成人版身心障礙鑑定功能量表之鑑定人員訓練課程與其初步成果

2007 年公布之身心障礙權益者保障法以「國際健康功能與身心障礙分類系統（ICF）」為導向。因此，於身心障礙鑑定新制中之醫療鑑定包括身體功能∕構造與活動∕參與，由專業團隊進行鑑定評估。「身心障礙鑑定功能量表成人版」為活動∕參與之評估工具。為使2012 年7 月身心障礙鑑定新制正式上路之進行更為周延，衛生署在2011 年「功能量表成人版」第一版完成後，便參照課程規劃計畫進行一連串之「身心障礙鑑定專業人員訓練課程」。本文針對訓練課程，說明課程規畫過程、內容、執行及成果。訓練課程歷經3 個月之規劃，由於時間與人力之考量，初步以訓練專業人員正確收集功能量表之資料為主要目標。於2011 年6 月至10 月間分別舉辦種子教師訓練課程及一般學員訓練課程，種子教師課程為兩天共11.5 小時，北、中、南、東部各舉辦一場；一般學員課程為一天共7 小時，於北、中、南、東部共舉辦23 場。一般學員課程主題為：ICF 簡介與身心障礙鑑定新制流程、身心障礙鑑定功能量表內容、障礙鑑定功能量表演練與實習與新制身心障礙鑑定整合平台簡介與示範；種子教師課程尚包括身心障礙福利政策與法規、「世界衛生組織障礙評估手冊2.0 版」（WHODAS 2.0）心理計量學。鑑定人員資格必須為具有本國合格證照之相關專業人員，且具有一年以上臨床經驗，並以具有一年身心障礙者相關臨床服務經驗者優先。每一場課程皆有筆試測驗，70 分以上始可領取研習證書。課程中學員若有任何問題皆可記錄在回饋單以作為後續課程內容與功能量表修改之參考。共有種子教師學員261 人及一般學員2613 人參與受訓，總計2874 人；而種子學員235 人及一般學員2112 人通過測驗檢覈且符合鑑定專業人員資格，總計2347 人，合格率為82%。訓練課程成果已達成甚或超過原先各縣市預計之需求人數。經由課程訓練而合格的鑑定人員數遠超出原規劃的人數。未來若欲提升以ICF 為基礎之身心障礙服務內容，還需要參考國內外資料以規畫、執行並追蹤訓練課程持續狀況，以了解所培訓的人員將所學用於臨床之效用。

According to The People with Disabilities Rights Protection Act, the local authority in Taiwan should issue disability identifications based on the results of disability evaluation by a medical team since July 2012. The content of the disability evaluation includes body function and structures as well as activity and participations and environmental factors of ICF/ICF-CY. The Functioning Scale of the Disability Evaluation System (FUNDES) has been designed to assess the activity and participations status of the applicants. To prepare the manpower needed for the execution of the disability eligibility system in 2012, a series of training programs for the testers of FUNDES have been held from June to December in 2011 when the first version of the FUNDES was established. The purpose of this article is to describe the planning, content, and execution of the training programs and its outcomes. The training program was planned for 3 months. The main purpose of the training program was to train the professionals to be able to collect the FUNDES data correctly based on clinical settings. In 2011, 4 courses for seeded teachers (11.5 hours) and 19 courses (7 hours) for general professionals have been held in four geographic areas of Taiwan. The contents of the general course are: Introduction to ICF and procedure of the disability eligibility system, content of FUNDES, demonstration and practice of the FUNDES, and introducing and demonstrating the information system of the disability eligibility system. The qualified testers of FUNDES are related to certificated professionals with one-year clinical experience, and must be trained and passed the program examination. There were 261 participants in the seeded teacher training courses, and 2613 participants in the general courses. After examination, only 2347 professionals (235 seeded teachers and 2112 professionals) passed and met the qualification requirement. The passing rate was 82%. The number of qualified testers met or exceeded the required number of every city or county in Taiwan. The results showed that such training programs had satisfied the outcomes for fulfilling needed tester number of the FUNDES. To enhance the service quality for people with special needs based on ICF/ICF-CY framework in the future, the training program for clinical application of ICF should be designed, executed and followed based on literature reviews or experiences.