ICF在脊髓損傷的應(yīng)用-勵建安

勵建安(Jiànān)南京醫(yī)科大學(xué)國際功能(gōngnéng)、殘疾和健康分類

-脊髓損傷的核心組合

ICFCoreSetsforSCI第一頁，共九十一頁。精選ppt功能與殘疾的綜合(zōnghé)模式第二頁，共九十一頁。2精選ppt環(huán)境因素個人(gèrén)因素相關(guān)(xiāngguān)因素活動(huódòng)身體功能與身體結(jié)構(gòu)參與健康狀況

(疾病、外傷)功能與殘疾的綜合模式第三頁，共九十一頁。3精選ppt健康狀況健康狀況是疾病、疾患、損傷或者外傷的總稱健康狀況可以(kěyǐ)包括其他情況，例如老齡、應(yīng)激、先天畸形以及遺傳因素等健康狀況使用ICD-10作為標(biāo)準(zhǔn)編碼第四頁，共九十一頁。4精選ppt環(huán)境因素個人(gèrén)因素相關(guān)(xiāngguān)因素活動(huódòng)身體功能與身體結(jié)構(gòu)參與慢性膝關(guān)節(jié)不穩(wěn)

M23.5功能與殘疾的綜合模式第五頁，共九十一頁。5精選ppt身體(shēntǐ)功能與身體(shēntǐ)結(jié)構(gòu)身體功能指身體的生理功能，包括心理(xīnlǐ)功能身體結(jié)構(gòu)指身體的解剖結(jié)構(gòu)，例如器官、肢體和相關(guān)部件相當(dāng)于障礙Impairments第六頁，共九十一頁。6精選ppt環(huán)境因素個人(gèrén)因素相關(guān)(xiāngguān)因素活動(huódòng)疼痛、關(guān)節(jié)穩(wěn)定性、交叉韌帶參與慢性膝關(guān)節(jié)不穩(wěn)

M23.5功能與殘疾的綜合模式第七頁，共九十一頁。7精選ppt活動(huódòng)與參與活動指個人執(zhí)行任務(wù)或者(huòzhě)個人的行動，代表個體功能參與指參加生活環(huán)境的活動，代表社會功能活動(huódòng)限制參與限制第八頁，共九十一頁。8精選ppt環(huán)境因素個人(gèrén)因素相關(guān)(xiāngguān)因素攜帶物體(wùtǐ)、彎膝、步行、攀爬疼痛、關(guān)節(jié)穩(wěn)定性、交叉韌帶照顧孫子、家務(wù)、協(xié)助丈夫工作慢性膝關(guān)節(jié)不穩(wěn)

M23.5功能與殘疾的綜合模式第九頁，共九十一頁。9精選ppt環(huán)境因素人們居住和生活(shēnghuó)的物理、社會和態(tài)度環(huán)境環(huán)境因素是個人之外的因素積極因素

(facilitator)消極因素(barrier)第十頁，共九十一頁。10精選ppt-住在4樓，無電梯+使用(shǐyòng)拐杖/康復(fù)/藥物治療個人(gèrén)因素相關(guān)(xiāngguān)因素攜帶物體、彎膝、步行、攀爬疼痛、關(guān)節(jié)穩(wěn)定性、交叉韌帶照顧孫子、家務(wù)、協(xié)助丈夫工作慢性膝關(guān)節(jié)不穩(wěn)

M23.5功能與殘疾的綜合模式第十一頁，共九十一頁。11精選ppt個人(gèrén)因素包括(bāokuò)性別、年齡、人種、體質(zhì)、生活方式、習(xí)慣、社會背景、其它社會功能第十二頁，共九十一頁。12精選ppt-住在4樓，無電梯+使用拐杖、康復(fù)治療(zhìliáo)、藥物治療(zhìliáo)60歲，生性(shēngxìng)積極相關(guān)(xiāngguān)因素攜帶物體、彎膝、步行、攀爬疼痛、關(guān)節(jié)穩(wěn)定性、交叉韌帶照顧孫子、家務(wù)、協(xié)助丈夫工作慢性膝關(guān)節(jié)不穩(wěn)

M23.5功能與殘疾的綜合模式第十三頁，共九十一頁。13精選ppt身體結(jié)構(gòu)和功能障礙活動受限參與限制殘疾(cánjí)第十四頁，共九十一頁。14精選ppt身體結(jié)構(gòu)和功能與參與活動功能(gōngnéng)改善第十五頁，共九十一頁。15精選ppt功能(gōngnéng)改善第十六頁，共九十一頁。16精選pptICF是國際通用的描述功能(gōngnéng)、殘疾和健康狀況的國際語言和概念第十七頁，共九十一頁。17精選ppt第十八頁，共九十一頁。18精選ppt健康狀況（疾病(jíbìng)、外傷）253項環(huán)境因素個人(gèrén)因素相關(guān)(xiāngguān)因素384項活動與參與493項身體結(jié)構(gòu)310項身體功能第十九頁，共九十一頁。19精選pptb1

