世界衛生組織“國際功能、失能和健康分類(ICF)”：理論架構、範圍、分類與編碼原則

WHO International Classifications of Functioning, Disability and Health (ICF): Introduction to its Structure, Parts, Components and Coding System

林金定(Jin-Ding Lin)

《身心障礙研究季刊》 6卷2期 (2008/06) Pp. 102-127

https://doi.org/10.30072/JDR.200806.0002

摘要

世界衛生組織於1980年發展了「國際損傷、失能及殘障分類標準(International Classification of Impairments, Disabilities, and Handicaps, ICIDH)」，儘管ICIDH針對損傷、失能與殘障明確的意義與分類，經過過去二十多年的運作，但日常生活中三者能仍是混著使用，使得這個分類在實務應用上面臨許多的困難。為了提供身心障礙的國際分類標準，世界衛生組織於2001年公布「國際功能、失能和健康分類(International Classifications of Functioning, Disability and Health, ICF)」，ICF已從過去ICIDH以「疾病結果」的分類轉變為以「健康成份」的分類，這各分類標準將應影響世界各國衛生政策甚遠，本文主要目的乃在探討世界衛生組織的身心障礙分類的理論發展，並介紹ICF的理論架構、範圍、分類與編碼原則，最後並整理分析ICF編碼的範例說明。ICF為醫療衛生資訊系統提供一種新的編碼程序，提供國際間一個共同的語言往後學者專家可以對不同國家的資料進行客觀性的比較；此外，它也可成為一套衛生與社會政策工具，用於衛生政策與社會保障計劃、勞動、保險、教育、經濟和一般立法以及環境改造等，對於世界各國影響深遠。台灣於民國96年7月1日通過「身心障礙者權益保障法」，修正條文中明訂身心障礙類別將比照世界衛生組織ICF標準，原來的16類修改為8大類，這將對台灣的身心障礙分類造成極大的衝擊，不過，這也顯示台灣與國際接軌的決心，因此本文內所分析探討有關ICF的理論基礎與分類編碼規則將有其時代的意義與必要性。作者最後結論ICF對未來衛生政策、社會福利、教育、勞政、保險與環境改造將造成重大影響，這個分類標準將提升未來身心障礙者公平機會與減少社會政策歧視的重要基礎。

關鍵字

身心障礙分類 ； 身體功能 ； 身體結構 ； 國際功能 ； 失能和健康分類ICF ； 損傷 ； 參與 ； 環境因素

並列摘要

The WHO developed a preliminary scheme concerning consequences of disease in 1972, and the first edition of International Classification of Impairments, Disabilities, and Handicaps (ICIDH) was published in 1980. Revision process for ICIDH initiated in 1993, resulted in development of International Classifications of Functioning, Disability and Health (ICF). ICF as an international standard, it provides a scientific basis for consequences of health conditions, to establish a common language to improve communications, to permit comparison of data across countries, health care disciplines, services and time and to provide a systematic coding scheme for health information systems. The aims of present paper are to examine the ICF's theories, structure, terminology, areas, category and coding system. Taiwanese government has stipulated that the Disability Human Right Protection Law will adopt the ICF as the basis of disability classification in July 2007. It means that we are moving forward to the international community and this international classification-ICF will provide a unified and standard language and framework for the description of human functioning and disability as an important component of health. The author concludes that the ICF will provide positive input to policy determination by providing information to help establish health policy, security, social service, education, labor service, environmental improvement, to promote equal opportunities for all people, and support the fight against discrimination based on disability.

並列關鍵字

Activity ； body function ； body structure ； disability classification ； environmental factors ； ICF ； ICIDH ； impairment ； participation ； WHO

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