身心障礙與復健醫學－復健專科醫師在身心障礙領域的挑戰與機會

Disability and Rehabilitation -the Challenge and Opportunity of Physiatrists in Disability

張光華(Kwang-Hwa Chang) ； 劉燦宏(Tsan-Hon Liou)

《台灣復健醫學雜誌》 42卷2期 (2014/06) Pp. 71-79

https://doi.org/10.6315/2014.42(2)01

摘要

身心障礙是人類長久以來的問題，其中夾雜了醫療、社會福利、政治及人權等因素，因此相當複雜；2001年世界衛生組織（WHO）頒布新的國際健康功能與身心障礙分類系統（International classification of functioning, disability and health, ICF）後，開啟了對身心障礙的研究契機，目前身心障礙的定義也是根據ICF而來，依WHO身心障礙報告統計，目前盛行率為15%，全球約10億人口屬於身心障礙者；過去我國身心障礙鑑定工作主要根據醫療模式，因此盛行率不到5%，遠低於國際水平；據此我國「身心障礙者權益保障法」規定自2012年7月起，身心障礙鑑定制度必須依據ICF的精神，希望未來我國身心障礙制度能與國際接軌。復健專科醫師在訓練過程中，比其他專科醫師更了解身心障礙的理論，而且更熟悉跨專業、跨領域的團隊合作模式，因此應該發揮本身在身心障礙研究的優勢，迎接身心障礙的挑戰與機會。

關鍵字

身心障礙 ； ICF ； 生理心理社會模式 ； 盛行率

並列摘要

Disability, a long-standing problem affecting mankind, is associated with medical, social welfare, political, and human rights problems and, therefore, is complex. The World Health Organization (WHO) promulgated the International Classification of Functioning, Disability, and Health (ICF) in 2001, facilitating the study of disability in recent years. According to the WHO Disability Report, the worldwide prevalence of disability is 15%, and the minimal worldwide prevalence is estimated to be 1 billion cases. Before 2012, disability evaluation was based mainly on the medical model in Taiwan, and, therefore, the prevalence was lower than 5%, which is much lower than the international level. The Taiwan government legislated a constitutional amendment entitled the People with Disabilities Rights Protection Act in 2007. The act has mandated that individual eligibility for disability benefits be assessed according to the ICF framework since July 2012. Physiatrists have advantages during training; specifically, they have a greater understanding of disability theory and are more familiar with multidisciplinary teamwork compared with other specialists. Therefore, physiatrists must increase their knowledge to overcome the challenges and opportunities of disability.

並列關鍵字

disability ； International Classification of Functioning ； Disability ； and Health (ICF) ； biopsychosocial model ； prevalence