∫—≠™’ “°≈‡æ◊ËÕ°“√®”·π°°“√∑”ß“π§«“¡æ‘°“√·≈–  ÿ¢¿“æ InternationalClassification ofFunctioning,DisabilityandHealth

International

Classification of Functioning,

Disability and

Health

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World Health Organization Geneva

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International classification of functioning, disability and health : ICF.

1.Human development 2.Body constitution 3. Health status 4. Disability evaluation 5.Socioeconomic factors 6.Causality 7.Classification 8.Manuals I.Title: ICF

(NLM classification: W 15)

© World Health Organization 2001 (ISBN 974-93325-2-0)

Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved.

The designations employed and the presentation of the material in this

publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the

delimitation of its frontiers or boundaries.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.

Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

ii

∫—≠™’√“¬™◊ËÕ ‘Ëßµ’æ‘¡æå¢ÕßÀâÕß ¡ÿ¥Õߧ尓√Õπ“¡—¬‚≈°

∫—≠™’ “°≈‡æ◊ËÕ°“√®”·π°°“√∑”ß“π§«“¡æ‘°“√·≈– ÿ¢¿“æ : ICF

1. °“√æ—≤π“∫ÿ§§≈ 2. ‚§√ß √â“ߢÕß√à“ß°“¬ 3.  ¿“«– ÿ¢¿“æ 4. °“√ª√–‡¡‘𧫓¡æ‘°“√

5. ªí®®—¬¥â“π‡»√…∞“π–∑“ß —ߧ¡ 6. §«“¡ —¡æ—π∏å√–À«à“߇Àµÿ·≈–º≈ 7. °“√®—¥ª√–‡¿∑

8. §Ÿà¡◊Õ

I. ™◊ËÕÀπ—ß ◊Õ ICF

(ISBN 974-93325-2-0) (NLM classification: W 15)

©Õߧ尓√Õπ“¡—¬‚≈° 2001

¢Õ ß«π ‘∑∏‘Ï°“√µ’æ‘¡æå‡Õ° “√¢ÕßÕߧ尓√Õπ“¡—¬‚≈°µ“¡‡°≥±å«‘∏’∑’Ë 2 Õπÿ —≠≠“≈‘¢ ‘∑∏‘Ï “°≈

Õߧ尓√Õπ“¡—¬‚≈°‰¡à‰¥â„À⧫“¡‡ÀÁπ«à“‡π◊ÈÕÀ“∑’Ë𔇠πÕ„π ‘Ëßæ‘¡æ凪ìπ ‘Ëß∑’Ë¥’∑’Ë ÿ¥ ·µà≈–ª√–‡∑»

µâÕßæ‘®“√≥“𔉪„™â„Àâ‡À¡“– ¡

∫√‘…—∑∑’ˉ¥â√—∫°√√¡ ‘∑∏‘Ï„π°“√º≈‘µ ‘Ëßæ‘¡æå ‰¥â√—∫ ‘∑∏‘χ©æ“–°“√æ‘¡æå ¡‘‰¥â√—∫ ‘∑∏‘摇»… (≈‘¢ ‘∑∏‘Ï) Õ◊Ëπ„¥

¢âÕº‘¥æ≈“¥·≈–°“√≈–‡«âπ√«¡∑—Èß™◊ËÕ‡©æ“–¢Õߺ≈‘µ¿—≥±å (º≈º≈‘µ) ®–¢÷Èπµâπ¥â«¬Õ—°…√

µ—«æ‘¡æå„À≠à

∫—≠™’ “°≈‡æ◊ËÕ°“√®”·π°°“√∑”ß“π §«“¡æ‘°“√ ·≈– ÿ¢¿“æ : ICF (©∫—∫¿“…“‰∑¬)

