1Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University, Heerlen, The Netherlands.
Clin Rehabil. 2014 Mar;28(3):211-20. doi: 10.1177/0269215513499029. Epub 2013 Aug 29.
The concept of participation has been extensively used in health and social care literature since the World Health Organization introduced its description in the International Classification of Functioning, Disability and Health (ICF) in 2001. More recently, the concept of social participation is frequently used in research articles and policy reports. However, in the ICF, no specific definition exists for social participation, and an explanation of differences between the concepts is not available.
The central question in this discussion article is whether participation, as defined by the ICF, and social participation are distinct concepts. This article illustrates the concepts of participation and social participation, presents a critical discussion of their definitions, followed by implications for rehabilitation and possible future directions.
A clear definition for participation or social participation does not yet exist. Definitions for social participation differ from each other and are not sufficiently distinct from the ICF definition of participation. Although the ICF is regarded an important conceptual framework, it is criticised for not being comprehensive. The relevance of societal involvement of clients is evident for rehabilitation, but the current ICF definition of participation does not sufficiently capture societal involvement.
Changing the ICF's definition of participation towards social roles would overcome a number of its shortcomings. Societal involvement would then be understood in the light of social roles. Consequently, there would be no need to make a distinction between social participation and participation.
自 2001 年世界卫生组织（WHO）在《国际功能、残疾和健康分类》（ICF）中引入其描述以来，参与的概念在卫生和社会保健文献中得到了广泛应用。最近，社会参与的概念在研究文章和政策报告中经常被使用。然而，在 ICF 中，没有对社会参与的具体定义，也没有对这两个概念之间差异的解释。
本文讨论的核心问题是，ICF 定义的参与与社会参与是否是两个不同的概念。本文阐述了参与和社会参与的概念，对其定义进行了批判性讨论，并探讨了对康复的影响和可能的未来方向。
目前还没有对参与或社会参与的明确定义。社会参与的定义彼此不同，与 ICF 对参与的定义没有足够的区别。尽管 ICF 被认为是一个重要的概念框架，但它也因不够全面而受到批评。客户的社会参与对康复至关重要，但 ICF 参与的现有定义没有充分捕捉到社会参与。
将 ICF 对参与的定义改为社会角色将克服其许多缺点。社会参与将在社会角色的背景下被理解。因此，没有必要对社会参与和参与进行区分。
