The implementation of the International Classification of Functioning, Disability and Health in Germany: experiences and problems

作者：Michael F. Schuntermann · 发表于：International Journal of Rehabilitation Research · 年份：2005 · DOI：10.1097/00004356-200506000-00001 · 被引用次数：72 · 研究领域：Health and Medical Studies、Medical Practices and Rehabilitation

The bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF) has already found wide acceptance in Germany. In particular, the introduction of contextual factors (environmental factors and personal factors) is welcomed. Several rehabilitation facilities have used the model and the chapters of the revision version (Beta-2) as guidelines for documenting their interviews with rehabilitation patients. Their experiences are encouraging. However, it has already been recognized that coding with the ICF will be difficult and time consuming. Thus, the practicability of the ICF should be improved. Training in the use of the ICF is absolutely essential. It is welcomed that the ICF provides a common vocabulary for both people with disability and for professionals in the fields of rehabilitation and disability. This is particularly important in Germany because we have a rather complicated social system. In contrast to the International Classification of Impairments, Disabilities and Handicaps (ICIDH), the ICF, in general, contains neutral terms only. Many of our physicians in rehabilitation complain about that. Obviously they also need to be able to express the signs and symptoms of restrictions of functioning in negative terms and in this respect they feel that the ICIDH was more helpful. While both the concept of activities and the concept of participation are clearly understood from the point of view of content some of us have severe proble...