[目的]伤残人员就业是一项重要的社会和公共卫生挑战.尽管该人群中大部分能够工作,并且就业可以明显改善他们的生活,很多伤残人员目前处于失业状态.本研究对影响“麻萨诸塞州就业与伤残调查”参试者就业及工作意愿的障碍因素加以探讨.[方法]基于一项开展于2003年在总数为2952名加入麻萨诸塞州医疗计划的伤残人员的横断面(crosssectional)调查.[结果]虽然伤残及健康问题对伤残人员就业有重要影响,这些并非决定该类人员工作意愿的主要因素.然而,社会经济地位,与工作有关的活动,以及有关政策或专项计划与就业和工作意愿二者皆为相关.[结论]由于影响工作意愿的障碍多为政策性因素,改变现有政策或者制定专为鼓励伤残人员工作而设计的计划,对成功帮助他们获取就业从而改善生活质量至关重要.“,”[Objective] The employment of people with disabilities is an important social and public health challenge.Although the life of this population could be significantly improved if they are employed and a large part of disabled people are able to work,many of them are currently unemployed.In the present study,we investigated the barriers affecting employment as well as work intention among the participants of the Massachusetts Medicaid (MassHealth) Employment and Disability Survey.[ Methods] A cross-sectional survey conducted in 2003 on a total of 2 952 people with disabilities who were members of MassHealth plans.[Results] Our results demonstrated that while disabilities and health problems had a strong influence on the employment of disabled people,these factors were not major determinants of their work intention.Instead,socioeconomic status,work related activities,and policies/special programs were associated with both employment and work intention.[Conclusion] Since the barriers affecting work intention are more policy-associated,policy changes or new programs tailored specifically to encourage disabled people to work will be critical to achieve success in helping them in gaining employment and improving their quality of life as well.