以ICF共同語言連結身心障礙鑑定和需求評估兩工具的初探研究

台灣於2012年起實施以ICF為架構的身心障礙鑑定與福利服務輸送系統，其身心障礙鑑定和需求評估所用的工具都與ICF活動/參與(d)代碼有關，並採滾動式修正。因此本文目的為：(1)以d二級碼當校標探討需求評估表2015年版和功能量表8.0成人版連結情形；(2)探討兩量表連結資訊的課程對需求評估的可能成效。方法：2015~2018年間，分三期進行。第一期根據ICF連結原則和專家共識以完成兩量表的ICF d代碼配對表，同時由實際身心障礙成人鑑定到需求評估流程，收集需求評估人員對參考功能量表評估結果的看法。第二和第三期分別設計和進行需求評估人員2小時和6.5小時的培訓，介紹功能量表及兩量表的連結資訊於需求評估的運用，收集課程的可能效益。結果：檢視兩量表ICF代碼配對表，需求評估表60個d題項有37題（62%）可以連結到功能量表。課程前，需求評估人員對功能量表的了解與運用有限；課程後，需求評估人員對功能量表的評估結果了解顯著提升，並認為進行需求評估前或中，運用功能量表資訊可促進身心障礙鑑定和需求評估工作的整合與運用。建議未來持續研究功能量表10.0版和需求評估表2023年版的連結研究，並提供繼續教育課程或運用資訊科技，讓需求評估人員知道如何運用功能量表的評估結果，以強化提升障礙者社會參與之政策。

Since 2012, Taiwan has implemented the ICF-based Disability Identification and Welfare Service Delivery System. The tools used in disability identification and needs assessment are related to the ICF Activity/Participation (d) codes and are continually updated based on feedback from the field. The purposes of this manuscript are to: (1) describe the empirical results of the Functioning Scale of the Disability Evaluation System 8.0 Adult version (FUNDES-Adult 8.0) and the 2015-year version of the Needs Assessment Interview Form linked to the ICF 2nd-level d categories; and (2) explore the potential effectiveness of providing the linkage information for evaluators of needs assessment. Methods: There were three stages conducted from 2015 to 2018. In the first stage, the crosswalk table of ICF d-categories between the two tools was completed according to ICF linking rules and expert consensus. Simultaneously, by observing the actual disability identification and needs assessment process for adults, we collected information to understand the needs-assessment evaluators’perspectives on the FUNDES-Adult results. In the second and third stages, we conducted a 2-hour course and 6.5-hour course separately, each with linkage information, and examined the potential benefits of the courses for needs-assessment evaluators. Results: A total of 37 items (62%) of the Needs Assessment Form could be linked to the FUNDES-Adult in the crosswalk table. Before the training course, needs-assessment evaluators knew little about the FUNDES-Adult. After the course, their knowledge of the FUNDES-Adult significantly increased. Evaluators believed that using linkage information before or during the needs assessment could facilitate the integration and application of disability identification and needs assessment. It is recommended that further study of the linkage between FUNDES 10.0 and 2015-year version of Needs Assessment is needed. Continuing education courses or information technology could be used in the future to help needs-assessment evaluators understand the results and application of the FUNDES-Adult, thereby strengthening the impact of policies aimed at enhancing the social participation of people with disabilities.