Abstract: Background Rural doctors are the most convenient providers of community-based rehabilitative services for chronic disease patients and disabled people in rural areas，with the promotion of graded diagnosis and treatment policies， people began to pay attention to the competence of community-based rehabilitative services among rural doctors. Objective By investigating the competence of community-based rehabilitative service among rural doctors，analyzing the shortage of competence，and providing references for improving it. Methods A multi-stage stratified cluster sampling and purposive sampling methods were used to select 3 916 rural doctors from five provinces in east，central，and western China. The survey was conducted from July to August 2020. The questionnaire mainly focused on investigating the possession of rural doctors' competence in rehabilitation function assessment and community rehabilitation guidance，as well as whether the competence could meet their actual work needs. Results Of the 3 916 rural doctors surveyed，2 391（61.1%）、3 704（94.6%）、2 365（60.4%）were found to have competence in rehabilitation function assessment，community rehabilitation guidance，and comprehensive community-based rehabilitative service，respectively. The comparison of the rehabilitation function assessing competence，community rehabilitation guiding competence，and comprehensive community rehabilitation service competence of rural doctors in the eastern，central，and western regions showed statistically significant differences（P<0.001），while the rural doctors in the western region had the lowest proportion of competence；There were statistically significant differences （P<0.05）in the proportion of the rehabilitation function assessing competence and the comprehensive competence of community rehabilitation services among rural doctors with different educational backgrounds and practicing qualifications. Rural doctors with an educational background of technical secondary school/ high school or below had a relatively higher proportion of competence，and general practitioners also had a relatively higher proportion of competence. The proportion of rural doctors who need to provide six services in daily work，including muscle strength grading assessment，motor function assessment，joint activity assessment，rehabilitation guidance for common disease patients，rehabilitation guidance for chronic disease patients，and rehabilitation guidance for disabled patients，is 73.5%（2 880/3 916）、73.8%（2 891/3 916）、74.1%（2 900/3 916）、96.3% （3 773/3 916）、95.9%（3 754/3 916）、89.1%（3 490/3 916），respectively. The proportion of the three classification competencies included in the rehabilitation function assessment competence that meet the work needs does not exceed 75%，and the three classification competencies included in the community rehabilitation guidance competence meet the work needs with a rate of 92.4%（3 487/3 916）、91.7%（3 441/3 916）、85.6%（2 987/3 916），respectively. Conclusion Overall，the community-based rehabilitation service competence of rural doctors in China was in relatively good condition. However，there were deficiencies in the competence of rural doctors in Western China. The community-based rehabilitation service competence of rural doctors could meet the needs of rural residents，and with the gradual formation of the continuous rehabilitation service mode of staying in the hospital during the acute period and returning to the community during the recovery period，rural residents will have a higher demand for the community-based rehabilitation service of rural doctors. Therefore，positive measures should be taken to enhance the rehabilitation service competence of rural doctors，and practical exercises are the more effective measures we have found.

Key words: Rural doctor；Community-based rehabilitative service；Rehabilitation function assessing competence；Community rehabilitation guiding competence；Eastern, central and western regions

摘要： 背景 村医是农村地区慢性病患者、失能老人、残疾人康复服务的最便捷的提供者，随着分级诊疗政 策推进，村医的康复服务能力引起关注。目的 了解村医社区康复服务能力掌握情况，分析其康复服务能力存在的不足，提出能力提升策略。方法 于 2020 年 7—8 月，采用多阶段分层整群抽样和典型抽样相结合方式，抽取我国东、中、西部地区 5 个省份的部分村医展开调查，内容涉及村医的康复功能评定、社区康复指导能力的具备情况，以及各项能力满足工作需要情况。结果 共回收有效问卷 3 916 份，接受调查的村医中，分别有 2 391 名（61.1%）、3 704名（94.6%）、2 365 名（60.4%）村医具备康复功能评定能力、社区康复指导能力、社区康复服务综合能力；东、中、西部村医的康复功能评定能力具备率、社区康复指导能力具备率和社区康复服务综合能力具备率比较，差异有统计学意义（P<0.001），其中西部地区村医各项能力具备率均较低；不同学历和执业资质村医的康复功能评定能力具备率与社区康复服务综合能力具备率比较，差异有统计学意义（P<0.05），其中，高中 / 中专以下学历村医的能力具备率较高，全科医师的能力具备率较高；报告在日常工作中需要提供肌力分级评定、运动功能评定、关节活动评定、常见病患者康复指导、慢性病患者康复指导、伤残患者康复指导 6 种服务能力的村医占比分别为 73.5%（2 880/3 916）、73.8%（2 891/3 916）、74.1%（2 900/3 916）、96.3%（3 773/3 916）、95.9%（3 754/3 916）、89.1%（3 490/3 916），在能力满足工作需求方面，三种康复功能评定能力满足工作需要的比例均未超 75%，三种患者康复指导能力满足工作需要率分别为 92.4%（3 487/3 916）、91.7%（3 441/3 916）、85.6%（2 987/3 916）。结论 我国村医的社区康复服务能力具备情况总体上较好，但西部地区村医社区康复服务能力存在不足；村医社区康复服务能力可基本满足村民需求，但随着急性期在医院、恢复期回社区的连续性康复服务模式逐步形成，农村居民对村医的社区康复服务将会有更高的需求，应通过实践锻炼等方式提升村医康复服务能力，补齐能力短板。

关键词: 乡村医生, 社区康复服务, 康复功能评定能力, 社区康复指导能力, 东中西部地区