Experience of Implementing WHO-International Classification of Functioning, Disability and Health (ICF) in Disability Welfare Policy in Taiwan

應用世界衛生組織－國際健康功能與身心障礙分類系統（WHO-ICF）作為台灣身心障礙者鑑定初探研究

嚴嘉楓(Chia-Feng Yen) ； 林佳靜(Chia-Chin Lin) ； 廖華芳(Hua-Fang Liao) ； 陳適卿(Shih-Ching Chen) ； 林靖瑛(Ching-Ying Lin) ； 邱弘毅(Hung-Yi Chiu) ； 劉燦宏(Tsan-Hon Liou)

《身心障礙研究季刊》 10卷1期 (2012/03) Pp. 2-19

https://doi.org/10.30072/JDR.201203.0001

摘要

目的：本研究旨在說明如何應用「國際健康功能與身心障礙（ICF）分類」系統設計出台灣身心障礙鑑定工具及需求評估制度。研究方法：本研究以專家決策過程（decision-making process）為主要研究方式，資料收集期間為2008-2010年。參與專家共計199位，根據其專長並依ICF架構分成16組，各組以焦點團體及德菲法，針對未來評估方法、標準及評估人員資格等進行研議及決策。結果：（一）以ICF 整合模式取代長久以來身心障礙者鑑定之醫療模式，並設計兩階段鑑定評估來界定身心障礙者；（二）階段性完成身心障礙者鑑定之流程、標準及工具，並初步決議從ICF 2480位碼中，挑選出137個做為台灣障礙者鑑定核心碼；（三）本研究從研議過程中歸納出對醫療體系、中央、地方政府與身心障礙者及其家屬四方面的衝擊。結論：WHO已針對許多疾病發展出核心編碼，但皆無法應用於身心障礙者鑑定，所以如何從ICF分類系統或架構中發展適合台灣障礙者鑑定之用的題項是格外重要與創新，惟本研究結果還需要鑑定實驗計畫來驗證工具的可行性。

關鍵字

世界衛生組織 ； 身心障礙者 ； 身心障礙者鑑定 ； 國際健康功能及身心障礙分類系統

並列摘要

Objectives: The objective of this study is to demonstrate the process of applying WHO-ICF in Taiwan. Methods: We initiated a national decision-making process involving members of Taiwan's ICF Project Team. A total of 199 professionals participated in one of 16 groups which were according to the ICF framework. In each group, one member led the discussion in the form of a focus group session, using voting to reach agreement. These groups were asked to develop evaluation methods and standards, and to formulate related courses to train disability assessment workers. Each group discussed and drafted related regulations. Results: We completed the phased to replace the integration model for medical model to define people with disability using WHO-ICF in Taiwan and design two stages for definition of people with disability during 2008-2010. The project has now completed several parts of the standards, tools, and practice manuals based on the ICF. We selected a total of 137 out of all ICF codes for disability assessment from total 2480 codes. Lastly, we found dilemmas and impacts in four aspects which are hospitals, local and central government, people with disabilities and the main caregiver. Conclusions: Several core sets developed by WHO are mainly for diseases and not applicable to disability assessment. Therefore it is vitally important to select more applicable items from ICF related categories targeted at determining disability eligibility, but the new assessment protocols and tools need to be tested and observed in the future.

並列關鍵字

Disability ； disability welfare policy ； International Classification of Functioning ； Disability and Health (ICF) ； World Health Organization

參考文獻

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