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1、概论残疾学基础,康复医学概论,案例,May have caused paralysis of legs (Body Function) Affects ability to walk or climb stairs (Activity) Impedes ability to attend school or find employment within the current environment (Participation) BUT.,残疾的定义,残疾（disability）：是指因外伤、疾病、发育缺陷或精神因素造成明显的身心功能障碍，以致不同程度地丧失正常生活、工作和学习能力的一种状态
2、。 广义的残疾包括病损、残障在内，成为人体身心功能障碍的总称。,残疾人（people with disability，disabled person）：是指心理、生理、人体结构上，某种组织、功能丧失或者不正常，使得部分或全部失去以正常方式从事个人或社会生活能力的人。 1975年在联合国大会上通过的“关于残疾者权利的宣言”对“残疾人”的定义已作了明确的规定：“不论是先天或后天原因，身体或精神不健全而完全或部分地不能保证通常的个人生活或社会生活需要的人” 。,近年来残疾的趋势,残疾的变化与社会人口分布的变化有关，残疾具有高龄化的趋势； 中枢神经系统伤病引起的功能障碍日益增多，尤其是脑血管意外和儿童
3、脑性瘫痪有重度化的倾向； 多重障碍者有增多的趋势，其中以肢体功能障碍合并精神障碍者为多。,致残原因,疾病 营养不良 遗传 意外事故 物理、化学因素 社会、心理因素,国际残疾分类 国际残损、残疾和残障分类ICIDH 国际功能、残疾和健康分类ICF,我国的残疾分类 视力残疾 听力残疾 言语残疾 智力残疾 精神残疾 肢体残疾,常用的残疾分级,与残疾有关的术语,功能与功能障碍 功能是指组织、器官、肢体的特征性活动。本应具有的功能不能正常发挥时称为功能障碍 能力与能力减弱或丧失 能力是指个体的行为能力。能力减退称为能力减弱，能力丧失称为无能力 以上所造成的社会环境后果 行动、独立自主、就业、经济自给和社
4、会生活,残疾的分类（ICIDH，1980）,残损（impairment ） 功能与功能障碍器官水平 残疾（disability） 能力与能力减弱或丧失个体水平 残障（handicap） 文化、社会、经济和环境形成不良后果社会水平,国际残损、残疾和残障分类 ICIDH概念模式图,不仅注重残疾，而且注重残疾的转归、结果。 以残疾为出发点，从不同的层次来剖析残疾状况及其结果，是国际疾病分类（ICD）的一个进步。,国际功能、残疾和健康分类,2001年5月第54届世界卫生大会上正式签署并定名了“国际功能、残疾和健康分类” （International Classification of Function
5、ing, Disability and Health，英文缩写ICF）,中文简称为国际功能分类。,International Classification of Functioning, Disability and Health ICF Approved by the World Health Assembly in May 2001,ICF概念模式图,ICF建立在一种残疾性的社会模式基础上，从残疾人融入社会的角度出发，将残疾性作为一种社会性问题，并强调社会集体行动，要求改善环境以使残疾人充分参与社会生活的各个方面。,国际新旧残疾分类比较International classificatio
6、n,ICIDH Impairment （残损） Disability （残疾） Handicap （残障）,ICF Functioning Body function Body structure （身体功能或结构损伤） Activities limitations （活动受限） Participation restrictions （参与受限）,ICF的特点,广泛性： 平等性： 准确定义： 类目使用中性词语： 结构与功能分离： 用活动替代残疾：,16,健康状况,健康状况是疾病、疾患、损伤或者外伤的总称 健康状况可以包括其他情况，例如老龄、应激、先天畸形以及遗传因素等 健康状况使用ICD-10
7、作为标准编码,17,健康状况 (疾病、外伤),疾病的生物医学模式,诊断-功能-ICD10,ICD - 10: M 23.5 Tear of articular cartilage of knee,Health condition (disease, trauma),Environmental factors,Personal factors,Contextual factors,Activity,Body function and body structure,Participation,The integrative model of functioning and disability,H
8、ealth condition (disease, trauma),Environmental factors,Personal factors,Contextual factors,Activity,Body function and body structure,Participation,Tear of articular cartilage of knee M 23.5,The integrative model of functioning and disability,Tear of articular cartilage of knee M 23.5,Environmental
9、factors,Personal factors,Contextual factors,Activity,Body function and body structure,Participation,The integrative model of functioning and disability,Body Function & Structure,Body functions are physiological functions of body systems, including psychological functions 身体功能指身体的生理功能，包括心理功能 Body str
10、uctures are anatomical parts of the body, such as organs, limbs and their components 身体结构指身体的解剖结构，例如器官、肢体和相关部件 相当于障碍Impairments,Tear of articular cartilage of knee M 23.5,Environmental factors,Personal factors,Contextual factors,Activity,Participation,Pain, stability of joints, muscle power,Cruciate
11、 ligament,The integrative model of functioning and disability,Tear of articular cartilage of knee M 23.5,Environmental factors,Personal factors,Contextual factors,Activity,Participation,Pain, stability of joints, muscle power,Cruciate ligament,The integrative model of functioning and disability,Acti
12、vity & Participation,Activity is the execution of a task or action by an individual. It represents the individual perspective of functioning. 活动指个人执行任务或者个人的行动，代表个体功能 Participation is involvement in a life situation. It represents the societal perspective of functioning.,Activity limitations 活动受限,Act
13、ivity & Participation,Participation is involvement in a life situation. It represents the societal perspective of functioning. 参与指参加生活环境的活动，代表社会功能,Participation restrictions 参与限制,Tear of articular cartilage of knee M 23.5,Environmental factors,Personal factors,Contextual factors,Activity,Participati
14、on,Pain, stability of joints, muscle power,Cruciate ligament,Take care of her grandchild Doing housework Assisting her husband with his business,Carrying objects, kneeling, walking, climbing,The integrative model of functioning and disability,Tear of articular cartilage of knee M 23.5,Environmental
15、factors,Personal factors,Contextual factors,Activity,Participation,Pain, stability of joints, muscle power,Cruciate ligament,Take care of her grandchild Doing housework Assisting her husband with his business,Carrying objects, kneeling, walking, climbing,The integrative model of functioning and disa
16、bility,Environmental Factors环境因素,Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives 人们居住和生活的物理、社会和态度环境 Environmental factors are external to individuals and can have positive (facilitator) or negative (barrier) influence on the individual 环境因素是个人之外的因素 积极因素 (facilitator) 消极因素(barrier),Tear of articular cartilage of knee M 23.5,Environmental factors,Personal factors,Contextual facto
