Schuntermann M F
Verband Deutscher Rentenverischerungsträger, Rehabilitations-wissenschaftliche Abteilung, Frankfurt am Main.
Rehabilitation (Stuttg). 1996 Feb;35(1):6-13.
Published by the World Health Organization in 1980, the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) provides a conceptual framework for information by enabling classification, and hence description, of the three dimensions of the phenomenon of "disablement" (as a consequence of disease, injury or congenital condition). The ICIDH permits a highly complex issue to be easily grasped to a certain extent, and has gained almost worldwide recognition as a valuable tool in the perception of the problem of disablement, in describing this problem and developing solutions for this problem. With modern definitions in rehabilitation using its basic terms, the ICIDH will before long also be established as a tool for purposes of documentation, evaluation and treatment planning in the field of rehabilitation. Notwithstanding its successes, the ICIDH not only raises practical problems but theoretical ones as well. The points of criticism relate to the consequences of disease model, the definitions of the basic terms, and the overlap of basic term extensions. In order to overcome the definitional and overlap problems it is suggested, for one, to clearly distinguish between the phenomena and their symptoms and, for the other, to eliminate any overlap that may exist in the formulation of the concepts the definitions of the basic terms build on. The ICIDH model of disease consequences may be viewed as a preliminary step towards developing a theory of disablement. Such a theory would in particular be designed to enable explanation and prognosis of disablement creation processes as well as development of causally founded methods of intervention in rehabilitation. It should moreover include a theory of the etiologic processes involved in disablement as well as a theory of rehabilitative intervention. The crucial future tasks of the rehabilitation sciences will include the further development of a theory of disablement enabling provision of assistance to persons with disablement, or at risk of being disabled, in a more purposeful and causally founded manner than has been the case so far.
《国际损伤、残疾和残障分类》（ICIDH）由世界卫生组织于1980年发布，它通过对“失能”现象（因疾病、损伤或先天性疾病导致）的三个维度进行分类从而描述，为信息提供了一个概念框架。ICIDH能使一个高度复杂的问题在一定程度上易于理解，并且作为认识失能问题、描述该问题及制定解决方案的宝贵工具，已获得几乎全球范围的认可。随着现代康复定义采用其基本术语，ICIDH不久后还将成为康复领域用于记录、评估和治疗规划的工具。尽管取得了成功，但ICIDH不仅引发了实际问题，也带来了理论问题。批评点涉及疾病模型的后果、基本术语的定义以及基本术语外延的重叠。为克服定义和重叠问题，一方面建议明确区分现象及其症状，另一方面消除基本术语定义所基于的概念表述中可能存在的任何重叠。ICIDH的疾病后果模型可被视为发展失能理论的初步步骤。这样一种理论尤其旨在能够解释和预测失能产生过程，并开发基于因果关系的康复干预方法。此外，它还应包括失能相关病因过程的理论以及康复干预的理论。康复科学未来的关键任务将包括进一步发展失能理论，以便能够以比迄今为止更有针对性且基于因果关系的方式，为失能者或有失能风险的人提供帮助。
