- 期刊
身心障礙者對於個別化醫療復健輔助器具設計服務需求暨市場供需調查
Market Analysis for the Need of Individualized Assisted Device in Patients with Physical-mental Disabilities
摘要
民國89年度之全國領有身心障礙手冊者總人數為711,064人，而身心障礙者之失能及社會功能障礙，可以經由正確的輔具使用獲得改善，但身心障礙者之整體個別化輔具需求在台灣仍狀況不明。本研究的目的在調查：(1)身心障礙者對輔具之瞭解及需求情形，(2)身心障礙者對個別化輔具之需求情形，(3)不同障別之身心障礙者對輔具需求之情況及異同，(4)同一障別不同障度之身心障礙者對輔具需求之情況及異同，(5)身心障礙者之輔具需求與個人因素之相關性。 本研究以問卷調查訪問2850位領有內政部核發“身心障礙者手冊”之國民，回收有效問卷539份。就輔具的瞭解程度而言，“完全沒概念”、“不太瞭解”及“一知半解者”共佔58%；但“需要”及“十分需要”輔具者共佔66%。就輔具是否符合身心障礙者之切身需要來說，“完全不符合”、 “不太符合”及“差強人意”者合計57%；而認為輔具“需要”或“十分需要”做個別化設計者共佔51%。身心障礙者之整體輔具需求種類，以行動輔具佔最多(34%)，上下肢相關及裝具輔具次之(32.5%)，日常生活輔具第三(25.4%)。就各障別而言，肢障及多重障礙者對輔具之需求種類，與上逑之整體需求類似；而智障者之需求偏向就業、溝通科技及電腦相關輔具；聽障者則需要溝通輔具。就個別化輔具之需求而言，肢障及多重障礙者需要特製鞋、特製鞋墊、特製座墊、握筆輔具、張力抑制輔具及擺位功能輔具等；智障者需要警示系統、特殊保護裝置及訓練認知電腦軟體等；聽障者需要電話話筒擴音器、振動式手錶、燈號式門鈴及可置於枕頭下之振動式鬧鐘等。另外，相關係數分析結果發現，殘障等級愈重度者對輔具之需求愈大；生活自理能力愈差者愈需要上肢、下肢、日常生活、認知功能及溝通輔具，但愈不需要就業及運動競技輔具。愈能獨立就業者愈需要就業、休閒娛樂及運動競技輔具，但愈不需要溝通輔具。 本研究之結論為：(1)身心障礙者對輔具仍欠缺足夠的瞭解，推廣教育的普及值得我們進一步努力，(2)市場上之輔具尚未能滿足身心障礙者的切身需要，期待更完善的個別化設計與改良。尤其是下肢、上肢、及日常生活輔具等大宗需求之輔具，應為重點研發項目，(3)期望政府相關單位及各輔具研發中心能制定統一且合理之輔具服務流程，充實輔具評估及製作之專業人力訓練，以及積極的整合及資料交流，以肩負輔具推廣教育及改良研發之積極角色。
並列摘要
The number of people with physical-mental disabilities in Taiwan was 711,064 in the year 2000. The difficulties in performing activities of daily lives and social function handicaps in these people can often be alleviate with the proper application of assisted device. The individualized need of assisted device in people with physical-mental disabilities was never investigated in Taiwan. Therefore, the objectives in this investigation were to: 1. understand the need of assisted device in people with physical-mental disabilities, 2. understand the need of individualized assisted device in people with physical-mental disabilities, 3. observe the similarities and differences in the need for assisted device in people with different disabilities, 4. observe the similarities and differences in assisted device application in people with different disability levels, 5. observe the relationship in the need for assisted device and personal factors. Our investigation sent out 2,850 questionnaires to the people regarded as physical-mental disabilities by the department of internal affairs, and received back a total of 539 valid questionnaires. Fifty-eight percent of subjects either did not have or only have limited understanding regarding the concept of assisted device application; however, in terms of the necessity of assisted device, 66% felt that they were extremely necessary. Whether the assisted device were well constructed or not in order to fit the people with physical-mental disabilities, 57% of them felt that the assisted device were either totally unfit, mildly unfit or with little satisfaction. Fifty-one percent felt that the assisted device should be molded and constructed individually. In terms of the overall types of the required assisted device for the physical-mental disabilities subjects, thirty-four percent were assisted device for locomotion, 32.5% belonged to the upper and lower extremities assisted devices or orthosis, 25.4% were assisted device for activities of daily living. The types of assisted device required for physical or multiple disabilities were similar to the aforementioned data as in the physical-mental disabilities. For subjects with disabilities such as mental retardation, they required assisted device that could assist them in vocational, communication, and cognitive function purposes. Hearing disability individuals needed assisted device to help them communicate. In terms of individualized assisted device designs, subjects with extremity and multiple disabilities needed specially designed shoes, insoles, seating systems, pen grasping utensils, reflex inhibitory pattern and proper positioning device. Mental retardation disability subjects required further modern technology assistance such as alarming system, special protection facilities, and computer softwares for cognitive training. Subjects with hearing disability needed telephone volume amplifiers, vibratory watches, illuminated door-bells, and under the pillow vibratory alarm clocks. With statistical analysis of the aforementioned data, we realized subjects with the more severe level of disability, the need for assisted device assistance was higher. For subjects who were dependent in terms of daily activities, they had higher need for assisted device that can help them perform upper and lower extremity, daily activity, cognitive, and communicating functions. However, the need of assisted device for athletic and vocational purposes was lower. For subjects who were more independent in terms of daily activities, they strongly needed assisted device for athletic and vocational purposes, and the need of assisted device for communication purposes was low. In conclusion, we discovered that: 1. Subjects with physical-mental disabilities lacked proper concept and understanding of assisted device usages. More educational efforts must be implemented to help them to understand the significance of assisted device, 2. Most of the assisted device were unfit for the physical-mental disabilities subjects. Individualized constructions are required for this subject population, especially in upper and lower extremity assisted device, and in the assisted device for assisting daily activities, 3. It will be wise if the government and assisted device construction centers can work together and offer a service protocol that would be more convenient for the needed individuals. They can also work together in the training of more capable technician for assisted device, and in educating the public regarding the correct concept and the significance of assisted device application.