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

  • Review
  • Intervention




There is a high incidence of impairments among working age adults, and their prevalence is increasing in the West. 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.


To assess the effectiveness of personal assistance for adults with physical and intellectual 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 permanent physical and intellectual impairments living in the community who require assistance to perform tasks of daily living (e.g., bathing and eating) and participate in normal activities. 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. Because no two studies made the same comparison, studies were not combined for meta-analyses. Studies were assessed for bias. Results and potential sources of bias are presented for included studies.

Main results

Two studies involving 1002 participants compared personal assistance versus usual care. Whilst personal assistance was generally preferred over other services, some people prefer other services. Personal assistance may have some benefits for some recipients and may benefit caregivers. Paid assistance probably substitutes for informal care and may cost government more than alternatives; however, some evidence suggests it may reduce costs. The total costs to recipients and society are unknown.

Authors' conclusions

Research in this field is limited. Personal assistance is expensive and difficult to organise, especially in places that do not already have services in place, but its total cost relative to other services is unknown. When implementing new programmes, recipients could be randomly assigned to different forms of assistance (e.g. organised by individual users versus organised through a cooperative). While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of assistance are most effective and efficient for particular people.



對於有身體與智能障礙的成人 (19 – 64歲) 之個人化協助





電子資料庫,包括CENTRAL、MEDLINE、EMBASE、CINAHL、PsycINFO、ERIC、Dissertation Abstracts International和其他多種專業的瑞典資料庫,從1980年至2005年六月;檢驗參考文獻名單;並連絡共345名專業人士、組織、政府機關以得知相關研究。


住在社區中有永久身體與智能障礙,需生活起居協助 (例如,盥洗和進食) 與可正常活動的參與者 (19至64歲) 。事前控制分配受試者至試驗組或控制組並且要同時檢測試驗組與控制組的結果。






這個領域的研究是侷限的。個人化的協助是昂貴的,而且組織上有困難,特別對那些尚未準備好提供這類服務的地方而言。但是相對比較其他種類服務的花費是未知的。當施行新的計畫時,接受者可以被隨機分配到不同形式的協助 (例如,以個人使用者或合作方式來組織) 。雖然擁護者會以大量的理由來支持個人化協助,這篇回顧顯示,仍需要進一步的試驗,來決定哪一種協助模式對某類族群,是最有效果也最有效率的。



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



Plain language summary

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

Personal assistance 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 both physical and intellectual impairments. A literature search identified 2 studies that met the inclusion criteria, which included 1002 participants. They suggested 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.