福利机构成年残疾人照护服务需求分级评估工具应用评价OA

Objective To apply and systematically evaluate the care-need grading assessment tool for adults with disabilities in wel-fare institutions. Methods From June to July,2025,four disability care institutions in Shanghai were selected,and a total of 1 002 adults with disabilities were assessed using the self-developed care-need grading assessment tool for adults with disabil-ities in welfare institutions.The application effectiveness of the tool was evaluated by analyzing the classification results of care need grading and the reclassification in grade distribution.The application validity was assessed through score differences across functional dimensions,reduced-dimension clustering scatter plots for each grade,and external variables.The application efficiency was evaluated based on the average assessment duration and learning curves.The application utility value was assessed through the distribution characteristics and map-ping relationships of service lists across different grades. Results The distribution across disability levels was 84 in Level 1,298 in Level 2,92 in Level 3,246 in Level 4,and 282 in Level 5,indicating a trend where individuals from higher levels in the original system shifted toward the mid-dle and lower levels of the new system.The tool demonstrated strong discriminatory power across the four func-tional dimensions(P<0.001),indicating favorable discriminant validity.The five classified levels exhibited clear clustering boundaries in the reduced-dimension space,reflecting robust structural validity.The classification re-sults were consistent with theoretical expectations regarding external variables,including age,disability type,dis-ability grade,number of comorbidities,and primary clinical diagnoses(P<0.05),demonstrating sound external validity.The median assessment duration was 5.80 minutes,with a significant learning effect(P=0.037),show-casing high efficiency.Finally,service lists tailored to different care levels were developed,where service content exhibited graded differences across care levels and accurately mapped the care-need characteristics of each grade,reflecting substantial utility value. Conclusion This tool can classify the care needs of adults with disabilities into five levels,with sound validity and high assessment efficiency;while the resulting service lists for different care levels can be used to guide practical im-plementation,which can be used for the graded assessment of care needs among adults with disabilities.