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《国际功能、残疾和健康分类(ICF)在精神科患者医学康复中的实际应用》

[The practical application of the International Classification of Functioning, Disability and Health (ICF) in medical rehabilitation of psychiatric patients].

作者信息

Grundmann J, Keller K, Bräuning-Edelmann M

机构信息

Rehabilitationszentrum "Häuser am Latterbach", Medizinische und berufliche Rehabilitation für Menschen mit psychischen Erkrankungen und Behinderungen, Diakonie Oberbayern, Innere Mission München e. V.

出版信息

Rehabilitation (Stuttg). 2005 Dec;44(6):335-43. doi: 10.1055/s-2005-867044.

DOI:10.1055/s-2005-867044
PMID:16320177
Abstract

The WHO Classification of Functioning, Disability and Health enables the description of functional health, disability and impairment on an international and interdisciplinary level in a common language. The fundamental underlying assumption of this Classification, which is orientated around a bio-psycho-social model of health and impairment, has been accepted by rehabilitation scientists in general. Unfortunately, the WHO does not make any recommendations as to how this classification could be applied in practice. In this article, various problems are outlined which could occur when the ICF is applied. Furthermore an example from a psychiatric rehabilitation institution illustrates the way the ICF could serve as an instrument for an extensive rehabilitation management programme. Here, Stucki's use will be made of Rehab-Cycle model. This describes a comprehensive sequence of steps which help analyse the patients problems from a patient-centred standpoint, to set up a schedule for treatment and to evaluate the results. Within Stucki's model the ICF is used as a system to analyse problems upon which intervention can be set. This method is illustrated with an example from a rehabilitation case. Summarizing, it is pointed out that through easier communication (as a result of the ICF) interdisciplinary productivity and efficiency will increase. On this basis it is possible to achieve a more comprehensive multimodal approach in the treatment of people suffering from psychic impairments or disability.

摘要

世界卫生组织的《国际功能、残疾和健康分类》能够以一种通用语言在国际和跨学科层面描述功能健康、残疾和损伤情况。这一基于生物 - 心理 - 社会健康与损伤模型的分类的基本假设已被康复科学家普遍接受。遗憾的是,世界卫生组织并未就如何在实践中应用该分类提出任何建议。本文概述了应用《国际功能、残疾和健康分类》(ICF)时可能出现的各种问题。此外,一个精神科康复机构的实例说明了ICF可作为广泛康复管理计划工具的方式。在此,将采用施图基(Stucki)的康复循环模型。该模型描述了一系列全面的步骤,有助于从以患者为中心的角度分析患者问题、制定治疗计划并评估结果。在施图基的模型中,ICF被用作分析问题的系统,据此可进行干预。文中通过一个康复案例的实例对此方法进行了说明。总之,指出通过(因ICF而实现的)更便捷的沟通,跨学科的生产力和效率将会提高。在此基础上,有可能在治疗精神损伤或残疾患者时实现更全面的多模式方法。

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