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听力障碍和言语障碍儿童保健、康复和教育服务的国际政策架构、核心内容与优先领域研究OA北大核心CSTPCD

Research on framework,core content and priority areas of international policy of healthcare,rehabilitation and education services for children with hearing and speech impairments

中文摘要英文摘要

目的 分析听力障碍和言语障碍儿童国际保健、康复和教育服务相关政策架构与核心内容以及其优先发展领域. 方法 基于WHO《健康服务体系中的康复》和健康服务6大构成要素的理论,参照WHO《全球听力报告》,系统分析听力障碍和言语障碍儿童保健、康复与教育服务的国际政策的架构、核心内容以及优先发展领域. 结果 在领导力与治理方面,需要构建跨部门的治理体制与治理能力,通过包容性政策制定和计划,与各利益相关者合作,共同实施提高耳和听力健康的政策和计划.在筹资方面,需要建立可持续融资和健康保护政策,提倡追加年投资,以扩大耳和听力保健服务的覆盖范围.在人力资源方面,加强教育和培训项目,扩展有关耳和听力保健、言语治疗以及特殊教育教师的教育项目,提高专业人员的服务能力.在服务提供方面,构建综合以人为本的耳和听力保健体系,将耳和听力保健干预措施整合到国家健康计划中,同时考虑到各个层面的需求和优先事项,建立涉及保健、康复和教育的综合性和包容性的服务体系.在医疗技术与设备设施领域,促进高质量听力技术的获取,特别关注助听器和人工耳蜗等技术的有效性和成本效益,将辅助技术和无障碍技术充分应用到教育和康复中;提高听力障碍儿童对听力损失的预防、诊断、治疗和康复的整体水平;将数字技术推广到儿童保健、康复和教育服务中.在信息系统与监测领域,发展标准化的监测指标,建立听力保健服务评估机制,推广远程监测和远程服务.在康复和教育领域,要建立融合的监测数据平台,提高儿童听力言语康复的服务质量.WHO提出的听力障碍和言语障碍儿童的保健、康复与教育服务的优先发展领域涉及5大领域:早期干预和教育、听力和言语治疗、心理社会支持、社交技能和社区参与以及职业教育和生活技能培训. 结论 本研究基于健康服务体系6大构成要素,系统分析了听力障碍和言语障碍儿童保健、康复与教育服务的国际政策,构建了听力障碍和言语障碍儿童保健、康复与教育服务架构和核心内容.在WHO健康服务体系视域下,发展听力障碍健康和康复事业并构建听力障碍健康和康复服务体系,需重点关注5大领域,即早期干预和教育、听力和言语治疗、心理社会支持、社交技能和社区参与以及职业教育和生活技能培训.

Objective To analyze the framework,core content and priority development areas of international policy concerning healthcare,rehabilitation and educational services for children with hearing and speech impairments. Methods Based on the WHO's"Rehabilitation in Health Systems"and the six building blocks of health services,this study conducted a systematic analysis of the international policy framework,core content and priority areas for global healthcare,rehabilitation and education services for children with hearing and speech impairments,with reference to the WHO World Report on Hearing. Results Regarding leadership and governance,an inter-sectoral governance system and capabilities are necessary,formed through inclusive policy-making and collaborative planning with all stakeholders to enhance ear and hear-ing health initiatives.In the area of financing,sustainable funding and health protection policies are vital,advo-cating for incremental annual investments to broaden the scope of ear and hearing healthcare services.Human re-sources development calls for bolstering educational and training initiatives,expanding programs for ear and hearing healthcare,speech therapy and special education professionals,to elevate service delivery proficiency.For service provision,establishing an integrated,person-centered ear and hearing care system is advocated,which weaves ear and hearing care interventions into comprehensive health strategies,acknowledging the neces-sities and priorities across all levels and establishing an inclusive service system in the realms of children's health-care,rehabilitation and education.In terms of medical technology and infrastructure,the study encourages the fa-cilitation of high-caliber hearing technologies,emphasizing the efficacy and cost-effectiveness of devices like hearing aids and cochlear implants,and fully incorporating assistive and accessible technologies into educational and rehabilitative practices to improve the comprehensive care of children with hearing loss.Digital technologies'proliferation within children's healthcare,rehabilitation and educational services is also encouraged.In the field of information systems and monitoring,the development of standardized monitoring metrics and the establish-ment of evaluation mechanisms for hearing healthcare services are proposed,promoting remote surveillance and services.For rehabilitation and education,the establishment of a unified monitoring data platform to augment the quality of hearing and speech rehabilitation services for children is suggested.The WHO delineates five interna-tional priority development areas for healthcare,rehabilitation,and educational services for children with hearing and speech impairments,namely early intervention and education,hearing and speech therapy,psychosocial sup-port,social skills and community participation,and vocational education and life skills training. Conclusion Based on the six components of the health service system,this study systematically analyzed the internation-al policies of health care,rehabilitation and education services for hearing-impaired and speech-impaired chil-dren,and constructed the service structure and core contents of health care,rehabilitation and education services for them.Under the vision of WHO health service system,the development of hearing-impaired health and reha-bilitation,and the construction of hearing-impaired health and rehabilitation service system should focus on five areas:early intervention and education,hearing and speech therapy,psychosocial support,social skills and com-munity participation,and vocational education and life skills training.

张青;李彦群;贾文蓉;刘巧云;姜瑞林

邯郸学院特殊教育学院教育康复学系,河北邯郸市 056005||河北省特殊教育协同创新中心,河北邯郸市 050061华东师范大学教育学部,上海市 200062

临床医学

听力障碍和言语障碍保健康复教育国际政策

hearing and speech impairementhealth carerehabilitationeducationinternational policies

《中国康复理论与实践》 2024 (004)

373-380 / 8

1.河北省高等学校人文社会科学研究项目(No.GH202034);2.河北省高等教育教学改革研究与实践项目(No.2015GJJG192);3.邯郸学院教育科学研究课题(No.J202007) Supported by Humanities and Social Science Research Project of Hebei Education Department(No.GH202034),Research and Practice Project of Higher Education Teaching Reform in Hebei Province(No.2015GJJG192),and Handan University Educational Science Research Project(No.J202007)

10.3969/j.issn.1006-9771.2024.04.001

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