国际功能、残疾和健康分类架构在智力残疾标准制订中的应用探讨

智力残疾(intellectualdisability) ,又称智力落后(mentalretardation) ,其标准及分类是随着人们对智力残疾本质的认识而不断完善起来的。智力残疾的概念经历了一个长期演化的过程,因此,关于智力残疾的标准及分类也不断被修正。自195 9年美国智力落后学会(AmericanAssociationonMentalRetardation ,AAMR)把适应性行为引入智残的诊断以来,理论界对智力和适应性行为作为智残标准已无大异议,但在适应性行为的结构问题上却一直存在着争论[1] ,因此,智力残疾的标准及分类仍然是一个悬而未决的问题。2 0 0 1年5月,第5 4届世界卫生大会通过了《…     

《国际功能、残疾和健康分类》应用指导(四)

(续第 3期 )9ICF分类系统在临床中的应用ICF作为一种有关功能、残疾和健康的分类工具 ,可以应用于不同的领域[1] ,其中临床领域的应用是一个非常重要的方面。ICF作为临床工具可以用于需求评定、治疗方法的选择、职业康复与评定、康复及其结果评估等多个方面。ICF还可以用于临床教育与研究。9.1ICF分类系统在临床中应用的理论与实践意义以及发展现状9.1.1ICF临床应用的理论与实践意义　ICF作为一种有效的分类工具 ,在临床领域的应用可以集中为以下 5个方面 :①ICF及其临床评定量表可以用于了解及研究健康和与健康有关的状况、结果 …     

《国际功能、残疾和健康分类》的发展和应用进展

世界卫生组织（WHO）于2001年正式发布了《国际功能、残疾和健康分类》（International Classification of Functioning,Disability and Health,简称ICF）。该分类是WHO分类家族中的重要成员,是WHO提出的国际通用的在个体和人群水平上描述和测量健康的理论性框架结构。WHO在世界卫生组织第五十八届世界卫生大会有关残疾与康复的决议（WHO58．23）《残疾,包括预防、管理和康复》中,将ICF列为残疾与康复的重要标准性文件,ICF的研究、开发与应用将对新世纪的残疾和康复工作产生极其重要的影响。     

国际残疾调查与统计的主要方法研究

1国际残疾调查的主要方式就世界范围而言,残疾调查可以按3种方式进行:1.1人口普查方式　即在人口普查中加入残疾调查项目,通过有关残疾项目筛查出残疾发生率以及与残疾有关的社会经济特征[1] 。此种方式的优点是可以较好地采集多方面的数据,并能与其他非残疾人的数据进行比较;缺点是不能调查针对残疾人的许多专门数据[2 ] 。以美国为例,根据《美国残疾人法》(1990年通过,1992年生效) ,残疾人定义为具有下列特征的个体:①有身体或精神障碍持续性限制某项或多项主要生活活动;②具有该种障碍记录;③被认为有这种障碍[3] 。美国人口普查数据中关…     

《国际功能、残疾和健康分类》对当代康复医学教育发展的影响

世界卫生组织 (WHO)经过近 10年的努力 ,组织全世界 6 5个国家的专家共同开发了应用于描述和说明功能、残疾和健康状态的分类系统《国际功能、残疾和健康分类》(InternationalClassificationofFunction ing ,DisabilityandHealth ,ICF) ,并由WHO第 5 4届世界卫生大会正式通过 ,开始在全球实施。ICF作为重要的有关健康与残疾的理论与方法系统 ,必将对康复医学教育产生重大的影响。ICF作为一种教育工具 ,也可以用于康复课程的设计以及康复教育评估等诸多康复教育领域 ,本研究将探讨ICF在当代康复医学教育中应用的几个理论与实践问题…     

国际社会有关残疾普查与统计政策研究

1 联合国有关残疾普查与统计机构与标准 在国际残疾人10年中,自从实施<世界残疾人行动纲领>和<残疾人机会均等标准规则>后,对残疾人统计的要求越来越高,<世界残疾人行动纲领>和<残疾人机会均等标准规则>特别要求联合国建立专门系统,定期收集、发布关于残疾的信息,主要涉及国家性数据、基本残疾发生率,以及确定残疾人口等.     