®—¥æ‘¡æå‚¥¬ß∫ª√–¡“≥°√¡°“√·æ∑¬å °√–∑√«ß “∏“≥ ÿ¢ ªï æ.». 2547

iii

A. Introduction 1

1. Background 3

2. Aims of ICF 5

3. Properties of ICF 7

4. Overview of ICF components 10

5. Model of Functioning and Disability 18

6. Use of ICF 21

B. One-level classification 27

C. Two-level classification 32

D. Detailed classification with definitions 46

Body Functions 47

Body Structures 105

Activities and Participation 123

Environmental Factors 171

E. Annexes 209

1. Taxonomic and terminological issues 211

2. Guidelines for coding ICF 219

3. Possible uses of the Activities and Participation list 234

4. Case examples 239

5. ICF and people with disabilities 242

6. Ethical guidelines for use of ICF 244

7. Summary of the revision process 246

8. Future directions for the ICF 250

9. Suggested ICF data requirements for ideal and minimal health information systems or surveys

253

10. Acknowledgements 254

F. Index 269

iii

 “√∫—≠

°. ∫∑π” 1

1. §«“¡‡ªìπ¡“ 3

2. ®ÿ¥¡ÿàßÀ¡“¬¢Õß ICF 5

3. §ÿ≥ ¡∫—µ‘¢Õß ICF 7

4. Õߧåª√–°Õ∫‚¥¬ —߇¢ª¢Õß ICF 10

5. √Ÿª·∫∫¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–§«“¡æ‘°“√ 18

6. °“√„™â ICF 21

¢. ∫—≠™’°“√®”·π°Àπ÷Ëß√–¥—∫ 27

§. ∫—≠™’°“√®”·π° Õß√–¥—∫ 32

ß. ∫—≠™’°“√®”·π°„π√“¬≈–‡Õ’¬¥æ√âÕ¡§”𑬓¡ 46

°“√∑”ß“π¢Õß√à“ß°“¬ 47

‚§√ß √â“ߢÕß√à“ß°“¬ 105

°‘®°√√¡·≈–°“√¡’ à«π√à«¡ 123

ªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡ 171

®. ¿“§ºπ«° 209

1. À≈—°°“√®”·π°ª√–‡¿∑ ·≈–°“√∫—≠≠—µ‘»—æ∑å 211

2. ·π«∑“ß°“√„Àâ√À— ¢Õß ICF 219

3.  ‘Ëß∑’ËÕ“®π”¡“„™â‰¥â®“°√“¬°“√°‘®°√√¡·≈–°“√¡’ à«π√à«¡ 234

4. °√≥’µ—«Õ¬à“ß 239

5. ICF ·≈–§πæ‘°“√ 242

6. ®√‘¬∏√√¡„π°“√„™â ICF 244

7.  √ÿª°√–∫«π°“√·°â‰¢ª√—∫ª√ÿß 246

8. ∑‘»∑“ß„πÕ𓧵¢Õß ICF 250

9. ¢âÕ·π–𔇰’ˬ«°—∫°“√„™â¢âÕ¡Ÿ≈ ICF  ”À√—∫√–∫∫¢âÕ¡Ÿ≈∑“ß 253  ÿ¢¿“æÕ¬à“߬àÕ ·≈–„πÕÿ¥¡§µ‘ À√◊Õ°“√ ”√«®µà“ßÊ

10. °‘µµ‘°√√¡ª√–°“» 254

©. ¥—™π’ 269

∫∑π”

3

3

ICF ∫∑π”

1 ¡“®“°°“√ª√—∫ª√ÿß∫—≠™’ “°≈¢Õß°“√®”·π°ª√–‡¿∑¢Õߧ«“¡∫°æ√àÕß §«“¡æ‘°“√ ·≈–§«“¡¥âÕ¬ ¡√√∂¿“æ (ICIDH) ´÷Ë߉¥âµ’

æ‘¡æ出¬·æ√à‡ªìπ°“√∑¥≈Õß ‚¥¬Õߧ尓√Õπ“¡—¬‚≈° ‡¡◊ËÕªï æ.».2523 À≈—ß®“°∑’ˉ¥âæ—≤π“ ·≈–∑¥≈Õß„™â„πæ◊Èπ∑’Ë ·≈–ºà“π°“√ª√÷°…“

