Personal assistance for adults (19-64) with physical impairments

  • Review
  • Intervention

Authors


Abstract

Background

There is a high incidence of impairments among working age adults. Many countries offer personal assistance in the form of individualised support for people living in the community by a paid assistant other than a healthcare professional for at least 20 hours per week.

Objectives

To assess the effectiveness of personal assistance for adults with physical impairments, and the impacts of personal assistance on others, compared to other interventions.

Search methods

Electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Dissertation Abstracts International and a variety of specialist Swedish databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research.

Selection criteria

Adults (19-64) with physical impairments living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities due to permanent impairments. Controlled studies of personal assistance in which participants were prospectively assigned to study groups and in which control group outcomes were measured concurrently with intervention group outcomes were included.

Data collection and analysis

Titles and abstracts were examined by two reviewers. Outcome data were extracted. Studies were assessed for the possibility of bias. Results and potential sources of bias are presented for included studies.

Main results

One randomised controlled trial involving 817 participants compared personal assistance versus usual care was identified. Whilst personal assistance was generally preferred over other services, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and may benefit caregivers. Whilst paid assistance probably substitutes for informal care and may cost government more than alternatives, the total costs to recipients and society are currently unknown.

Authors' conclusions

Research in this field is limited. When implementing new programmes, recipients could be randomly assigned to different forms of assistance. While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of personal assistance are most effective and efficient for particular people.

摘要

背景

對於有肢體障礙的成人(19–64歲)之個人協助

在工作年齡的成人中,障礙的發生率相當高。許多國家提供個人協助的服務,聘用非健康照護專業的給薪助理人員,為住在社區的人提供每星期至少20小時的個別支持。

目標

為了評估個人協助相較於其他介入措施,對有肢體障礙的成人之成效,以及對他人的影響。

搜尋策略

我們搜尋了從1980年到2005年6月的電子資料庫,包括Central,MEDLINE,EMBASE,CINAHL,PsycINFO,ERIC, Dissertation Abstracts International,以及多種專業瑞典資料庫;也檢查了參考文獻目錄,並且聯絡了345個專家、組織、政府機構和慈善機構,嘗試去確定相關研究的地點。

選擇標準

居住在社區的有肢體障礙的成人(19–64歲),因永久性的損害而需要協助來執行日常生活的事務(如洗澡、吃飯),和參與正常活動。收納的試驗為關於個人協助的對照試驗,其中受試者以前瞻性方式,被分配到不同的研究組別中,並且同時測量介入組和對照組的結果預後。

資料收集與分析

兩位審稿者審查標題和摘要,結果數據被萃取出來。另外,也評估收納的研究誤差的可能性。本篇回顧提出收納研究的結果和潛在的誤差來源。

主要結論

本篇回顧篩選出一個包含817位受試者、比較個人協助和一般照護的隨機對照試驗。雖然個人協助普遍較其他服務受歡迎,也有些人喜歡其他模式的照顧。這項回顧指出,個人協助可能對一些受助者有好處,且對其主要照顧者有助益。雖然付費的協助可能代替了非正式的照顧,且相較於其他方案,可能讓政府花費較多,但對於受助者及社會整體的成本目前仍不清楚。

作者結論

在此一領域的研究有限。當實施新方案時,受助人會被隨機分配到不同形式的協助。雖然倡導者可能因各種原因而支持個人協助,此篇回顧顯示,仍需要進一步的研究來確定針對此一特殊族群,何種個人協助的模式最為有效且效率最高。

翻譯人

本摘要由成功大學附設醫院黃惠群翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

一篇研究顯示個人協助對於有肢體障礙的成年人可能有助益:需要更多的研究 個人協助在此定義為對於有障礙的人,每週至少20小時的付費支持服務。本篇回顧探討個人協助,相較於其他形式的照顧,對於有肢體障礙的成人的有效性。文獻檢索發現一篇符合納入標準的研究,包含了817位的受試者,此研究推論個人協助可能較其他種服務方式受歡迎,然而某些人仍偏好其他照顧方式。該篇研究推論個人協助可能對一些受助者以及他們的非正式照顧者有助益。付費的協助可能代替了非正式的照顧,且相較於其他方案,可能讓政府花費較多,然而相較之下,對於受助者及社會整體的成本仍不清楚。

Plain language summary

One study shows promise for Personal Assistance delivered to adults with physical impairments: more research is needed

Personal assistance is is here defined as paid support of at least 20 hours per week for people with impairments. This review investigated the effectiveness of personal assistance versus any other form of care for adults with physical impairments. A literature search identified one study that met the inclusion criteria, which included 817 participants. It suggests that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance may have some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown.