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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
 
[object Object],[object Object],[object Object],[object Object],[object Object],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
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
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 Bureau NHV Model
NGO(CFCF) Local Hospital Health  Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau Handicap International NHV Model
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
Demography data Injury classification Rehab needs Physical function Mental health Social integration NHV Model 2008 Baseline 2010 Follow-up M  county
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 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
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
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
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
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
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
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
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
Economic outcome Average cost: 4,350 yuan
Research outcome 地震伤员康复需求调查报告 2011-01-08 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
5 Physiatricians 6 Physical Therapists 6 Rehabilitation Nurses 50 Patient Wards
 
Long term mechanism—cooperation in the future 3 years ,[object Object],[object Object],[object Object]
 
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

  • 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.
  • 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
  • 5. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital NHV Model
  • 6. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau NHV Model
  • 7. NGO(CFCF) Local Hospital Health Bureau Disabled Person’s Federation IBR CBR Handicap International Local hospital Health Bureau Handicap International NHV Model
  • 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
  • 9. Demography data Injury classification Rehab needs Physical function Mental health Social integration NHV Model 2008 Baseline 2010 Follow-up M county
  • 10. M county VS A county S county VS VS NHV Model 2008 Baseline 2010 Follow-up
  • 11. Medical outcome in M county—ADL
  • 12. Medical outcome in M county—ADL
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 21. Economic outcome Average cost: 4,350 yuan
  • 22.
  • 23. 5 Physiatricians 6 Physical Therapists 6 Rehabilitation Nurses 50 Patient Wards
  • 24.  
  • 25.
  • 26.  
  • 27. Based on the earthquake survivors government and non-government IBR and CBR