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世界卫生组织的《国际功能、残疾与健康分类》(ICF)为我们理解健康、功能和残疾提供了一个新的基础。然而在其应用过程中可能会遇到不同的挑战。本文旨在解决其中的两个挑战:ICF内容效度以及ICF与其他健康相关概念如全健康、生活质量(QoL)和健康相关生活质量(HRQoL)的关系。正在进行的一系列效度研究证实,ICF是一个完备的分类:它既涵盖构成人类功能和残疾体验的健康及其相关领域,又涵盖大多数影响功能和残疾体验的环境因素。而且ICF也有助于人们把健康理解为一个序列:以身体为中心的观念(身体的健康体验)、综合的观念(“全健康体验”),并最终发展成为整体观念(“人类体验”),最后这种整体观念把健康看作人类体验的一部分。ICF将健康从一个狭隘的观点转变为广义的功能观点,使得健康作为人类体验的一部分可操作化。ICF及其类目也可以作为客观评价全健康的起点:HRQoL既然被定义为个体对健康和全健康的健康相关领域的一种知觉,基于ICF功能概念的类目也就可作为HRQoL评定的基础。
The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization provides a new basis for our understanding of health, function and disability. However, different challenges may be encountered in the application process. This article addresses two of these challenges: the validity of ICF content and the relationship of ICF with other health-related concepts such as total health, quality of life (QoL) and health-related quality of life (HRQoL). A series of ongoing validation studies confirm that ICF is a well-established classification that covers both the health and related fields that make up human functions and disability experiences, as well as most of the environmental factors that affect functional and disability experiences. And the ICF also helps people to understand health as a sequence: a body-centered concept (the body’s health experience), a comprehensive idea (the “all-health experience”) and eventually the whole idea (“the human experience ”), And finally this holistic concept regards health as part of the human experience. The ICF transforms health from a narrow perspective into a broad functional perspective that makes health part of the human experience as operable. The ICF and its categories may also serve as a starting point for objective assessment of total health: HRQoL Since defined as an individual’s perception of health and well-being in the health-related area, categories based on ICF functional concepts can also serve as a basis for HRQoL assessment .