Schneidert Marguerite, Hurst Rachel, Miller Janice, Ustün Bedirhan
Environmental Task Force, CAS/EIP, World Health Organization, 20 Ave Appia, 1211 Geneva, Switzerland.
Disabil Rehabil. 2003;25(11-12):588-95. doi: 10.1080/0963828031000137090.
This paper provides a framework for understanding the impact of environmental factors on functioning when a person has a health condition. This understanding provides the rationale for including environmental factors in WHO's International Classification of Functioning, Disability and Health (ICF).
This conceptual paper uses a review format to provide, firstly, an historical perspective on the integration of environmental factors into the understanding of disability and the ICF; secondly, a description of the overall ICF and, specifically, the environmental factors section; and thirdly, an overview of the interaction of a person with a health condition and the environment in which they live, and the outcome of disability.
The ICF is a classification that allows a comprehensive and detailed description of a person's experience of disability, including the environmental barriers and facilitators that have an impact on a person's functioning. The recognition of the central role played by environmental factors has changed the locus of the problem and, hence, focus of intervention, from the individual to the environment in which the individual lives. Disability is no longer understood as a feature of the individual, but rather as the outcome of an interaction of the person with a health condition and the environmental factors.
本文提供了一个框架，用于理解当一个人患有健康状况时环境因素对其功能的影响。这种理解为将环境因素纳入世界卫生组织的《国际功能、残疾和健康分类》（ICF）提供了理论依据。
这篇概念性论文采用综述形式，首先提供关于将环境因素纳入残疾理解和ICF的历史视角；其次描述ICF的整体情况，特别是环境因素部分；第三概述患有健康状况的人与他们生活的环境之间的相互作用以及残疾的结果。
ICF是一种分类方法，能够全面且详细地描述一个人的残疾经历，包括对个人功能有影响的环境障碍和促进因素。对环境因素所起核心作用的认识改变了问题的所在，进而改变了干预的重点，从个体转向个体生活的环境。残疾不再被理解为个体的特征，而是患有健康状况的人与环境因素相互作用的结果。