《国际功能、残疾和健康分类》在残疾人事务中的应用

世界卫生组织于 2 0 0 1年正式颁布了《国际功能、残疾和健康分类》(InternationalClassificationofFunc tioning ,DisabilityandHealth ,ICF) ,WHO希望它能在有关社会政策制定、统计、卫生管理、临床以及教育等领域得到广泛的应用[1、2 ] ,成为一种国际性的共同术语分类体系。ICF可以在残疾人事务中得到广泛的应用 ,本研究将探讨ICF在残疾人事务中应用的有关理论与方法以及应注意的问题。1ICF在残疾人事务中的主要应用领域与方法1.1ICF与残疾政策制定　ICF是WHO依据当代卫生研究以及残疾研究的成果 ,从卫生以及与残疾人相关事…     

对功能、残疾和健康国际分类中文版的研究

系统分析<国际功能、残疾和健康分类>(ICF)产生的历史背景、主要特点、理论模式和应用领域,并就今后ICF在中国的发展提出了有关的研究与应用设想.     

《国际功能、残疾和健康分类》检查表:发展和应用

导言　　 2 0 0 1年 10月 2 1- 2 7日 ,在美国马里兰州贝塞斯达 (Ｂｅｔｈｅｓｄａ)召开了世界卫生组织国际分类家族 (ｔｈｅＦａｍｉｌｙｏｆＩｎｔｅｒｎａｔｉｏｎａｌＣｌａｓｓｉｆｉｃａｔｉｏｎｓ,ＷＨＯ ＦＩＣ)合作中心领导人会议 ,会议要求秘书处为 2 0 0 2年的中心领导人会议提交一份报告 ,说明ＩＣＦ检查表的发展和应用。本报告就是应这一要求而作。检查表的发展历史及其在ＩＣＦ修订过程中的应用检查表起源于世界卫生组织和美国国家健康研究所在 16个国家的 2 0个地点组织实施的跨文化可适用性研究 (ｔｈｅＣｒｏｓｓＣｕｌｔ…     

《国际功能、残疾和健康分类》应用指导(二)

7ICF分类系统活动和参与部分应用指导活动是由个体执行一项任务或行动。活动受限是个体在进行活动时可能遇到困难。参与是投入到一种生活情景中。参与局限性是个体投入到生活情景中可能经历到不便。7.1活动和参与部分分类体系　附图显示了活动和参与部分分类体系7.2活动和参与之间的结构关系　根据领域列表 ,就活动 (A)和参与 (P)之间的联系 ,ICF提出了四种结构关系 ,可以满足不同的需求[1] 。具体如下 :7.2 .1活动领域和参与领域是不同的集合 (无交叉 )　即将一部分类目的集合仅作为活动 (即个体所执行的任务或行动 )进行编码 ,而另一…     

Achieving meaningful measurements of ICF concepts

PURPOSE: This paper reviews the strengths and weaknesses of two different approaches to assessing ICF concepts: coding versus quantitative scales. It illustrates the advantages of an alternative, integrative approach, called functional staging. METHOD: A prospective cohort study. A total of 516 subjects in the Rehabilitation Outcome Study. RESULTS: ICF codes provide a useful approach for classifying easy-to-interpret health-related information on individuals that can be incorporated into administrative records and databases. By minimizing measurement error, quantitative scales are well suited for synthesizing health-related data that can be used to compare the health states of groups of individuals across studies, conditions, and countries as well as to detect clinically meaningful change. A functional staging approach combines the attractive features of ICF coding and quantitative scales to help the user interpret the clinical meaningfulness of summary scores while retaining measurement reliability, validity and precision. CONCLUSIONS: A functional staging approach to assessing ICF concepts holds promise as a useful technique for measuring and interpreting the core concepts in the ICF framework.     

Achieving meaningful measurements of ICF concepts

Purpose. This paper reviews the strengths and weaknesses of two different approaches to assessing ICF concepts: coding versus quantitative scales. It illustrates the advantages of an alternative, integrative approach, called functional staging.

Method. A prospective cohort study. A total of 516 subjects in the Rehabilitation Outcome Study.

