基于ICF的作业治疗：理论架构与方法体系

目的 研究《国际功能、残疾和健康分类》(ICF)在作业治疗中的理论架构、方法体系及其在临床实践中的系统应用。方法 基于ICF理论,结合世界作业治疗师联合会的相关政策文件,分析作业治疗发展的理论架构,探讨基于ICF框架下临床情境下系统化的作业治疗。结果 基于ICF构建作业治疗的理论架构与方法体系,明确现代康复服务中综合作业治疗干预的目标、原则与应用方法。作业治疗干预目标是通过多学科、跨领域地应用综合作业治疗方案,提高个体的活动和参与,使功能最佳化。作业治疗基于生物-心理-社会模式,坚持以人为本和功能定向的原则,在不同情景下实施个性化的干预方案。在临床实践中,建议系统应用世界卫生组织国际健康分类家族,构建系统化的作业治疗服务体系,即功能与需求分析(ICHI)-功能分类、评估及编码(ICF)-疾病分类、诊断及编码(ICD)-作业治疗干预(ICHI)。结论 构建了基于ICF的作业治疗理论架构与方法体系,建立了综合性的临床作业治疗应用模式,明确了以活动和参与为导向的作业治疗干预目标,提高了作业治疗的系统化、结构化、标准化及精细化水平。

Application of ICF in occupational therapy: conceptual framework and approaches

Objective To study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. Methods Based on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. Results This study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. Conclusion An ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.