–

b8s1

–

s8d1

–

d9e1

–

e5章ICF–

金字塔結(jié)構(gòu)(jiégòu)ICF身體功能身體結(jié)構(gòu)活動與參與環(huán)境因素個人因素bsde第二十頁，共九十一頁。20精選ppt第一級：身體結(jié)構(gòu)(jiégòu)與功能

SkinandrelatedstructuresStructuresrelatedtomovementStructuresrelatedtothegenitourinaryandreproductivesystemsStructuresrelatedtothedigestive,metabolicandendocrinesystemsStructuresofthecardiovascular,immunologicalandrespiratorysystems聲音和言語相關(guān)的組織結(jié)構(gòu)Theeye,earandrelatedstructuresStructuresofthenervoussystemFunctionsoftheskinandrelatedstructuresNeuromusculoskeletalandmovement-relatedfunctionsGenitourinaryandreproductivefunctionsFunctionsofthedigestive,metabolicandendocrinesystemsFunctionsofthecardiovascular,haematological,immunologicalandrespiratorysystems聲音和言語功能SensoryfunctionsandpainMentalfunctionsChapter8Chapter7Chapter6Chapter5Chapter4Chapter3Chapter2Chapter1身體(shēntǐ)結(jié)構(gòu)(s)身體(shēntǐ)功能

(b)第二十一頁，共九十一頁。21精選ppt第一級：活動(huódòng)與參與主要的生活區(qū)域 人際關(guān)系家庭區(qū)域 個人自理活動交流一般任務(wù)與需求學(xué)習(xí)與應(yīng)用技術(shù)社區(qū)、社會和公民活動Chapter8Chapter7Chapter6Chapter5Chapter4Chapter3Chapter2Chapter1Chapter9第二十二頁，共九十一頁。22精選ppt第一級：環(huán)境因素(e)服務(wù)、體系與政策態(tài)度支持與關(guān)系自然環(huán)境和人類對環(huán)境的改造產(chǎn)品與技術(shù)Chapter5Chapter4Chapter3Chapter2Chapter1第二十三頁，共九十一頁。23精選pptb1

–

b8s1

–

s8d1

–

d9e1

–

e5ChaptersICF–

第二級結(jié)構(gòu)(jiégòu)ICF身體功能身體結(jié)構(gòu)活動與參與環(huán)境因素個人因素bsdeb110

–

b899s110

–

s899d110

–

d999e110

–

e5992ndLevel第二十四頁，共九十一頁。24精選ppt第二級結(jié)構(gòu)(jiégòu)

–

舉例章節(jié) b1腦高級功能(gōngnéng)

Mentalfunction整體腦高級功能(b110–b139)b110 意識b114 定向b117 智力b122 整體心理功能b126 個性b130 主觀能動性b134 睡眠b139 非特指的整體心理功能特定的腦高級功能Specificmentalfunctions(b140–b189)第二十五頁，共九十一頁。25精選pptICFBodyFunctionsbb1100

–

b7809b11420

–

b54509b1

–

b8b110

–

b899BodyStructuresss1

–

s8s110

–

s899s1100

–

s8309s11000

–

s76009Activity&Participationdd1

–

d9d110

–

d999d1150

–

d9309EnvironmentalFactorsee1

–

e5e110

–

e599e1100

–

e5959ICF–

三級結(jié)構(gòu)(jiégòu)Thehigherthemoreprecise第二十六頁，共九十一頁。26精選pptb

腦高級功能Mentalfunctions 一級

b114

定向功能

二級

b1141地點(dìdiǎn)定向

b1142人物定向

b11420自我定向

b11421他人定向ICF條目(tiáomù)舉例三級四級第二十七頁，共九十一頁。27精選pptICF總條目：1454

有多少在特定的疾病需要(xūyào)？

臨床和科研有何用途？

評判標(biāo)準(zhǔn)？第二十八頁，共九十一頁。28精選ppt發(fā)展ICF核心(héxīn)組合CoreSets

第二十九頁，共九十一頁。精選ppt瞎子摸象(xiāzǐmōxiàng)的故事第三十頁，共九十一頁。30精選pptICFandICFCoreSets確定評定(píngdìng)條目whattomeasure應(yīng)用基礎(chǔ)：howtomeasure第三十一頁，共九十一頁。31精選pptb1b130b134b152b180b1801

