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基于《国际功能、残疾和健康分类》制定台湾地区残疾评估质量保证指标:德尔菲共识。

Development of indicators to assure quality of disability evaluation based on the International Classification of Functioning, Disability, and Health in Taiwan: a Delphi consensus.

机构信息

Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.

Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

出版信息

Disabil Rehabil. 2020 Apr;42(7):975-982. doi: 10.1080/09638288.2018.1514536. Epub 2018 Dec 30.

Abstract

To develop a set of quality indicators (QIs) for managing the International Classification of Functioning, Disability, and Health-based disability evaluation system in Taiwan. Using a three-round Delphi exercise, 20 representatives from the social welfare associations for people with disability completed the consensus process. Questionnaire 1 comprised 52 potentially important factors relevant to good services for persons with disabilities in the system. An additional nine items were added to questionnaires 2 and 3. The responders rated the importance of each item using a 5-point Likert scale. The set of QIs for managing the system comprised items that obtained high consensus and a mean score ≥4.5 found in round 3. Those QIs included a composite of measures about a comfortable and barrier-free assessment room, on-site assistance (being important for client access and safety), client's privacy, rights protection, and satisfaction, convenient service, attitude of staff (towards client centeredness), accuracy of report (system effectiveness), and competent staff (system efficiency). Spearman's rho (mean ± standard deviation) of round 3 was 0.79 ± 0.09, and Cronbach's α = 0.90. This set of QIs is suitable for managing the system serving people with disabilities. It is feasible in practice and scientifically acceptable, but further validation is needed.Implications for rehabilitationWith this study, we were able to develop a set of quality indicators for managing the International Classification of Functioning, Disability and Health-based disability evaluation system.The set of quality indicators included a composite of measures about a comfortable and barrier-free assessment room and on-site assistance; client's privacy, rights protection, and satisfaction, convenient service, attitude of staff; accuracy of report, and competent staff.These quality indicators foster client-centeredness, access, safety, system effectiveness and efficiency, feasibility, and science; and are relevant to managing a system that is intended to serve people with disabilities.

摘要

为台湾的国际功能、残疾和健康分类(ICF)残疾评估系统管理制定一套质量指标(QIs)。通过三轮德尔菲法研究,来自残疾人社会福利协会的 20 名代表完成了共识过程。问卷 1 包括与系统中残疾人良好服务相关的 52 个潜在重要因素。问卷 2 和 3 分别增加了另外 9 项。应答者使用 5 分李克特量表对每个项目的重要性进行评分。该系统管理的 QIs 包括在第 3 轮获得高共识和平均得分≥4.5 的项目。这些 QIs 包括一个关于舒适无障碍评估室、现场协助(对客户访问和安全很重要)、客户隐私、权利保护和满意度、便捷服务、员工态度(以客户为中心)、报告准确性(系统有效性)和称职员工(系统效率)的综合措施。第 3 轮的斯皮尔曼 rho(平均值±标准差)为 0.79±0.09,克朗巴赫的α=0.90。这组 QIs 适用于管理为残疾人服务的系统。它在实践中是可行的,在科学上是可以接受的,但需要进一步验证。

对康复的意义通过这项研究,我们能够制定一套管理基于国际功能、残疾和健康分类(ICF)的残疾评估系统的质量指标。这套质量指标包括一个舒适无障碍评估室和现场协助的综合措施;客户的隐私、权利保护和满意度、便捷服务、员工态度;报告的准确性和称职的员工。这些质量指标促进以客户为中心、访问、安全、系统有效性和效率、可行性和科学性,并与管理旨在为残疾人服务的系统相关。

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