À“√◊Õ√à«¡°—π√–À«à“ߪ√–‡∑» „π√–¬–‡«≈“À⓪ï∑’˺à“π¡“ ®÷߉¥â√—∫°“√¬Õ¡√—∫„Àâ„™â„πª√–‡∑»µà“ßÊ ‚¥¬¡µ‘°“√ª√–™ÿ¡ ¢ÕßÕߧ尓√Õπ“¡—¬

‚≈°§√—Èß∑’ËÀâ“ ‘∫ ’Ë ‡¡◊ËÕ«—π∑’Ë 22 情¿“§¡ 2543 («“√–∑’Ë WHA54.21)

2 §”‡À≈à“π’Èπ”¡“„™â·∑𧔇¥‘¡∑’Ë«à“ ç§«“¡∫°æ√àÕßé, 秫“¡æ‘°“√é ·≈– 秫“¡¥âÕ¬ ¡√√∂¿“æé ‡ªìπ°“√¢¬“¬¢Õ∫‡¢µ¢Õß°“√

®”·π°ª√–‡¿∑ ‚¥¬„Àâ “¡“√∂π”ª√– ∫°“√≥å„π‡™‘ß∫«°¡“„™â„π°“√Õ∏‘∫“¬¥â«¬ „π∫∑π”π’È®–¡’°“√Õ∏‘∫“¬‡æ‘Ë¡‡µ‘¡∂÷ߧ”„À¡à‡À≈à“π’È

·≈–∫√√¬“¬Õ¬à“ß≈–‡Õ’¬¥„π°“√∫—≠™’®”·π°ª√–‡¿∑ Õ¬à“߉√°Áµ“¡ §”µà“ßÊ ¥—ß°≈à“«®–„™â„𧫓¡À¡“¬‡©æ“–¢Õß¡—π∑’Ë Õ“®®–·µ°µà“ß

‰ª®“°°“√„™â„π‡«≈“ª°µ‘

3 ¢Õ∫‡¢µ®–À¡“¬∂÷ß™ÿ¥∑’Ë√–∫ÿ§«“¡À¡“¬·≈–‡À¡“–°—∫°“√ªØ‘∫—µ‘¢Õß°“√∑”ß“π∑“ß √’√–«‘∑¬“∑’ˇ°’ˬ«¢âÕß ‚§√ß √â“ß∑“ß°“¬«‘¿“§

°“√°√–∑” ß“π À√◊Õ‡π◊ÈÕÀ“¢Õß™’«‘µ

1. §«“¡‡ªìπ¡“

∫—≠™’ “°≈‡æ◊ËÕ°“√®”·π°°“√∑”ß“π§«“¡æ‘°“√·≈– ÿ¢¿“æ (International Classification of Functioning, Disability and Health) À√◊Õ∑’ˇ√’¬°°—π«à“ ICF ¹¡’®ÿ¥¡ÿàßÀ¡“¬À≈—° ‡æ◊ËÕ°“√

𔇠πÕ¿“…“¡“µ√“∞“π∑’Ë√«¡‰«â¥â«¬°—π ·≈–‚§√ß √â“ß„π°“√Õ∏‘∫“¬ ÿ¢¿“æ ·≈– ∂“π– à«π ª√–°Õ∫∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ®–„Àâ§”π‘¬“¡Õߧåª√–°Õ∫¢Õß ÿ¢¿“æ ·≈–∫“ßÕߧåª√–°Õ∫¢Õß

°“√Õ¬Ÿà¥’°‘π¥’∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ (‡™àπ °“√»÷°…“ ·≈–°“√∑”ß“π) ICF §√Õ∫§≈ÿ¡¢Õ∫‡¢µ  ÿ¢¿“æ ·≈–¢Õ∫‡¢µ à«πª√–°Õ∫∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ‚¥¬æ‘®“√≥“®“°√à“ß°“¬µ—«∫ÿ§§≈ ·≈–

 —ߧ¡„π 2 ª√–°“√ §◊Õ (1) °“√∑”ß“π¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ß; ·≈– (2) °‘®°√√¡ ·≈–°“√¡’