s299s710s720s730s73001s73011

d170d230d360d410d415d430

e110e115e120e125e135e150

1454ICF核心組合第三十二頁，共九十一頁。32精選pptb1b130b134b152b180b1801

s299s710s720s730s73001s73011

d170d230d360d410d415d430

e110e115e120e125e135e150

1454ICF核心組合特定疾病特定環(huán)境第三十三頁，共九十一頁。33精選ppt骨關(guān)節(jié)炎OA–

身體(shēntǐ)功能b280 疼痛的感覺 b710 關(guān)節(jié)活動功能 b730 肌肉功能b770 步態(tài)(bùtài)b715 關(guān)節(jié)穩(wěn)定性b740 肌肉耐力b780 與肌肉相關(guān)的感覺和運動功能b760 自主運動的控制b134 睡眠功能b735肌肉張力簡要ICF核心組合全套ICF核心組合第三十四頁，共九十一頁。34精選ppt

s750 下肢結(jié)構(gòu)(jiégòu)s730 上肢結(jié)構(gòu)s770 其它與運動相關(guān)的肌肉骨骼結(jié)構(gòu)

s740 骨盆結(jié)構(gòu)s720 肩部結(jié)構(gòu)OA–

身體(shēntǐ)結(jié)構(gòu)簡要ICF核心組合全套ICF核心組合第三十五頁，共九十一頁。35精選pptd450 步行d540 穿衣d445手和手臂使用d510 自我洗浴d470 使用交通工具d530 如廁d430 抬舉和攜帶物品d640 做家務(wù)d910 社區(qū)生活d440 手精細活動(huódòng)d410 改變身體位置OA–

活動(huódòng)與參與簡要ICF核心組合全套ICF核心組合第三十六頁，共九十一頁。36精選ppte115

與個人日常生活相關(guān)的產(chǎn)品與技術(shù)e310 近親e580 醫(yī)療服務(wù)、體系和政策e150 公共場合的建筑設(shè)計、產(chǎn)品和技術(shù)

e355 醫(yī)務(wù)人員e540 交通服務(wù)、體系和政策e120 個人室內(nèi)和室外活動和交通的產(chǎn)品與技術(shù)

e135 就業(yè)相關(guān)的產(chǎn)品與技術(shù)e155 私人使用的建筑(jiànzhù)設(shè)計、建造和建筑(jiànzhù)產(chǎn)品

e340個人護理人員和助手OA–

環(huán)境因素簡要ICF核心組合全套ICF核心組合第三十七頁，共九十一頁。37精選ppt

定量(dìngliàng)分級Qualifiers

問題(wèntí)的嚴(yán)重程度如何量化已經(jīng)(yǐjing)清楚的?是功能障礙是什么并不清楚的?是b1141.0123489第三十八頁，共九十一頁。38精選ppt第三十九頁，共九十一頁。精選ppt定量(dìngliàng)分級(qualifier)0 沒有問題(無、缺乏、可以忽視(hūshì)等)

0-4%

1輕度問題(輕、低等)

5-24%

2中度問題(中等、較好等)

25-49%

3 嚴(yán)重問題(高、極端等)

50-95%

4全部問題(最嚴(yán)重、全部受累等) 96-100%

8 無法特定

(當(dāng)前的信息無法確定嚴(yán)重程度)9 無法應(yīng)用

(不恰當(dāng)或者不可能使用)第四十頁，共九十一頁。40精選ppt環(huán)境因素雙向分級(fēnjí)障礙因素Barrier--促進(cùjìn)因素Facilitator++第四十一頁，共九十一頁。41精選ppt第四十二頁，共九十一頁。42精選pptProblem-solvingapproach第四十三頁，共九十一頁。43精選pptRehab-CycleAssessmentEvaluationAssignmentIntervention第四十四頁，共九十一頁。44精選pptAssessmentEvaluationAssignmentInterventionRehab-CycleICFModelICF&ICFCoreSets第四十五頁，共九十一頁。45精選pptDiagnosis(ICD-10)Rehabilitatongoalsteamperspectiveenvironmentalfactors personalfactors bodystructures&functionsactivities&participationpatientperspectiveWhatarethepatient'sproblemsandneedsfromhis/herperspective?Whatarethepatient'sproblemsfromtheteamperspective?UsetheICFCoreSets!第四十六頁，共九十一頁。46精選pptDiagnosis(ICD-10)Rehabilitatongoalsteamperspectiveenvironmentalfactors personalfactors bodystructures&functionsactivities&participationpatientperspective第四十七頁，共九十一頁。47精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+Whatarethepatients'problemsandneedsfromhis/herperspective?Whatarethepatients'problemsfromtherehabilitationteamperspective?UsetheICF-Core-setsasaChecklist!GoalsofrehabilitationInterventionprogramgoal:

Long-termgoal:

