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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2026, Vol. 22 ›› Issue (01): 34 -41. doi: 10.3877/cma.j.issn.1673-5250.2026.01.006

Original Article

Impact of the integrated " medical-education-rehabilitation-childcare" service management model on the self-care and social adaptation abilities of children with intellectual disabilities and the life quality of their parents

Dongqing Zhang1,2, Zewei Li3, Depeng Peng3, Dongsheng Lu3, Qiu Wang1,†()   

  1. 1Department of Rehabilitation Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2Department of Rehabilitation Medicine, Mianyang Hospital·Mianyang Central Hospital Affiliated to the School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, Sichuan Province, China
    3Department of Rehabilitation Medicine, People′s Hospital of Pingshan County, Pingshan 645350, Sichuan Province, China
  • Received:2025-09-26 Revised:2025-12-26 Published:2026-02-01
  • Corresponding author: Qiu Wang
  • Supported by:
    Central Government Guides Local Scientific and Technological Development Project of Sichuan Province(2024ZYD0292); Innovation Team Project of Sichuan Provincial Health Commission(24CXTD17)
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Objective

To explore the improvement effect of " medical-education-rehabilitation-childcare" service management model on the self-care and social adaptation abilities of children with intellectual disabilities and the quality of life (QoL) of their parents.

Methods

A total of 80 children with intellectual disabilities admitted to Pingshan County " Qingmiao Rescue" Rehabilitation and Care Center for Disabled Children and the Department of Rehabilitation Medicine, People′s Hospital of Pingshan County from June 2022 to December 2024 were included as study subjects by quota sampling method. They were divided into study group (n=40, who received intervention using " medical-education-rehabilitation-childcare" service management model) and control group (n=40, who received intervention using a combination of routine comprehensive rehabilitation training and family rehabilitation training) by random number table method. Before and after intervention, the Barthel index scale was used to assess the activity of daily living (ADL) of the two groups of children with intellectual disabilities, the social maturity scale was used to assess their social adaptability, and the World Health Organization quality of life scale-brief (WHOQOL-BREF) was used to assess the QoL of the children′s parents. Statistical comparisons were performed using independent or paired samples t test, Mann-Whitney U test, or Wilcoxon signed-rank test. The procedures followed in this study complied with the regulations of the Ethics Committee of People′s Hospital of Pingshan County and were approved by the ethics committee (Approval No. 20244142).

Results

①There were no significant differences in gender, age, intelligence quotient (IQ), and degree of intellectual disability between the two groups of children with intellectual disabilities (all P>0.05). ②Before intervention, there were no differences in each dimension score and total score of ADL ability, S-M, as well as the total QoL scores of the parents of two groups of children (all P>0.05). After intervention, the total score of ADL ability in study group was (70.5±13.3) points, which was significantly higher than (62.3±16.2) points in control group (t=-3.04, P=0.002). Meanwhile, after intervention, both the total score and each dimension score of ADL ability and S-M in study group of children were significantly improved compared to before intervention within the group (all P<0.05). After intervention, the total S-M score and scores for interpersonal communication, participation in group activities, and self-management ability in the study group were significantly higher than those in control group (P=0.035, 0.007, 0.005, 0.001). After the intervention, the total QoL score of the parents of children in study group was (72.4±9.9) points, which was significantly higher than that of control group (58.0±10.2) points, and the difference was statistically significant (t=-7.58, P<0.001). After intervention, the total QoL scores of the parents of children in both the study group and the control group were significantly higher than those before the intervention within each group, and the differences were statistically significant (P<0.05).

Conclusions

Compared with the conventional comprehensive rehabilitation training and family rehabilitation training model, the " medical-education-rehabilitation-childcare" service management model has greater advantages and can significantly improve the self-care ability, social adaptation behavior of children with intellectual disabilities and the QoL of their parents.