 à«π√à«¡ ² ‡π◊ËÕß®“°°“√®”·π°ª√–‡¿∑ ICF ¡’°“√®—¥ °≈ÿà¡„π¢Õ∫‡¢µ (Domain)³ ∑’Ë·µ°µà“ß

°—πµ“¡¿“«– ÿ¢¿“æ¢Õß·µà≈–∫ÿ§§≈ (µ—«Õ¬à“߇™àπ ºŸâªÉ«¬ À√◊ÕºŸâ∑’Ë¡’§«“¡º‘¥ª°µ‘ “¡“√∂∑”Õ–‰√

‰¥â∫â“ß) °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ¡’§«“¡À¡“¬∑’˧√Õ∫§≈ÿ¡ °“√∑”ß“π∑—ÈßÀ¡¥¢Õß√à“ß°“¬

°‘®°√√¡ ·≈–°“√¡’ à«π√à«¡„π∑”πÕ߇¥’¬«°—𠧫“¡æ‘°“√ °Á¡’§«“¡À¡“¬§√Õ∫§≈ÿ¡∂÷ߧ«“¡

∫°æ√àÕߢÕß√à“ß°“¬ °“√®”°—¥„π°“√∑”°‘®°√√¡ ·≈–¢âÕ®”°—¥ „π°“√¡’ à«π√à«¡ πÕ°®“°π’È ICF

¬—ߪ√–°Õ∫¥â«¬ªí®®—¬ ‘Ëß·«¥≈âÕ¡ ´÷Ëß¡’§«“¡‡™◊ËÕ¡‚¬ß°—∫ ¿“«–°√≥’µà“ßÊ ∑”„À⺟ℙ⠓¡“√∂∫—π∑÷°

‡°’ˬ«°—∫°“√∑”Àπâ“∑’Ë¢Õßªí®‡®°∫ÿ§§≈ §«“¡æ‘°“√ ·≈– ÿ¢¿“æ¢Õß∫ÿ§§≈„π¢Õ∫‡¢µµà“ßÊ ‰¥â ICF ‡ªìπ à«πÀπ÷ËߢÕß°≈ÿà¡«‘∏’°“√®”·π° “°≈∑’Ëæ—≤π“¢÷Èπ¡“‚¥¬Õߧ尓√Õπ“¡—¬‚≈° (WHO) ‡æ◊ËÕ π”¡“„™â„π¥â“πµà“ßÊ ∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ‚¥¬°”Àπ¥°√Õ∫°“√„ à√À— ¢âÕ¡Ÿ≈∑’˧√Õ∫§≈ÿ¡∑“ߥâ“π  ÿ¢¿“æ (µ—«Õ¬à“߇™àπ °“√«‘π‘®©—¬, °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–‡Àµÿº≈„π°“√√—∫∫√‘°“√¥â“π  “∏“√≥ ÿ¢) ‚¥¬„™â¿“…“ “¡—≠¡“µ√∞“π “°≈ “¡“√∂ ◊ËÕ§«“¡À¡“¬¥â“π°“√ “∏“√≥ ÿ¢‰¥â∑—Ë«‚≈°

°“√®”·π°ª√–‡¿∑ ¢ÕßÕߧ尓√Õπ“¡—¬‚≈°„π ICD-10 (™◊ËÕ¬àÕ¢Õß International Classification of Diseases Tenth Revision ∫—≠™’®”·π°‚√§√–À«à“ߪ√–‡∑»©∫—∫·°â‰¢

4

ICF ∫∑π”

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§√—Èß∑’Ë 10) ⁴ ´÷Ëß®—¥°≈ÿࡵ“¡ “‡Àµÿ¢Õß‚√§  à«π ICF ®–®—¥°≈ÿࡵ“¡ °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬

