《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (12): 1454-1464.doi: 10.3969/j.issn.1006-9771.2023.12.010

• 标准与规范 • 上一篇    下一篇

基于ICD-11和ICF的活动和参与与生活质量测量工具的内容比较

杨亚茹1,2,3, 杨剑1,2,3()   

  1. 1.华东师范大学体育与健康学院，上海市 200241
    2.华东师范大学青少年健康评价与运动干预教育部重点实验室，上海市 200241
    3.世界卫生组织国际分类家族合作中心，北京市 100068
  • 收稿日期:2023-03-10 修回日期:2023-10-23 出版日期:2023-12-25 发布日期:2023-12-28
  • 通讯作者: 杨剑(1970-)，男，汉族，江苏徐州市人，博士，教授，世界卫生组织国际分类家族合作中心专家委员，中国心理学会康复心理学专委会副主任委员，中国残疾人康复协会残疾分类研究专业委员会副主任委员，主要研究方向：儿童青少年体育与健康、儿童青少年健康、ICF、康复科学、健康心理学、锻炼心理学、康复心理学、残疾研究。E-mail： yangjianxz@sina.com
  • 作者简介:杨亚茹(1997-)，女，汉族，北京市人，博士研究生，世界卫生组织国际分类家族合作中心委员，中国心理学会康复心理学专委会委员，中国残疾人康复协会残疾分类研究专业委员会常务委员，主要研究方向：ICF、康复心理学、特殊教育、康复科学、健康心理学、锻炼心理学、残疾研究。
  • 基金资助:
    1.上海高校"立德树人"人文社会科学重点研究基地子项目(1100-41222-16057);2.青少年体育教育研究上海市社会科学创新研究基地子项目(11001-412321-17006);3.华东师范大学青少年运动促进健康研究院子项目

Content comparison of assessment tools of activity and participation, and quality of life: based on ICD-11 and ICF

YANG Yaru1,2,3, YANG Jian1,2,3()   

  1. 1. College of Physical Education and Health, East China Normal University, Shanghai 200241, China
    2. Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China
    3. WHO-FICs CC in China, Beijing 100068, China
  • Received:2023-03-10 Revised:2023-10-23 Published:2023-12-25 Online:2023-12-28
  • Contact: YANG Jian, E-mail: yangjianxz@sina.com
  • Supported by:
    Shanghai University Key Research Base for Humanities and Social Sciences(1100-41222-16057);Shanghai Social Science Research Base for Youth Physical Education(11001-412321-17006);East China Normal University Institute of Youth Sports Promoting Health

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摘要：

目的 运用《国际功能、残疾和健康分类》(ICF)对主要活动和参与测量工具以及生活质量测量工具的测量项目内容进行内容编码和分析。

方法 选择具有代表性的活动类、综合性活动和参与类以及生活质量评定工具，对它们的测量结构和内容进行分析。基于ICF联系规则和内容匹配方法，将测量工具的测量项目概念与ICF类目和ICD-11进行匹配，分析各测量工具的测量项目的内容与ICF类目概念间内涵与外延之间的关系，并进行编码。

结果 活动类的测量工具有Barthel指数(BI)、工具性日常生活活动能力(IADL)等标准化活动评定工具，主要运用于医疗、康复、社区等情境。测量模式为基于对活动功能的直接观察和对个人或其他人(照顾者)的半结构化访谈。测量时长25~60 min。多数测量工具是标准参照的测量工具。有关活动和参与类的整体功能的评定工具，如健康调查简表(SF-36)、世界卫生组织生活质量测定量表简表(WHOQOL-BREF)、世界卫生组织生活质量测定量表-残疾版(WHOQOL-DIS)以及世界卫生组织残疾评定量表(WHODAS 2.0)均为常模参照类评定工具，可以在医疗、康复、教育和社会服务等情境下应用。由专业人员采用访谈以及观察测量的形式完成测量，也可由被评估者自填问卷完成。测量时长30~60 min。从测量内容看，BI和IADL的测量项目主要集中于自我照护活动和功能性活动，即ICF的活动(d4)、自我照护(d5)和家庭生活(d6)等类目。SF-36主要涉及一般任务和要求(d2)、交流(d3)、活动(d4)、自我照护(d5)以及家庭生活(d6)等类目。WHOQOL-BREF和WHOQOL-DIS生活质量测量项目包括一般任务和要求(d2)、交流(d3)、活动(d4)、人际互动和联系(d7)和社区、社会和公民生活(d9)类目。WHODAS 2.0是覆盖ICF活动和参与9个领域最广泛的测量工具。

结论 运用ICF类目定义、术语和编码以及ICF联系规则确定6种典型的测量工具的测量内容。WHOQOL-BREF和WHOQOL-DIS生活质量类评定工具与WHODAS 2.0作为整体功能评定工具，评定内容涉及ICF的活动和参与的9个领域。生活质量测量工具涉及生活质量和福祉等领域，内容更广泛宏观。

关键词: 国际疾病分类第十一次修订本, 国际功能、残疾和健康分类, 日常生活活动, 健康相关生活质量, 评估

Abstract:

Objective To encode and analyze the measurement items of major activity and participation function assessment tools and quality of life assessment tools using International Classification of Functioning, Disability and Health (ICF).

Methods Representative tools in the activity category, comprehensive activity and participation category, as well as quality of life assessment tools were selected for analysis of their measurement structures and content. Based on the ICF linking rule and content matching method, the concepts of measurement items in various tools were matched with ICF categories, analyzing the relationships between the content of measurement items and the concepts of ICF categories, and then coded in ICF and ICD-11.

Results Measurement tools in the activity category, such as Barthel index (BI) and Instrumental Activities of Daily Living (IADL), were primarily standardized activity assessment tools in medical, rehabilitation, and community settings. The measurement was conducted through direct observation of activity function and semi-structured interviews with individuals or their caregivers, with 25 to 60 minutes. Most measurement tools were standardized reference tools. Assessment tools related to overall functioning in the activity and participation category, such as 36-item Short-Form Health Survey (SF-36), World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), World Health Organization Quality of Life-Disability (WHOQOL-DIS) and World Health Orgnization Disability Assessment Scheme 2.0 (WHODAS 2.0) were norm-referenced assessment tools applicable in medical, rehabilitation, education, and social service contexts. The measurement was carried out by professionals through interviews and observations, or completed by the assessed individuals through self-administered questionnaires, with a measurement duration of 30 to 60 minutes. In terms of measurement content, IADL and BI mainly focus on activities of self care and functional activities, corresponding to ICF categories such as mobility (d4), self-care (d5), and domestic life (d6). SF-36 primarily covers general tasks and demands (d2), communication (d3), mobility (d4), self-care (d5), and domestic life (d6). WHOQOL-BREF and WHOQOL-DIS items related to general tasks and demands (d2), communication (d3), mobility (d4), interpersonal interactions and relationships (d7), and community, social, and civic life (d9). WHODAS 2.0 was the most comprehensive measurement tool covering all nine domains of activity and participation in the ICF.

Conclusion This study amalyzed the structures and contents of items of six assessments tools using ICF nomenclature, terminology, codes and linking rules. WHOQOL-BREF, WHOQOL-DIS and WHODAS 2.0 are comprehensive functioning evaluation tools, covering all nine ICF domains of activity and participation, as well as quality of life and well-being.

Key words: International Classification of Diseases 11th Revision, International Classification of Functioning, Disability and Health, activities of daily living, health-related quality of life, assessment

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