目的：网络调查国内多省份医疗系统和非医疗系统言语治疗从业人员发展现状。方法采用网络调查问卷，对国内30个省发放调查表进行网络言语治疗从业人员现状调查，并将调查对象分为医疗系统和非医疗系统两组，采集言语治疗人员的基本信息、学历、专业、职称、工作时间、待遇、治疗病种等信息，进行统计分析，比较两组间的差异和共性特点。结果共收集的982份调查表中，医疗系统657例，非医疗系325例。①医疗系统学士学位占59.8%，学士学位以下35.9%，非医疗系统分别为47.7%和40.9%；医疗系统中正式职工38.8%，合同制职工57.2%，非医疗系统中正式职工40.9%，合同制职工54.2%，差异无统计学意义（>0.05）。②医疗系统康复治疗学专业65.4%，非医疗系统康复治疗学专业26.5%，非学前教育12.6%，差异有统计学意义（<0.05）。③医疗系统5年以下工作年限为80.1%，非医疗系统为73.8%；医疗系统初级职称62.7%，非医疗系统初级职称42.2%，差异有统计学意义（<0.05）。④医疗系统中有康复治疗师执照者占63.6%，非医疗系统中教师占53.8%，差异有统计学意义（<0.05）。⑤医疗系统与非医疗系统人员在临床各科室分布明显不同，治疗疾病类型不同，医疗系统的言语治疗从业人员多取得康复治疗师执业，治疗对象以成人为主。非医疗系统言语治疗从业人员无职称者居多，从业人员以教师为主，治疗对象以儿童为主差异有统计意义（<0.05）。⑥医疗系统言语治疗从业人员比非医疗系统每日工作量大，工作时间长，差异有统计意义（<0.05）。⑦医疗系统和非医疗系统（待遇）年收入2万元以内的各占15.8%、19.4%，2~5万各占57.5%、59.4%，差异有统计学意义（<0.05）。⑧医疗系统中每年参加培训班次数5次以下者占51.3%，非医疗系统占40.6%；言语治疗从业兼职明显，差异有统计意义（<0.05）。结论国内言语治疗从业人员普遍年轻，所在单位大多为正式职工或合同制，享有基本保障；无论在医疗系统，还是非医疗系统的从业人员学历多在本科及以下，职称普遍较低；国内言语治疗从业人员专业多样，无培训上岗所占比例较高，年参加培训不多，非医疗系统更明显；虽然医疗系统的工资要比非医疗系统的工资高，但仍低于国家平均工资水平；医疗系统与非医疗系统言语治疗从业人员一致认为治疗收费应提高，调整治疗收费成为体现劳动价值的标准之一；增加对言语治疗从业者的认识、提高待遇，与国际接轨，加入世界言语治疗师联盟，完善言语治疗师教育准入制度，建全国家对言语治疗者资质的认证及晋升制度是言语治疗学发展的关键；医疗系统和非医疗系统言语治疗的亚专业教育是未来发展的必经之路；建设非医疗系统的言语康复治疗在社区残疾康复中更加重要。%Objective To investigate the speech therapy practitioner status of medical and non-medical systems in many Chinese provinces by web survey. Methods In order to comprehend the speech therapy practitioner status, the questionnaires were delivered to thirty provinces in China through network. The participants were divided into two groups, i.e. medical and non-medical systems. After collection of the basic information, education background, profession, job title, work time, pay and the diseases of treatment, the common characteristics and differences were compared between the two groups by statistical analysis. Results A total of 982 survey questionnaires were collected, among which the medical system accounted for 657, non-medical system for 325. The proportion of bachelor's degree was 59.8%, that below bachelor's degree was 35.9% in the medical system; and in the non-medical system those were 47.7%and 40.9%respectively. The ratio of staff was 38.8%, yet the ratio of contract workers was 57.2%in the medical system;while in the non-medical system the ratio of staff was 40.9%and the ratio of contract workers was 54.2%. However, there were no significant differences between the two groups ( >0.05). Rehabilitation therapy specialty in the medical system accounted for 65.4%, which was significantly different from 26.5% in the non-medical system ( < 0.05). The subjects of having less than 5-year working experience accounted for 80.1% in the medical systems and 73.8%in the non-medical system, primary job title accounted for 62.7% in the medical system and 42.2% in the non-medical system, there were significant differences between the two groups ( < 0.05). The people having the rehabilitation therapist license in the medical system made up 63.6%, while the teachers in the non-medical system accounted for 53.8%, there was statistical difference ( <0.05). There were differences between the two groups in the distribution of subjects in clinical departments and the types of diseases treated. In the medical system, speech therapy practitioners almost had licenses, their treatment objects were mainly adu however, most of the speech therapy practitioners in the non-medical system did not have a license, they were mostly teachers and their patients were mainly children, there were significant differences ( < 0.05). The practitioners in the medical system had much more daily workload and longer working hours than the participants in the non-medical system ( < 0.05). About the pay, the participants having yearly income of 20 thousands yuan in the medical and non-medical systems accounted for 15.8% and 19.4% respectively, those having yearly income of 20-50 thousands yuan accounted for 57.5% and 59.4% respectively; there were significan t differences ( < 0.05). The participants who attended training classes less than five times per year occupied 51.3% in the medical systems and 40.6% in the non-medical systems. Many participants who engaged in speech therapy had part-time jobs ( <0.05). Conclusions In China, speech treatment practitioners are generally young, they are mostly formal employees or contract workers, enjoying basic guarantees. Whether they are in the medical or non-medical system, the practitioners mostly have bachelor or even lower degree, that is to say, the title is generally low. In our country, speech treatment practitioners are from different professions, the proportion of non-training posts is high, there are not many having enough pre-employment training or yearly training, especially those in the non-medical system. Although the pay in the medical system is higher than that in the non-medical system, the pay in the medical system is still less than average national level. All of the speech treatment practitioners agree that treatment fee should be increased, and adjusting the treatment fee becomes one of the standards reflecting labor value. The keys to development of speech therapy are increasing the awareness on speech treatment practitioners, increasing their wage, acting on international convention, joining World Federation of Speech Therapists, improving the education admission system of speech therapists, and building the qualification of certification and the promotion system for speech therapists. Subprofessional education of speech therapy in medical and non-medical systems is the only way for future development. Construction of speech rehabilitation therapy in non-medical system is even more important in rehabilitation of the disabled in communities.
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