·≈–§«“¡ æ‘°“√∑’ˇ°’ˬ«¢âÕß°—∫¿“«– ÿ¢¿“æ ¥—ßπ—È𠧫√®–„™â∑—Èß ICD-10 ·≈– ICF √à«¡°—π⁵

‡æ√“– ICD-10 „Àâ¢âÕ¡Ÿ≈¥â“π°“√«‘π‘®©—¬‚√§ §«“¡º‘¥ª°µ‘ À√◊Õ¿“«– ÿ¢¿“æ ‡¡◊ËÕπ”¢âÕ¡Ÿ≈¢Õß ICF ¥â“π°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬¡“ª√–°Õ∫®–∑”„À≥â¢âÕ¡Ÿ≈∑’Ë ¡∫Ÿ√≥å¢÷Èπ⁶ ‡ªìπ¿“æ√«¡∑“ߥâ“π  ÿ¢¿“æ¢Õß∫ÿ§§≈À√◊Õª√–™“°√∑’˧√Õ∫§≈ÿ¡ ¡’√“¬≈–‡Õ’¬¥™—¥‡®π¡“°¢÷Èπ ·≈–‡ªìπª√–‚¬™πå„π°“√

µ—¥ ‘π„®

°≈ÿà¡¢Õß∫—≠™’°“√®”·π°ª√–‡¿∑ √–À«à“ߪ√–‡∑»¢ÕßÕߧ尓√Õπ“¡—¬‚≈°‡ªìπ‡§√◊ËÕß¡◊Õ ”§—≠

„π°“√∑’Ë®– Õ∏‘∫“¬ ·≈–‡ª√’¬∫‡∑’¬∫ ÿ¢¿“æ¢Õߪ√–™“°√√–À«à“ߪ√–‡∑» ¢âÕ¡Ÿ≈∑’ˇ°’ˬ«°—∫Õ—µ√“

°“√µ“¬ („π ICD-10) ·≈–º≈≈—æ∏å¢Õß ÿ¢¿“æ („π ICF)  “¡“√∂π”¡“„™â√à«¡°—π„π°“√«—¥√–¥—∫

 ÿ¢¿“æ ·≈–„™â„π°“√µ‘¥µ“¡ ÿ¢¿“æ¢Õߪ√–™“°√∑—Èߪ√–‡∑» πÕ°®“°π’Ȭ—ß “¡“√∂π”¡“„™â

„π°“√ª√–‡¡‘πº≈∂÷ß “‡Àµÿ°“√µ“¬ ·≈–°“√‡°‘¥‚√§∑’Ë·µ°µà“߉¥â

ICF ‰¥â‡ª≈’ˬπ·ª≈ß®“°°“√®”·π° çº≈®“°°“√‡°‘¥‚√§é (©∫—∫ªï 1980) ¡“‡ªìπ°“√®”·π°

ç à«πª√–°Õ∫¢Õß ÿ¢¿“æé ´÷Ëß ç à«πª√–°Õ∫¢Õß ÿ¢¿“æé ™’È„Àâ‡ÀÁπ∂÷ß à«π ”§—≠µà“ßÊ ¢Õß  ÿ¢¿“æ „π¢≥–∑’Ë çº≈¢Õß°“√‡°‘¥‚√§é ®–‡πâπ∑’˺≈°√–∑∫∑’ˇ°‘¥®“°‚√§·≈– ¿“«– ÿ¢¿“æÕ◊ËπÊ

‡π◊ËÕß®“° ICF ®–‡ªìπ°≈“ß ‰¡à‡¢â“‰ª‡°’ˬ«¢âÕß„π°“√»÷°…“À“ “‡Àµÿ ∫ÿ§§≈ Õߧπ∑’Ë‚√§‡¥’¬«°—π Õ“®®–¡’√–¥—∫°“√∑”ß“π¢Õß√à“ß°“¬∑’Ë·µ°µà“ß°—πÀ√◊Õ∫ÿ§§≈ Õߧπ∑’Ë¡’√–¥—∫°“√∑”ß“π¢Õß√à“ß°“¬

∑’ˇ∑à“‡∑’¬¡°—ππ—Èπ ‰¡à®”‡ªìπ∑’Ë®–µâÕß¡’ ¿“«– ÿ¢¿“æ∑’ˇÀ¡◊Õπ°—π °“√„™â ICD-10 ·≈– ICF √à«¡

