Hubert M
Forschungsinstitut Technologie-Behindertenhilfe der Evangelischen Stiftung Volmarstein, Wetter/Ruhr, Wetter.
Rehabilitation (Stuttg). 2003 Feb;42(1):52-9. doi: 10.1055/s-2003-37051.
In Germany the assessment of needs for technical aids occurs widely unsystematic and without the possibility to verify the advice process. A systematic assessment of individual needs for technical aids that follows standardised indication criteria so far has not been paid much attention. Compared with this, the advice and supply measures in the Netherlands are increasingly based on a systematic and comprehensible analysis of the individual inquiry. This analysis is called "indication and selection advice" and is usually carried out by therapists. Under Dutch law, consultants can act rather independently of any commercial interest. The basics of the analysis derive from the ICIDH and theoretical models of occupational therapy. Besides an overview of the legislation on the supply with technical aids in the Netherlands, the procedure of needs assessment plus a specific instrument based on occupational therapy knowledge are presented. The realization of advice as a defined part of the supply process required a new definition of tasks for occupational therapists. The resulting changes in the comprehension of professional roles are briefly described, too. The results of this investigation regarding the practice of needs assessment in the Netherlands suggest that changes are also required in the German service delivery system and its legal basis. Because of their specific expert knowledge of indication and selection of suitable technical aids, a more extensive involvement of occupational therapists in this key process of measures of home adaptation and the supply with technical aids is recommended in Germany, too. The development of practicable, standardised instruments to assess individual needs is advisable because it will contribute to increased efficiency of the supply with technical aids.
在德国，对技术辅助器具需求的评估普遍缺乏系统性，且无法对咨询过程进行核实。迄今为止，按照标准化适应症标准对个人技术辅助器具需求进行的系统评估并未得到太多关注。相比之下，荷兰的咨询和供应措施越来越多地基于对个人咨询的系统且易懂的分析。这种分析被称为“适应症和选择咨询”，通常由治疗师进行。根据荷兰法律，咨询师在行动时可以相当独立于任何商业利益。该分析的基础源自《国际功能、残疾和健康分类》（ICIDH）以及职业治疗的理论模型。除了概述荷兰技术辅助器具供应方面的立法外，还介绍了需求评估程序以及基于职业治疗知识的特定工具。将咨询作为供应过程中一个明确部分来实现，需要对职业治疗师的任务进行重新定义。还简要描述了由此导致的对专业角色理解的变化。这项关于荷兰需求评估实践的调查结果表明，德国的服务提供系统及其法律基础也需要做出改变。鉴于职业治疗师在合适技术辅助器具的适应症和选择方面具有特定的专业知识，在德国也建议让他们更广泛地参与家庭适配措施和技术辅助器具供应这一关键过程。开发实用的标准化工具来评估个人需求是可取的，因为这将有助于提高技术辅助器具供应的效率。
