RÉSUMÉ
@#Objective To investigate the psychological status of leprosy people with disability and their expectation towards surgical outcomes before surgical operation.Methods 937 cases from nine provinces，which were covered by the China National Commonweal funded surgical camps, were surveyed by a structure questionnaire designed by the Department of Leprosy Control and Rehabilitation, Institute of Dermatology, the Chinese Academy of Medical Sciences (CAMS).Results Reasons for the patients to refuse the surgical operation included concerns in medical cost (79.19%), unawareness of the free medical surgery program (64.78%), scaring of surgery (48.88%), unwilling to expose their disabilities (46.43%), unwilling to expose their history of leprosy (45.57%), despairing with disability (43.86%), having no ideas on surgical Results (37.46%), believing that disability is an inevitable outcome of the disease (32.98%), and rejecting the operation becasue of age(30.63%). More than 90% of PALs who are willing to accept surgery expected that surgery can improve their physical ability and they may contribute more to their family or become less independent after surgery; however, they thought there was little opportunity to return to work after surgery.Conclusion It is helpful and necessary to understand the psychological status of the leprosy people with disability before surgery.
RÉSUMÉ
@#ObjectiveTo determine the rehabilitation awareness and needs in patients with disability due to leprosy.Methods4353 patients in 23 fields of 7 provinces were surveyed by interview and questionnaire.Results80% of patients knew general knowledge of disability prevention and rehabilitation, and believed that the self-care could prevent disability; but they seldom carried out the daily self-care practice.90% of patients lacked awareness in early manifestation of leprosy, treatment of the disease, basic cause of disability, and the way to prevent such as plantar ulcers. For needs of rehabilitation education, teaching by medical staff(86%), booklet(81%), video tape(70%) and recording(52%) had been selected.ConclusionThe awareness of rehabilitation and the practice must be combined together. Rehabilitation education should be carried out in advance systemically through different ways.
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@#ObjectiveTo approach the status of leprosy disabilities in newly detected cases in recent 11 years in China.MethodsBased upon the records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 24128 leprosy cases detected during 1989-1999 in China were analyzed in terms of leprosy disbility.ResultsThe proportion of disabilies in newly detected leprosy cases in 1989 in whole country was 46.49% and decreased to 32.7% in 1999, and the proportions of cases with grade Ⅱ disabilities were 25.55% (1989) and 22.06% (1999). There were 19 provinces where disability rate was more than 40%. Out of patients with disabilities, those with grades Ⅰ and Ⅱ disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.54%, 61.04% and 1.42%, respectively. There were 20 provinces where grade Ⅱ disabilities accounted for more than 50% of all patients with disabilities. The disability rates in patients aged under 15 years, 15-65 years and over 65 years were 24.74%, 39.3% and 53.33%. The patients with a delay in detection of 2 years had a disability rate of 28.95%, and those with a delay of more than 2 years and 5 years had the rates of 48.06% and 60.95%, respectively. The disability rate was 53.76% in patients with leprosy reactions. The grade Ⅱ disability rate in paucibacillary patients (28.53%) was significantly higher than that in multibacillary ones (22.03%). Conclusions Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 11 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.
RÉSUMÉ
Objective To approach the status of leprosy disabilities in newly detected cases in recent 10 years in China and provide the scientific basis for formulating the preventive strategies. Methods Based upon the individual records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 22 437 leprosy cases detected during 1989－ 1998 in China were analyzed in terms of leprosy disability. Results The proportion of disabilities in newly detected leprosy cases in 1989 in whole country was 46.49％ and decreased to 32.31％ in 1998, and the proportions of cases with grade II disabilities were 25.55％ (1989) and 20.23％ (1998). There were 18 provinces where disability rate was more than 40％ . Out of patients with disabilities, those with grades I and II disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.86％ , 60.64％ and 1.5％ , respectively. There were 25 provinces where grade II disabilities accounted for more than 50％ of all patients with disabilities. The disability rates in patients aged under 15 years, 15－ 65 years and over 65 years were 24％ , 39.85％ and 53.33％ . The patients with a delay in detection of 2 years had a disability rate of 29.85％ , and those with a delay of more than 2 years and 5 years had the rates of 48.82％ and 61.17％ , respectively. The disability rate was 52.9％ in patients with leprosy reactions and 46.1％ in patients with a damage of more than 3 nerves. The grade II disability rate in paucibacillary patients(28.99％ ) was significantly higher than that in multibacillary ones (22.04％ ). Conclusion Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 10 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.