第四十八頁，共九十一頁。48精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+b710Mobilityofjointfunctionsb715Stabilityofjointfunctionsb730Musclepowerfunctionsb435Immunologicalsystemfunctionss7302Structureofhands73011Wristjoints73021Jointsofhandandfingerss75011Kneejoints7502Structureofankleandfootd440Finehandused445Handandarmused430Liftingandcarryingobjectsd630Preparingmealsd640Doinghouseworkd4500Walkingshortdistancesd4551ClimbingGoalsofrehabilitationInterventionprogramgoal:

Long-termgoal:

第四十九頁，共九十一頁。49精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Long-termgoal:

第五十頁，共九十一頁。50精選pptREHAB-CycleAssessmentinfourstepsIdentificationoftheproblemsandneedsofthepatient,Determinationofthelong-term,interventionprogramandcyclegoalsandIdentificationofinterventiontargetsrelatedtothecyclegoals.第五十一頁，共九十一頁。51精選pptAssessmentwiththeICFSheetGoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

Patient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Long-termgoal:

第五十二頁，共九十一頁。52精選pptREHAB-CycleAssessmentinfourstepsIdentificationoftheproblemsandneedsofthepatient,Determinationofthelong-term,interventionprogramandcyclegoalsandIdentificationofinterventiontargetsrelatedtothecyclegoals.第五十三頁，共九十一頁。53精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

Whatisrelatedto(determine)thecyclegoals?Determinetheinterventiontargets第五十四頁，共九十一頁。54精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

第五十五頁，共九十一頁。55精選pptRehab-CycleAssessmentAssignment第五十六頁，共九十一頁。56精選pptAsignment HealthProfessionalsProgramorserviceInpatientoroutpatientrehab,homerehabTypeofspecificserviceSinglevsgroupFirstintervention,refresher第五十七頁，共九十一頁。57精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

第五十八頁，共九十一頁。58精選pptAsignment HealthProfessionalsProgramorserviceInpatientoroutpatientrehab,homerehabTypeofspecificserviceSinglevsgroupFirstintervention,refresherIntervention第五十九頁，共九十一頁。59精選pptAssessmentAssignmentInterventionRehab-Cycle第六十頁，共九十一頁。60精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

第六十一頁，共九十一頁。61精選pptAssessmentEvaluationAssignmentInterventionRehab-Cycle第六十二頁，共九十一頁。62精選pptAssessmentwiththeICFSheetPatient‘sperspectiveRehabilitationteamperspectiveBody-Structures/Functions

Activities/ParticipationPersonalFactorsReha-diagnosisICD-10chronicpolyarthritis[ICD:M05.9]EnvironmentalFactorsPaininrightkneeandshoulderPaininhandsandfingersShortenedmobilityandflexibilitySwellinginfinger,wristandkneejointsDifficultiesingettingdressedProblemsinbrushingteethandcombinghairDifficultiesinliftingthingsabovetheheadProblemspreparingmealsProblemsdoinghouseworkIhadtogiveupmyjobasasecretaryAllmyfree-timeactivitiesareaffectedMyintimaterelationshipwithmyhusbandisalsoaffectedbecauseofthepainMedication+

Livesinafourthfloorflat;Noelevator–

Needsaidsforhanduse+,Supportivehusband+

Self-helpgroup+Motivated+

adequatecopingstrategies+ImpairedmobilityofjointsImpairedjointstabilityImpairedmusclestrengthInflammationparametersinbloodSubluxationofmetacarpophalangeal(MCP)joints2and3right,beginningulnardriftrightDegenerativechangesinfingersFingersandwristjointsswollenRightkneeswollenBothanklejointsswollenHalluxvalguspositiion,right>left

FinehanduseHandandarmuseLiftingandcarryingobjectsPreparingmealsHouseworkWalkingshortdistancesClimbingstairs

GoalsofrehabilitationInterventionprogramgoal:

Independenceinself-careandhousework

Long-termgoal:Vocationalretraining

第六十三頁，共九十一頁。63精選pptICFClinicalPractice-RehabCycleICFSheet/ModelReferenceforthedocumentationoffunctioningbasedonhistory,examandanalysisMulti-disciplinarycommunicationandgoalsettingICFCoreSetsGuideformulti-disciplinaryassessmentBasisforinstitutional,professional,nationalorinternationalguidelineshowtomeasurespecificcategoriesGuidefortheassignmentofinterventionsandinterventionmanagement第六十四頁，共九十一頁。64精選ppt健康(jiànkāng)相關(guān)情況慢性全身性疼痛腰痛骨性關(guān)節(jié)炎骨質(zhì)疏松類風(fēng)濕性關(guān)節(jié)炎慢性缺血性心臟病糖尿病肥胖(féipàng)阻塞性肺疾病抑郁乳腺癌腦卒中第六十五頁，共九十一頁。65精選pptVolume36,Supplement44/August2004ICFCORESETSFORCHRONICCONDITIONSJournalofRehabilitationMedicine第六十六頁，