2011年新制身心障礙鑑定計畫結果分析

Result Analysis of the New Disability Assessment Plan for the Year 2011

黃寶(Pao Huang) ； 吳佩霖(Pei-Lin Wu) ； 楊士賢(Clement Shih-Hsien Yang) ； 王仁宏(Jen-Hung Wang) ； 樊志成(Chih-Cheng Fan) ； 郭惟致(Wei-Chih Kuo) ； 梁忠詔(Chung-Chao Liang)

《台灣復健醫學雜誌》 42卷1期 (2014/03) Pp. 31-40

https://doi.org/10.6315/2014.42(1)04

摘要

目的：本研究目的是想藉由新制身心障礙鑑定表之評估結果，來比較舊制身心障礙等級與使用新制身心障礙鑑定表結果其各項分數是否不同，並且探討此鑑定表當中之身體功能、身體結構、世界衛生組織障礙評估手冊2.0版（WHODAS2.0）、環境因素、動作活動及就業狀況之間的相關性。方法：本研究總共收取9446位持有身心障礙手冊，單一障別屬性，並年滿18 歲的個案，收案時間為2011年8月至2012年6月，參與「新制身心障礙鑑定工具」試測者，使用新制身心障礙鑑定表進行評估，評估項目包括身體功能、身體構造、WHODAS 2.0版及環境因素、動作活動及就業狀況，以Spearman等級相關係數（Spearman’s rho)來分析舊制身心障礙等級與新制各項主要評量項目之間的相關性。並以單因子變異量（ANOVA）分析不同的障礙等級，其身體功能、身體構造及WHODAS2.0版的評估結果是否有差異。以Spearman等級相關係數（Spearman’s rho）來分析動作活動分別與WHODAS 2.0及身體功能及構造總分平均的相關性。就業部分則以複邏輯斯迴歸分析（Multivariate Logistic Regression Model）分析影響就業與否之相關因素。結果：舊制不同身心障礙等級與2012 年新制身心障礙鑑定表，內容的身體功能及構造相關性達0.643；與WHODAS 2.0版的表現部分達0.356。WHODAS 2.0版中的表現與能力之間有顯著的差異，兩者差異最大為生活自理領域，差異最小為與他人相處。失能狀況以社會參與的表現及四處移動的能力困難分數最高，且失能狀況隨身障等級越高其分數越高。動作活動與WHODAS 2.0版有高度相關性達0.718；與身體功能及構造則呈低相關為0.124。障礙的情況越嚴重則就業率越趨下降；排除背景因素，以身體功能與結構鑑定區分，泌尿與生殖系統相關構造及其功能障礙者其就業率為最高。結論：本次使用的新制身心障礙鑑定表內的身體功能及身體構造，與舊制不同身心障礙等級相關性達中高度相關；受試者表示有使用輔具或它人的介入協助執行活動，於生活自理領域中的表現與能力之間差異最大。

關鍵字

身體功能及構造 ； 世界衛生組織障礙評估手冊2.0版 ； 環境因子 ； 身心障礙等級

並列摘要

Purpose: This study aims to compare the differences between the levels of disability in the old system and various scores in the disability assessment in the new system. In addition, the study explores the correlation between body function, body structure, scores on the World Health Organization (WHO) Disability Assessment Schedule 2.0 (WHODAS 2.0), environmental factors, movement performance, and employment status. Methods: The study collected a total of 9446 cases from people over 18 years old with a single disability. Cases were collected from July 2011 to June 2012. The participants in the ＂Disability Assessment Instrument of the New System＂ used the new assessment form for evaluation; the evaluation items included body function, body structure, WHODAS 2.0 score, and environmental factors. Spearman’s rho was used to analyze the correlation between the levels of disability in the old system and the major assessment items in the new system. Analysis of variance was used to analyze levels of disability and differences among body functions, body structure, and WHODAS 2.0 assessment results. Spearman’s rho was used to analyze the correlations between movement performance and the average WHODAS 2.0 score, body function, and body structure. A multivariate logistic regression model was used to analyze the relative factors of employment. Results: The correlation between body function and structure in the content of different levels of disability in the old system and the disability assessment form from the year 2012 reached 0.643, and the correlation of performance with the WHODAS 2.0 score reached 0.356. The performance and ability of the WHODAS 2.0 score were significantly different. The biggest difference was found in the domain of self-care in daily living, and the smallest difference was found for getting along. The highest scores for disability difficulties were performance in participating in society and movement ability. The level of disability was positively correlated with the score for incapable condition. Movement performance was highly correlated with the WHODAS 2.0 score and reached 0.718, but was poorly correlated with body function and structure, reaching 0.124. As disabilities became more severe, the employment rate decreased. Excluding background factors and just dividing by body function and structure, the employment rate was highest for those with disabilities related to the urinary and reproductive systems. Conclusion: Body function and structure in the disability assessment form of the new system were moderately correlated with different levels of disability in the old system. Also, subjects reported that providing aids or personnel to assist in the domain of self-care in daily living resulted in significant differences between performance and ability.

並列關鍵字

body function and structure ； WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) ； environmental factors ； the level of disability