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急性醫院與早期亞急性復健機構之ICF核心位碼組及其於物理治療之應用

The ICF Core Sets in the Acute Hospital and Early Post-acute Rehabilitation Facilities and Their Implication Physical Therapy

摘要


國際健康功能與身心障礙分類系統(International Classification of Functioning, Disability and Health,簡稱ICF)是一套描述健康與其影響因素之國際共同語言與編碼架構。然而ICF之位碼(categories)數超過1400個,臨床不可能應用這麼多位碼到所有患者,特別是在急性醫院與亞急性復健機構。因此ICF核心位碼組計畫(ICF Core Sets project)針對不同目的選取重要的ICF位碼,發展出不同特定健康或照護狀況之核心位碼組(core sets),希望藉此製訂出適當的測量與紀錄標準。完整版急性醫院與亞急性復健機構ICF核心位碼組,分神經系統、肌肉骨路系統,呼吸循環系統,是整合前驅研究與專家意見,經由正式臨床決策與專家會議過程發展而成。ICF核心位碼及其相關評估紀錄可做為臨床研究與治療時對病患功能與健康評估、溝通及報告的最基本標準,也是跨專業的完整評估和處置方案(scheme),應用者包括醫師、治療師、護理師,及其他專業人員。此外,由完整版中經研究選出約30項位碼的最少足夠資料模組(minimally sufficient data set),作為簡短版ICF核心位碼組。完整版與簡短版的急性醫院與亞急性復健機構ICF核心位碼組均已在不同國家或區域中經由專業人員與病患測試效度。本文介紹12個完整版與簡短版急性醫院與早期亞急性復健機構ICF核心位碼組,以及於9種病患之物理治療介入相關ICF位碼組。希望本文有助於相關專業人員於臨床運用ICF。

並列摘要


”The International Classification of Functioning, Disability and Health” (ICF) is a comprehensive framework for describing and classifying health and disability and its related factors. However, the entire coding system of the ICF which comprises over 1400 categories is difficult for being applied by clinicians to all their patients, especially in acute hospital and early post-acute rehabilitation facilities. Thus, the ICF Core Sets project aims to extract the ICF categories that are relevant to specific health conditions or care situations, and to define common standards for what should properly be measured and reported. The comprehensive ICF core sets for the acute hospital and early post-acute rehabilitation facilities were developed in a formal decision-making and consensus process, integrating evidence gathered from preliminary studies and expert opinion. The comprehensive ICF core sets for the acute hospital and early post-acute rehabilitation facilities serve as a common framework for the assessment, communication and reporting of functioning and health for clinical studies, clinical encounters and multi-professional comprehensive assessment and management. The ICF core sets that have been established for patients with neurological, musculoskeletal or cardiopulmonary conditions are intended for use by physicians, nurses, therapists and other health professionals. In addition, a minimally sufficient data set, brief ICF core set, which is feasible for use in clinical practice, encompasses about 30 categories. The ICF core sets for acute hospital and early post-acute rehabilitation facilities have been tested and validated in the patient and professional perspective and in different countries, regions, health care and provider settings. This paper introduces both comprehensive and brief ICF core sets for patients in the acute hospital and early post-acute rehabilitation facilities. In addition, the ICF core sets of 9 conditions in physical therapy were also introduced. We hope this article could enhance the application of ICF in clinical settings.

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