Key words: Intellectual disability, Activities of daily living, Social adjustment, Quality of life, Medical-education-rehabilitation-childcare service management model, Rehabilitation, Child
表1 本研究2组智力障碍患儿一般临床资料比较
组别 例数 性别[例数(%)] 年龄(岁，±s) IQ(分，±s) 智力障碍[例数(%)]
男 女 轻度 中度 重度
研究组 40 27(67.5) 13(32.5) 8.8±1.8 41.3±12.6 10(25.0) 16(40.0) 14(35.0)
对照组 40 24(60.0) 16(40.0) 9.0±1.8 39.9±11.5 8(20.0) 19(47.5) 13(32.5)
统计量   χ2＝0.46 t＝0.61 t＝0.52 χ2＝0.52
P值   0.498 0.544 0.604 0.772
表2 本研究2组智力障碍患儿干预前、后ADL能力各维度评分及总评分组间与组内比较(分)
组别 例数 进餐(±s) 床旁椅转移(±s)
干预前 干预后 t值 P值 干预前 干预后 t值 P值
研究组 40 6.9±2.0 9.9±1.8 －6.97 <0.001 7.8±2.3 10.6±2.6 －4.41 <0.001
对照组 40 7.0±2.1 9.2±2.2 －4.75 <0.001 8.3±2.5 10.4±3.1 －4.12 <0.001
统计量   t＝－0.19 t＝－1.42     t＝0.38 t＝－1.07    
P值   0.848 0.160     0.823 0.286    
组别 例数 修饰[M(Q1，Q3)] 如厕(±s)
干预前 干预后 Z值 P值 干预前 干预后 t值 P值
研究组 40 1.7(1.1，3.6) 4.3(2.4，7.3) －4.47 <0.001 3.5±0.8 4.9±1.6 －2.81 0.005
对照组 40 1.5(0.9，3.3) 2.5(1.3，4.3) －3.32 0.001 3.8±1.2 5.0±1.4 －3.16 0.002
统计量   Z＝1.09 Z＝－2.65     t＝0.39 t＝0.13    
P值   0.217 0.004     0.725 0.896    
组别 例数 洗澡[M(Q1，Q3)] 平地行走(±s)
干预前 干预后 Z值 P值 干预前 干预后 t值 P值
研究组 40 0.4(0.1，1.3) 1.8(1.1，2.3) －3.22 0.001 9.9±2.7 10.9±2.2 －2.53 0.011
对照组 40 0.6(0.2，1.1) 0.8(0.3，1.5) －0.92 0.246 9.4±2.8 10.5±2.7 －2.71 0.007
统计量   Z＝0.47 Z＝－2.62     t＝－0.82 t＝－0.66    
P值   0.621 0.009     0.415 0.509    
组别 例数 上下楼梯(±s) 穿衣(±s)
干预前 干预后 t值 P值 干预前 干预后 t值 P值
研究组 40 5.3±1.5 6.0±2.3 －2.45 0.014 5.6±2.0 8.9±1.2 －5.10 <0.001
对照组 40 5.0±1.4 5.8±1.6 －2.00 0.046 6.3±2.7 8.3±1.3 －4.00 <0.001
统计量   t＝0.23 t＝－0.67     t＝0.92 t＝－2.23    
P值   0.815 0.502     0.301 0.026    
组别 例数 大便控制[M(Q1，Q3)] 小便控制(±s)
干预前 干预后 Z值 P值 干预前 干预后 t值 P值
研究组 40 1.9(1.1，2.7) 2.5(2.1，5.3) －3.42 0.001 7.5±1.6 9.0±1.3 －3.21 0.001
对照组 40 1.8(1.3，3.1) 2.2(1.9，3.4) －1.73 0.083 6.9±3.1 7.9±2.0 －2.83 0.005
统计量   Z＝0.12 Z＝－1.50     t＝0.75 t＝－0.83    
P值   0.893 0.133     0.382 0.404    
组别 例数 总评分(±s)
干预前 干预后 t值 P值
研究组 40 50.5±17.7 70.5±13.3 －5.53 <0.001
对照组 40 49.5±17.7 62.3±16.2 －5.11 <0.001
统计量   t＝0.23 t＝－3.04    
P值   0.883 0.002    
表3 本研究2组智力障碍患儿干预前、后S-M各维度评分及总评分组间与组内比较(分)
组别 例数 独立生活能力(±s) 运动能力(±s)
干预前 干预后 t值 P值 干预前 干预后 t值 P值
研究组 40 15.6±4.3 22.2±4.7 －4.92 <0.001 6.0±1.9 7.5±2.4 －4.12 <0.001
对照组 40 16.2±3.7 18.9±4.2 －3.04 0.003 6.0±1.3 6.6±1.2 －2.15 0.035
统计量   t＝－0.88 t＝3.31     t＝－0.38 t＝－0.59    
P值   0.785 0.001     0.923 0.550    
组别 例数 作业操作能力[M(Q1，Q3)] 人际交往能力(±s)
干预前 干预后 Z值 P值 干预前 干预后 t值 P值
研究组 40 5.3(1.7，8.9) 9.1(3.8，11.0) －5.04 <0.001 6.7±1.7 10.5±2.5 －4.92 <0.001
对照组 40 5.9(2.3，8.2) 6.3(2.7，9.1) －2.74 0.011 6.7±1.5 7.8±2.2 －2.61 0.011
统计量   Z＝－0.45 Z＝－0.75     t＝－0.25 t＝－2.70    
P值   0.734 0.453     0.876 0.007    
组别 例数 参加集体活动能力(±s) 自我管理能力[M (Q1，Q3)]
干预前 干预后 t值 P值 干预前 干预后 Z值 P值
研究组 40 7.1±2.3 11.6±2.6 －4.82 <0.001 3.7(1.9，5.8) 7.2(3.8，9.6) －5.17 <0.001
对照组 40 7.5±2.1 8.6±2.0 －2.40 0.019 4.1(2.3，6.5) 4.9(2.5，7.8) －2.26 0.017
统计量   t＝0.93 t＝－2.81     Z＝－0.38 Z＝－3.27    
P值   0.684 0.005     0.938 0.001    
组别 例数 总评分(±s)
干预前 干预后 t值 P值
研究组 40 47.0±12.4 60.3±11.2 －5.07 <0.001
对照组 40 48.0±13.1 54.5±12.8 －2.24 0.028
统计量   t＝－0.40 t＝2.14    
P值   0.690 0.035    
表4 本研究2组智力障碍患儿干预前、后家长QoL总评分组间与组内比较(分，±s)
组别 例数 干预前 干预后 t值 P值
研究组 40 57.8±11.5 72.4±9.9 －7.65 <0.001
对照组 40 55.7±10.3 58.0±10.2 －2.32 0.025
t值   0.90 7.58    
P值   0.372 <0.001    
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