An evaluation of the fulfillment of welfare measures for persons with disabilities in Japan from the perspective of disability welfare service providers

Abstract

Using the 25 elements of the Community-based Rehabilitation (CBR) matrix as a scale, the fulfillment of disability welfare measures was evaluated in Japan from the perspective of disability welfare service providers based in the regional Japanese Tsuruoka City.

A recovery rate of 80.36% was achieved, with valid responses obtained from 90 of 112 the providers surveyed.

On a 4-point scale, the higher-ranking elements consisted of the health promotion element, social protection element, medical care element, and disabled people’s organization element (which scored the same as the medical care element), while the lower-ranking elements were the lifelong learning element, self-employment element, and wage employment element.

From a factor analysis of the elements, four factors were extracted, which were respectively named Autonomy, Independence, Learning, and Life. With the clarification of the background factors influencing the evaluation of welfare measures for persons with disabilities, it was revealed that Autonomy and Independence were interrelated in a Möbius strip-style fashion.

In other words, “Autonomy” and “Independence” are in a complementary relationship wherein they serve to heighten each other by relating to and continuing on from each.

With respect to normalization, significant differences were observed in all of the remaining elements except for the health promotion element, suggesting that substantial comprehensive welfare measures for persons with disabilities are required for the spread of normalization.

While the trend of the Disability Welfare Plan indicated that significant inroads were made in terms of the performance of long-term nursing care, Work Support Centers for Continuous Employment (“Type A”), and plan-based counselling and support, the actual volume of usage in Tsuruoka City fell short of the national level for all services.

Of the four factors extracted by factor analysis, measures related to education and medical care, which lead to “Independence” - which forms the basis of life and is easy to evaluate externally - are progressing across the entire area. However, measures aimed at internal “Autonomy” tend to be grasped subjectively, which resulted in a low evaluation by service providers.