewed the progress of international disability statistics based on ICF in the fields of disability measurement tools and disability surveys. There were many disability measurement tools have been developed and applied. These promote international disability statistics and disability statistics system. The disability statistics in China was analyzed and three recommendations were put forward.
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@#Objective To develop a framework and indicators system for disability-related service data in China. Methods Using International Classification of Functioning, Disability and Health (ICF) framework and approach, the framework and indicators system were developed using content analysis, logical reasoning and expert consultation. Results A system with nine aspects, 35 dimensions and 115 indicators was established. Eleven experts with disability-related background all accepted the system, and satisfied in the importance and operability.Conclusion A data framework and indicators system with nine aspects, 35 dimensions and 115 indicators has been established for disability-related service, which can be used in further data collection.
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@#This paper reviewed international documents of disability statistics. The results showed that all disability measurements had been adopted International Classification of Functioning, Disability and Health (ICF) terminology and approach. Disability statistics in US tailored to ICF framework and classification. Disability statistics in China had partially adopted ICF approach.
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@#Objective To analyzes the situation and influential factors of participation in physical activities for the people with disabilities. Methods The Administration Data of 2017 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed. Results There were 4% of the people with disabilities participation in physical activities. The main reasons for failing participation in physical activity included lack of suitable events, inadequate places and facilities, incomplete organization and guidance, and lack of family and social support. The participation in physical activities was influenced by factors as genders, ages, types of disability, grades of disability and household registration (P < 0.05). Conclusion The rate of participation of physical activity is low and the factors of gender, age, category and severity of disabilities may influence on it.
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@#Objective To investigate the needs and service of rehabilitation status of the people with intellectual disability, to support rehabilitation service for them. Methods A total of 167,872 cases with intellectual disability from the Administration Data of 2017 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed and rehabilitation needs included medical service and support, assistive productions, and rehabilitation training. Results 56.4% of the people with intellectual disability reported their rehabilitation needs. The rehabilitation needs were different with their ages, levels of disability and household registration (χ2 > 976.42, P < 0.001). Only 19.0% of the people with intellectual disability accessed rehabilitation services, and the influential factors included demographic variables, family economic status, transportation, knowledge and information, etc. Conclusion There are huge needs of rehabilitation services for the people with intellectual disability needed to be tailored. It is necessary to increase the supply of rehabilitation services using approach of precise rehabilitation, and improve the quality of rehabilitation services.
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@#Objective To investigate the needs and service of rehabilitation for people with psychatric disability and influential factors to support the development of rehabilitation services for them. Methods The Administration Data of 2016 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed. Results The people with psychatric disability reported rehabilitation needs in mainly the medical rehabilitation, functional training and assistive products. The highest rate of need was medical rehabilitation (58.99%) and the lowest need was functional training (10.08%). There were significant differences in the rehabilitation needs for the people with psychiatric disability in ages, genders, household registration, levels of disability, levels of education, employment, household income, poverty and registration of poverty. Rehabilitation services for the people with psychiatric disability included medical rehabilitation services, functional training services and assistive products services. The reported rate of access was medical rehabilitation services (25.82%, highest), and the assistive products services (3.06%, lowest ). There were significant differences in rate of access in their household registration, levels of disability, levels of education, employment, household income, poverty and registration of poverty. Furthermore, family in poverty, lack of knowledge, traffic inconvenience and other factors also influenced the access of rehabilitation services for the people with psychiatric disability. Conclusion The needs of rehabilitation is high for people with psychiatric disability, especially in the field of medical rehabilitation. There were factors influencing the access of rehabilitation, including genders, household registration, and levels of disability, etc. The access rate of rehabilitation is low, including the medical rehabilitation. There were other influential factors including family economic status and transportation. It is proposed to improve the reported rate of rehabilitation needs, and the coverage, quality and efficiency of rehabilitation services for people with psychiatric disability.
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@#Objective To analyze the development of community-based sport and rehabilitation for people with disabilities with the policy of Healthy China 2030, and then make political recommendation. Methods Policies and theories related to Healthy China 2030 and community-based services had been discussed. The data of community-based rehabilitation from China Disabled Persons' Federation statistics from 2011 to 2017 were analyzed. Results The policies background for community-based sport for people with disabilities developed with the development and implementation of Healthy China 2030, National Fitness Program and other related work programs during the Thirteenth Five-Year Plan Period. More and more people with disabilities participated in the community-based exercise. The facilities of community-based physical activity for people with disabilities improved continuously. The fitness guidance for the people with disabilities became more standardized. Conclusion Community-based physical activity and sport for people with disabilities should be developed based on the framework of Healthy China 2030, with the implementation of National Fitness Program (2016-2020) and Plan for the Disabled Culture and Sports Work during Thirteenth Five-Year Plan Period and so on, and implement Community-Based Rehabilitation Guidelines. It is important not only to increase the enthusiasm and participation, but also to provide good physical guidances, facilities and environment. It is proposed to integrate community-based sport and community-based rehabilitation, and to build a public service system for people with disabilities within the community.
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@#Objective To investigate the developmental characteristics of static visual acuity (SVA) and kinetic visual acuity (KVA) and the correlation between the for children. Methods From April to June, 2018, SVA and KVA of 715 children aged 6 to 10 years in Suzhou were tested with logarithmic visual chart and KVA meter. Results KVA and SVA increased with age within 6 to 9 years old, and decreased then. KVA was higher in boys than in girls (t = 4.604, P < 0.001), but not significantly different for SVA (t = 1.822, P > 0.05). There was a moderate positive correlation between KVA and SVA (r = 0.552, P < 0.01). KVA can predicted SVA (B = 0.617, P < 0.001). Conclusion KVA and SVA develop for children aged 6 to 9, and moderately positive correlate with each other. It means SVA may be improved via training of KVA.
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@#Objective To explore Rehabilitation 2030: international policy and development. Methods Literature review and policy research were used. Results This article analyzed the relationship between Rehabilitation 2030 and United Nation Sustainable Development Goals 2030 (SDGs), especially Goal 3, explained the significance of rehabilitation to implementation of the Convention on the Rights of Persons with Disabilities (CRPD), discussed Rehabilitation 2030 actions in awarenessraising, promotion of universal health coverage and accessibility of rehabilitation, development of governance of rehabilitation to enhance the quality and reduce the expense of rehabilitation, and construction of health information system inclusive to data of functioning and disability, and improvement of research of disability and rehabilitation using International Classification of Functioning, Disability and Health (ICF) model. Conclusion SDGs can be reached by actions of Rehabilitation 2030.
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@#This paper discussed the gap between the unmet needs and services of rehabilitation at global level and advocated implementation of "WHO Global Disability Action Plan 2014-2021". The following recommendations had been made: expanding coverage, improving quality, enhancing monitoring, and integrating data of functioning and disability, and rehabilitation into national health information system. It is important to develop rehabilitation to meet clients' rehabilitation needs to promote realization of the United Nations Sustainable Development Goals 2030 (SDGs).
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@#Identification, measure and metrics of functioning, disability and health data has been developed using ICF approach to construct national information framework and health data systems of functioning, disability and health. This framework and system make countries' data comparable. It is useful to monitor the quality of rehabilitation services and develop services for people with disabilities as recommended by World Health Organization Guideline: Rehabilitation in Health Systems.