Howard David, Nieuwenhuijsen Els R, Saleeby Patricia
College of Nursing, Health and Human Services, Indiana State University, Terre Haute, Indiana 47809, USA.
Disabil Rehabil. 2008;30(12-13):942-54. doi: 10.1080/09638280701800483.
Health promotion is an issue comprised of complex and multi-layered concepts that involves a process of enabling people to increase control over and improve their health. The aims and applications of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), with its focus on components of functioning, activities and participation, and environmental factors are salient to health promotion and health education efforts. For individuals with or without disabilities, health promotion occurs within the community in which they reside and is influenced by a complex interaction of personal and environmental factors. The aim of this paper is to discuss how the ICF can be useful in enhancing social change through health promotion and health education for all people, in particular those with disabilities and chronic conditions. In doing so health promotion concepts and the ecological approach linked with the ICF, the relationship of social change and social support to the ICF, the potential role of the ICF for national and local (city) policies, and the role of health professionals in this process will be examined. Building on this body of knowledge, the authors recommend that future research should focus on the relationship between policies and the social participation of people with disabilities in the community, the use of ICF measurement tools to improve the indicators established by the National Organization on Disability, the development of a new ICF core set for community accessibility and inclusion, better interventions to enhance social support, and enhancing the role of professionals in health promotion for people with disabilities or chronic health conditions.
健康促进是一个由复杂且多层次概念构成的问题，它涉及使人们能够增强对自身健康的掌控并改善健康状况的过程。世界卫生组织的《国际功能、残疾和健康分类》（ICF）的目标及应用，聚焦于功能、活动和参与的组成部分以及环境因素，这对健康促进和健康教育工作具有重要意义。对于有残疾或无残疾的个体而言，健康促进在他们所居住的社区中发生，并受到个人和环境因素复杂相互作用的影响。本文旨在探讨ICF如何通过对所有人，尤其是残疾人和慢性病患者的健康促进和健康教育，在促进社会变革方面发挥作用。在此过程中，将审视与ICF相关的健康促进概念和生态方法、社会变革和社会支持与ICF的关系、ICF在国家和地方（城市）政策中的潜在作用以及健康专业人员在此过程中的作用。基于这一知识体系，作者建议未来的研究应关注政策与社区中残疾人社会参与之间的关系、使用ICF测量工具改进国家残疾组织制定的指标、开发用于社区无障碍和包容性的新ICF核心集、更好地加强社会支持的干预措施，以及增强专业人员在残疾人或慢性健康状况患者健康促进方面的作用。
