ICIDH u u ICIDH Impairments DisabilitiesHandicaps Impairments Disabilities

ICIDH之障礙定義 u u ICIDH 將身心障礙可以分成三個不同層次：損傷或不全 (Impairments) 、失能(Disabilities)、和殘廢(Handicaps)。 所謂的損傷或不全(Impairments)是指 「任何心理的、生理的、以及解剖結構或功能的偏離或喪失」。 如果這樣的損傷或不全進一步妨礙或限制了一個正常人日常活動 的進行就可以算是進入了失能(Disabilities)的層次。 最後如果上述的損傷或不全(Impairments)和失能(Disabilities) 影響到了一個人生活的六個面向的社會角色執行那就構成了ICIDH 所謂的殘障(Handicaps) 。（李世代, 2007） Bickenbach, J. E. , Chatterji, S. , Badley, E. M. , and Ustun. , TB. (1999) Models of Disablement, universalism, and the international classification, and the international of impairments, disabilities and handicaps. Social Science and Medicine. 48. 1173 -1187.

ICIDH-2/ICF Model (Standard Environment/Current Environment) Health Condition Disorder/Disease Body Structure & Function (Impairment) ←→ Activity (Limitation) ←→ Participation (Restriction) Life Area (Task /or Action) Environment Factor & Personal Factor http: //secure. cihi. ca/cihiweb/en/downloads/icf_jun 02_papers_3 A_e. pdf (WHO, 2001)

ICF 定義 FUNCTIONING-all body functions, activities and participation. u DISABILITY-an experience that all people may well have, in which function is limited and during which environmental characteristics are highlighted. u RIGHTS-something due persons by virtue of law or nature (in disability, equalization of opportunity to participate in society). u

生活之六個面向的社會角色 定向良好 (Orientation) 身體獨立自主 (Physical Independence) 移行能力 (Mobility) 從事職場之角色 (Occupation) 融入社會、社會參與 (Social Integration) 經濟自主 (Economic Self. Sufficiency) ICIDH 所謂的Handicaps 是指：個人的Impairments 和Disabilities 已經對他(她) 產生不良或不利的社會影響(Social Consequences)，因而使他(她)無法扮演其 作為社會成員應有的社會角色。 （Bickenbach et al, 1999)

Rehabilitation therapies Treatment of “barriers” Information giving Skills training Body functions and structures Environment Aids & Appliances Adaptations Capacity Co-operation Assistance Legal Societal Activity Participation Goal setting Encouragement Behaviour change Personal factors

Activities and Participation (9 Domains) 1. 2. 3. 4. 5. 6. 7. 8. 9. Learning & Applying Knowledge General Tasks and Demands Communication Movement Self Care Domestic Life Areas Interpersonal Interactions Major Life Areas Community, Social & Civic Life

Contextual factors: Environmental Factors 1. 2. to 3. 4. 5. Products and technology Natural environment and human-made the environment Support and relationships Attitudes Services, systems and policies changes

The International Classification of Functioning and Health (ICF) ICF-checklist ICF-Introduction Concepts: domains of health The “anatomy” of heath The language of rehabilitation http: //www 3. who. int/icftemplate. cfm