Results. ICF codes provide a useful approach for classifying easy-to-interpret health-related information on individuals that can be incorporated into administrative records and databases. By minimizing measurement error, quantitative scales are well suited for synthesizing health-related data that can be used to compare the health states of groups of individuals across studies, conditions, and countries as well as to detect clinically meaningful change. A functional staging approach combines the attractive features of ICF coding and quantitative scales to help the user interpret the clinical meaningfulness of summary scores while retaining measurement reliability, validity and precision.

Conclusions. A functional staging approach to assessing ICF concepts holds promise as a useful technique for measuring and interpreting the core concepts in the ICF framework.     

The ICF as a framework for national data: the introduction of ICF into Australian data dictionaries

PURPOSE: A country's data may influence and inform its policy and services, if suitably designed. This paper describes how two related and interacting activities--work on disability concepts and classification as well as the preparation of national data dictionaries--have been carried out in Australia, with this purpose. METHOD: Three key ingredients were combined. A broadly based advisory group was established to ensure the use of disability concepts that are meaningful not only to policy makers but also to the Australian community. This group advised on two 'twin' activities: participation in the revision of the key international classification for disability, and specification of data elements for a national data dictionary according to international standards. RESULTS: National data elements were developed, based on the Beta-2 draft ICIDH-2, and accepted for use in Australian national data dictionaries on a trial basis. CONCLUSION: The purpose and process have been accepted as valuable, and there is interested anticipation of new Australian standard data elements based on the ICF.     

Mourning and mental retardation

Too often, the grieving needs of the mentally retarded are misunderstood and disenfranchised by both family members and treatment staff. I outline a training program to equip the staff of mental retardation agencies to respond to the special needs of their clientele, as well as a program for the family members of retarded individuals. Interventions with the client themselves are illustrated through a series of case studies illustrating the unique difficulties in the grieving process that can arise from the convergence of ambivalnce, depends, and guilt that complicates the relationships between mentally retarded individuals and many of the people in their lives. In spite of their intellectual limitations, the majority of retarded individuals experience the death and loss as charged with emotional significance and provide a challenge to those who would support them in their grieving.     

Coding of meaningful concepts in lymphedema-specific questionnaires with the ICF

Abstract

Purpose: To identify and quantify the meaningful concepts within questionnaires focusing on lymphedema using the International Classification of Functioning, Disability and Health (ICF). Methods: Electronic searches of Medline, EMBASE, CINAHL, CENtral and Pedro (2005–2010) were conducted. The concepts in the questionnaires were retrieved from the included studies and linked to the ICF. Results: Of the 2381 abstracts retrieved, 136 studies were included. The study population suffered from lymphedema in the upper limb (65%), in the lower limb (25%), in the midline (3%) and in combinations of these areas (7%). In total, 12 lymphedema-specific questionnaires were found (nine for the upper limb, two for the lower limb and one for lymphedema in general). A total of 301 concepts were extracted from the questionnaires, of which 271 (90%) could be linked to the ICF. There were 45 two-level ICF categories linked to concepts in ≥2 questionnaires; 13 in Body Functions, 6 in Body Structures, 16 in Activities and Participation and 10 in Environmental Factors. The most frequently measured categories were “Structure of upper extremity”, “Immunological system functions”, “Looking after one’s health”, “Sensation of pain”, “Touch functions”, “Dressing” and “Health services, systems and policies”. Conclusion: The ICF provides a valuable reference to identify concepts in questionnaires focusing on individuals with lymphedema.

• Implications for Rehabilitation

• Lymphedema is a chronic condition and the problems in physical functioning related to lymphedema can result in distress and loss of quality of life.

• ICF Core Sets for lymphedema consist of a lymphedema-specific selection of ICF categories, which makes it easier to implement the use of the ICF in medical and allied health care.

• ICF Core Sets for lymphedema can act as a framework for more unity in questionnaires concerning consequences of lymphedema.

• Part of the development process of ICF Core Sets for lymphedema is the linking of items from lymphedema-specific clinical questionnaires to ICF codes. The ICF codes most frequently used to link the items in the reviewed questionnaires were “Structure of upper extremity”, “Immunological system functions”, “Looking after one’s health”, “Sensation of pain”, “Touch functions”, “Dressing” and “Health services, systems and policies”.