Validation study of the Chinese version of the Community Integration Questionnaire-Revised for individuals with spinal cord injury in Mainland China.

OBJECTIVE: To validate the Chinese version of the Community Integration Questionnaire-Revised (CIQ-R-C) for individuals with spinal cord injury. DESIGN: Cross-sectional study. SETTING: Shanghai Sunshine Rehabilitation Center. PARTICIPANTS: 317 adults with spinal cord injury in a rehabilitation center in Mainland China. INTERVENTIONS: Not applicable. METHODS: The CIQ-R-C (including an additional e-shopping item), global QoL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were administered. Reliability and validity analyses were conducted. RESULTS: Good item-domain correlations were found for 15 of the 16-item original CIQ-R, except for item 10 (leisure alone or with others). Exploratory Factor Analysis supported a construct of the CIQ-R-C (excluding item 10) as made of four domains (CFI = 0.94; RMSEA = 0.06): home, social engagement, digital social networking, and traditional social networking. Good internal consistency and test-retest reliability were observed in the total and the home subscale of the CIQ-R-C. Satisfactory construct validity was shown by the correlation analysis among the CIQ-R-C Scale, SAS/SDS, global QoL, and MSPSS. CONCLUSION: The CIQ-R-C Scale is valid and reliable, and can be used to assess community integration of individuals with spinal cord injury in China.

Preliminary validation study of the WHO quality of life (WHOQOL) scales for people with spinal cord injury in Mainland China.

OBJECTIVE: To validate the WHOQOL Scales (WHOQOL-BREF and WHOQOL-DIS module) for people with spinal cord injury in Mainland China. DESIGN: Cross-sectional study. SETTING: Shanghai Sunshine Rehabilitation Center. PARTICIPANTS: 249 adults with SCI who were admitted to a rehabilitation training program between 2017 and 2019. INTERVENTIONS: Not applicable. METHODS: Questionnaires about personal and injury characteristics, the WHOQOL Scales, global QOL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Community Integration Questionnaire (CIQ) were administrated. Floor and ceiling effects, reliability, and validity analyses were tested. RESULTS: The 8 domains of the WHOQOL Scales showed no floor or ceiling effects. Cronbach alpha values of the WHOQOL-BREF and the WHOQOL-DIS were 0.93 and 0.78, respectively. Test-retest reliability was good for the WHOQOL Scales. Satisfactory criterion-related validity was shown by the correlation analysis among the WHOQOL Scales, SAS/SDS, CIQ, and global QOL. Good item-domain correlations (>0.50) were found for 38 items of the 39-item WHOQOL Scales, excepting the "impact of disability" (0.48) of the WHOQOL-DIS. Confirmatory Factor Analysis (CFA) supported a construct of the WHOQOL-DIS as made of four domains: autonomy, social inclusion, social activities, and discrimination. CFI and RMSEA values were 0.91 and 0.07, respectively, for the four-domain structure WHOQOL-DIS, with a higher-order factor. WHOQOL-BREF domains and WHOQOL-DIS scores showed the predicted pattern among a priori known groups. CONCLUSION: The WHOQOL Scales are valid and reliable, and they can be used to measure QOL in people with SCI in China. We suggest the WHOQOL-DIS be analyzed as one general item constituting a single 12-item domain.

Epidemiological study of Spinal Cord Injury individuals from halfway houses in Shanghai, China.

OBJECTIVE: To describe the characteristics of spinal cord injury (SCI) individuals in Shanghai and examine their treatment and rehabilitation for traumatic and complete SCI individuals. DESIGN: Community-based secondary data analyses. SETTING: Shanghai, China. METHODS: We analyzed gender, age at injury, complications, disturbances of function, treatment, etiology, and severity of injury of SCI individuals that enrolled in "halfway houses", government-supported community co-op centers. Bivariate statistical analyses were conducted to examine the factors associated with complete and traumatic SCI. RESULTS: We analyzed 808 SCI individuals who participated in halfway houses in Shanghai during 2009-2015. The male-to-female ratio was 2.1:1. The proportion of middle or elder age groups at injury (age 46 to 60 and age 61 or over) showed a rising trend from 1970 to 2015. The leading causes of SCIs in Shanghai were traumatic injuries (58%), followed by disease (29.5%). The proportion of traumatic injuries decreased over time, while the proportion of non-traumatic injuries rose significantly. A majority of traumatic injury individuals were aged between 16-45. CONCLUSION: The middle or elder age groups at injury among SCI individuals increased continuously from 1970 to 2015. The principal causes of injury in Shanghai were traumatic injuries and disease-related injuries. Men had a higher prevalence of traumatic SCI in Shanghai. Preventive measures should focus on male and middle-aged adults. As a fast-aging society in Shanghai, more effective prevention, medical care, and rehabilitation schemes should be implemented for aging SCI individuals.

[Study on elasticity of medical service demand at the township level in China].

OBJECTIVE: To find out the economic laws regulating medical service demand in accordance with influencing factors at the township level, thus to provide references for further adjusting the medical service demand reasonably in the future. METHODS: The model of medical service demand was established to measure the elasticity of demand in 49 township health clinics in 1995, 1999, 2003 and 2007. RESULTS: The price elasticity of outpatient and inpatient demand was stable during the four periods, and the average value was -0.029 and -0.132 respectively; the average value of income elasticity was 0.973 and 0.977, registering a downward trend in general. CONCLUSION: The medical service demand at the township level is price inelastic, indicating that it is a necessity for rural residents. The downward trend of income elasticity under the influence of some health policies illustrates a lightening in economic burden for medical service demand among rural residents in township health clinics.

[Study on the fund to ensure the implementation of public function of province-level, city-level and county-level center of disease prevention and control in China].

OBJECTIVE: To calculate the fund to ensure the implementation of public function of province-level, city-level and county-level center of disease prevention and control in China. METHODS: The principle was to fulfill public function, promote professional efficiency and give a comprehensive attention to employee depletion. Basic data were collected by sample CDC investigation. Value of some special indicators was demonstrated by specialist group. Results To ensure the implementation of public function, a total of 15.7 billion Yen per year should be allocated to all province-level, city-level and county-level center of disease prevention and control. The personnel expenses was 8.4 billion Yen and the daily expenses was 7.4 billion Yen per year.

[Study on insufficiency of government investment to the centers of disease prevention and control].

OBJECTIVE: To make clear the superaddition of government investment to the centers of disease prevention and control (CDC) which will ensure fulfillment of public functions of the center of disease prevention and control. Methods Centers of disease prevention and control had been sampled by two-stage stratified sampling method to investigate the status of government investment to the centers of disease prevention and control, which would be compared with the expected government investment to fulfill the public functions of CDC. RESULTS: According to the cost of manpower and the price in 2003, the government should give another 304.9% investment than current government investment (3.88 billions). For CDC of county level, the superaddition rate even reached 416.1%. The percentage of manpower expense would be 32.2% and the percentage of routine expense would be 67.8% of the superaddtion of government investment. The percentage of routine expense even reached 70.7% of the superaddtion of government investment. CONCLUSION: There was a big gap between the current government investment to CDC and the expected government investment to CDC. To fulfill the public function of CDC, the current government investment to CDC should increase by 3-4 times. The superaddition of government investment to CDC should be allocated more to the routine expense.