Power Emma, Anderson Alison, Togher Leanne
Speech Pathology, Faculty of Health Sciences, University of Sydney, East St Lidcombe, 1825 NSW, Australia.
J Commun Disord. 2011 May-Jun;44(3):261-75. doi: 10.1016/j.jcomdis.2010.12.004. Epub 2010 Dec 24.
Huntington's Disease (HD) is a fatal, hereditary neurodegenerative disorder that is characterized by a triad of motor, cognitive and psychiatric symptoms that impact on both communicative effectiveness and the treatment techniques used to maximize communicative participation. The purpose of this article is to describe the application of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to communication assessment and goal setting for a 37 year old man with HD.
Communication assessment consisted of qualitative interviews based on the ICF framework with the client and his mother, supplemented with quantitative communication assessments. Analysis and conceptualization of assessment information was completed with a modified version of the Rehabilitation Problem Solving Form (RPS-Form) (Steiner et al., 2002).
While impairments in body structures and functions were evident, analysis revealed that environmental factors such as family support were both key barriers and facilitators to communicative participation.
This case illustrates the potential of using the ICF to conceptualize communicative functioning and disability in HD and particularly highlights the importance of consideration of personal and environmental factors in revealing contributions to activity limitations and participation restrictions. Further investigation of applications of ICF for individuals with HD is suggested.
As a result of this activity, readers will recognize the application of the WHO ICF to assessment and goal setting in a complex hereditary condition, Huntington Disease. As a result of this activity, readers will describe the use of the Rehabilitation Problem Solving Form (RPS-Form) for communication disorders. As a result of this activity, readers will identify relevant issues in comprehensive communication assessment of a fatal, degenerative neurological condition such as the advantages and challenges of clinical use of the ICF and its coding. As a result of this activity, readers will introduce life storybooks as a potential legacy item in degenerative diseases.
亨廷顿舞蹈症（HD）是一种致命的遗传性神经退行性疾病，其特征为运动、认知和精神症状三联征，这会影响沟通效果以及用于最大化沟通参与度的治疗技术。本文旨在描述世界卫生组织的《国际功能、残疾和健康分类》（ICF）在一名37岁HD男性患者的沟通评估和目标设定中的应用。
沟通评估包括基于ICF框架对患者及其母亲进行的定性访谈，并辅以定量沟通评估。评估信息的分析和概念化使用了经修改的康复问题解决表（RPS表）（施泰纳等人，2002年）完成。
虽然身体结构和功能的损伤很明显，但分析表明，诸如家庭支持等环境因素既是沟通参与的关键障碍，也是促进因素。
本案例说明了使用ICF来概念化HD中的沟通功能和残疾的潜力，尤其突出了在揭示对活动受限和参与限制的影响方面考虑个人和环境因素的重要性。建议对ICF在HD患者中的应用进行进一步研究。
通过本活动，读者将认识到世界卫生组织ICF在复杂遗传性疾病亨廷顿舞蹈症的评估和目标设定中的应用。通过本活动，读者将描述康复问题解决表（RPS表）在沟通障碍中的使用。通过本活动，读者将识别在一种致命的退行性神经疾病的综合沟通评估中的相关问题，如ICF临床使用及其编码的优势和挑战。通过本活动，读者将介绍生活故事书作为退行性疾病中一种潜在的遗产项目。
