Wheelchair service provision education and training in low and lower middle income countries: a scoping review

<b>Purpose:</b> Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. <b>Method:</b> A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. <b>Results:</b> Education and training in LLMIC appears <i>ad hoc</i> and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. <b>Conclusions:</b> Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated.Implications for rehabilitationEducation and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue.Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision.Key wheelchair personnel need to establish their central role in this arena.The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures. Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue. Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision. Key wheelchair personnel need to establish their central role in this arena. The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures.

**研究目的**：将改善轮椅与坐姿辅助辅具适配从业人员的教育与培训可及性，以满足其个性化姿势与移动需求、作为一项基本人权，系当前工作的重中之重。本综述聚焦低收入及中低收入国家（low and lower middle income countries, LLMIC）内相关从业人员可获得的教育与培训资源，旨在明确其知识缺口所在，并确定人力资源教育的优先方向。
**研究方法**：本研究采用范围综述方法，梳理了1993年至2017年间该领域已发表的科学文献与灰色文献。检索策略涵盖在线数据库检索、手工文献检索以及关键利益相关方的咨询建议。研究采用内容分析法对检索到的文献进行整理，并提炼核心主题。
**研究结果**：LLMIC内的教育与培训工作呈现出非系统化且规模有限的特点，但包括世界卫生组织与非政府组织在内的各方对其重要性的认知正不断提升，相关机构已向多个国家推出教育项目，并开发了资质认证考试。在轮椅适配服务的负责人员方面存在权责不清的问题，许多LLMIC尚未明确指定专门的专业人员来监管该服务体系。
**研究结论**：所有参与轮椅适配服务的利益相关方均需接受教育与培训。推动相关项目开发以提升从业人员技能、强化服务能力并确保实践规范，乃是当前的优先任务。应考虑在特定场景下开展试点，提供适配的轮椅适配服务教育与培训并配套资质认证。教育项目的实施框架应包含成果评估与可迁移技能的培养。此外，应探讨设立专门的学科以监管轮椅适配服务体系。
**康复领域启示**：通过规范的适配服务获取合适的轮椅，教育与培训是轮椅适配流程中的关键环节。然而，这不仅是教育与培训问题，更是一项人权议题。所有参与轮椅适配服务的利益相关方均需接受强制性教育与培训。核心轮椅服务从业人员需确立其在该领域的核心地位。本研究提升了各界对与政府合作、推动构建可持续轮椅适配服务基础设施重要性的认知。教育与培训是通过规范适配服务获取合适轮椅的关键环节，亦是轮椅适配流程中的核心步骤。然而，其意义远超教育与培训本身，属于人权议题范畴。所有参与轮椅适配服务的利益相关方均需接受强制性教育与培训。核心轮椅服务从业人员应明确其在该领域的核心作用。本研究旨在提升各界对携手政府共建可持续轮椅适配服务基础设施之重要性的认知。