新制身心障礙鑑定與需求評估（ICF）執行之探討：身心障礙服務使用者觀點

Implementation of the ICF: Perspectives of the users with disabilities

2012年ICF在台灣作為鑑定依據，即「新制身心障礙鑑定與需求評估」（簡稱「新制」），過去單一以醫生鑑定「損傷」者被稱為「舊制」。本研究從障礙服務使用者觀點，探討其對新制看法與經驗，是否回應ICF精神及落實「新制」鑑定相關規定。以半結構訪談大綱深度訪談24位障礙者，含曾接受新舊制、只有新制及等待「新制」鑑定者。結果發現已經接受「新制」鑑定者：資訊不清楚、城鄉差距大、環境因素沒有被考量、專業人員和受評者權力不平等、受評者沒有參與機會、第三位鑑定者不存在，等待「新制」鑑定者擔心程度變輕福利變少。如同舊制，現階段國內新制執行與福利服務提供仍只看損傷。建議「新制」鑑定與需求評估規劃與執行重視障礙服務使用者參與、選擇，重視活動與社會參與及需求的個別差異。

Since July 2012, according to the new act of disability issued in 2007, a person's eligibility for disability benefits has been assessed based on the ICF. This study interviewed disabled people who were assessed by this new assessment system to explore their experiences of the new assessment. An in-depth, semi-structured interview was employed and 24 persons with disabilities (including three groups: those assessed by the old and new assessment system, only assessed by the new system and waiting for assessment by the new one) had completed the interviews between December of 2013 and January of 2015. From the participants' view, the new assessment is: information not accessible, welfare benefit and service delivery based on the level of impairment, a gap of welfare benefit existed between different local authorities, environmental factors excluded of the consideration in the assessment, the absence of the third assessors, lack of concern of the individual uniqueness and needs, no opportunity for the users involved in the assessment process, worried about the welfare benefit cut due to the level of disability level reduced. The findings suggest that the users' choice, social roles and activities could be considered in the assessment to meet their individual needs.