Magasi Susan, Wong Alex, Gray David B, Hammel Joy, Baum Carolyn, Wang Chia-Chiang, Heinemann Allen W
Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Department of Occupational Therapy, Washington University, St. Louis, MO.
Arch Phys Med Rehabil. 2015 Apr;96(4):569-77. doi: 10.1016/j.apmr.2014.12.002.
The ascendance of the World Health Organization's International Classification of Functioning, Disability and Heath (ICF) as the global standard for describing and characterizing aspects of disability has refocused attention on the role that environmental factors (EFs) have on the health and participation of people with disabilities, both as individuals and as a group. There has been a rise in the development of instruments designed to measure EFs alone and in relation to participation. Some instrument developers have used the ICF as a theoretical base for instrument development and to substantiate content validity claims. We contend that this is a misapplication of the ICF. There is a need to step back and reexamine the role that environmental theories can play in developing a conceptually driven approach to measuring the interaction between EFs and participation. For this review, we draw on the fields of social, community, and developmental psychology; disability studies; gerontology; public health; and rehabilitation. We discuss different approaches to the measurement of EFs. We suggest that given the complex nature of EFs and their influence on participation, there is a need for a fresh approach to EF measurement. The thoughtful application of theories and the use of advanced psychometric, measurement, and e-technologies and data visualization methods may enable researchers and clinicians to better quantify, document, and communicate the dynamic interrelationship between EFs and participation and health outcomes for people with disabilities at the individual, group, and population levels.
世界卫生组织的《国际功能、残疾和健康分类》（ICF）作为描述和界定残疾方面的全球标准日益受到重视，这使人们重新关注环境因素（EFs）对残疾人作为个体和群体的健康与参与所起的作用。专门用于单独测量环境因素以及测量环境因素与参与之间关系的工具不断涌现。一些工具开发者将ICF作为工具开发的理论基础，并用以证实内容效度声明。我们认为这是对ICF的误用。有必要回过头来重新审视环境理论在制定一种概念驱动的方法以测量环境因素与参与之间的相互作用时所能发挥的作用。在本次综述中，我们借鉴了社会心理学、社区心理学、发展心理学、残疾研究、老年学、公共卫生和康复等领域的知识。我们讨论了测量环境因素的不同方法。我们认为，鉴于环境因素的复杂性及其对参与的影响，需要一种全新的环境因素测量方法。对理论的深思熟虑的应用以及先进心理测量学、测量学、电子技术和数据可视化方法的使用，可能使研究人员和临床医生能够更好地量化、记录和传达环境因素与参与以及残疾人在个体、群体和总体层面的健康结果之间的动态相互关系。