°—π ®÷߇ªìπ°“√‡æ‘Ë¡§ÿ≥¿“æ¢ÕߢâÕ¡Ÿ≈‡æ◊ËÕ„™â„π°“√·æ∑¬å ©–π—Èπ°“√„™â ICF ‰¡à§«√¢â“¡

°√–∫«π°“√«‘π‘®©—¬‚¥¬∑—Ë«‰ª ¢Õß°“√‡°‘¥‚√§ ºŸâ«‘®—¬®– “¡“√∂À“¢âÕ √ÿª‰¥â‚¥¬„™â«‘∏’°“√∑“ß

«‘∑¬“»“ µ√å∑’ˇÀ¡“– ¡„π∑”πÕ߇¥’¬«°—π «‘∏’°“√π’È·µ°µà“ß®“°°“√„™â çµ—«°”Àπ¥∑“ß ÿ¢¿“æé À√◊Õ çªí®®—¬‡ ’ˬßé ‡æ◊ËÕ§«“¡ –¥«°„π°“√»÷°…“µ—«°”Àπ¥∑“ß ÿ¢¿“æÀ√◊Õªí®®—¬‡ ’Ë¬ß ®÷߉¥â√«¡

ªí®®—¬ ‘Ëß·«¥≈âÕ¡ ∑’Ë„™â„π°“√Õ∏‘∫“¬∂÷ß ¿“«–∑’Ëªí®‡®°∫ÿ§§≈Àπ÷Ëߥ”√ß™’«‘µÕ¬Ÿà‰«â¥â«¬

4

°Ø‡°≥±å¡“µ√∞“π¢Õß°“√„Àâ‚Õ°“ ∑’ˇ∑à“‡∑’¬¡°—π·°àºŸâæ‘°“√ ¡’¡µ‘√—∫„π∑’˪√–™ÿ¡∑—Ë«‰ª¢ÕßÕߧ尓√ Àª√–™“™“µ‘ §√—Èß∑’Ë 48 ‡¡◊ËÕ«—π∑’Ë 20 ∏—𫓧¡ §.».1993 (¡µ‘∑’Ë 48/96), 𑫬Õ√å§, NY, °Õß¢à“« “√ “∏“√≥– Õߧ尓√ Àª√–™“™“µ‘, 1994

5 ª√–‡¥Á𠔧—≠§◊Õ µâÕ߬ա√—∫«à“¡’§«“¡‡À≈◊ËÕ¡´âÕπ°—π√–À«à“ß ICD-10 ·≈– ICF ∫—≠™’®”·π°ª√–‡¿∑∑—Èß 2 ‡√‘Ë¡¥â«¬√–∫∫¢Õß√à“ß

°“¬ §«“¡∫°æ√àÕß Õâ“ßÕ‘ß ‚§√ß √â“ߢÕß√à“ß°“¬·≈–°“√∑”ß“π ´÷Ëߪ°µ‘·≈â«®–‡ªìπ à«π¢Õß°“√¥”‡π‘π¢Õß‚√§ ¥—ß∑’Ë„π ICD-10 √–∫ÿ

§«“¡∫°æ√àÕß (Õ“°“√·≈–Õ“°“√· ¥ß) ‡ªìπ à«πµà“ßÊ À≈“°À≈“¬∑’Ë∑”„À⇰‘¥‚√§ À√◊Õ‡ªìπ‡Àµÿ„À⇢ⓡ“√—∫∫√‘°“√ ÿ¢¿“æ  ”À√—∫ ICF

®–„™â§«“¡∫°æ√àÕß · ¥ßªí≠À“¢Õß‚§√ß √â“ß·≈–°“√∑”ß“π¢Õß√à“ß°“¬‡°’ˬ«‡π◊ËÕß°—∫¿“«– ÿ¢¿“æ

6 §π 2 §π∑’ˇªìπ‚√§‡¥’¬«°—π “¡“√∂∑”ß“π‰¥â·µ°µà“ß°—π ·≈–§π 2 §π∑’Ë∑”ß“π‰¥â‡∑à“°—π‰¡à®”‡ªìπµâÕß¡’¿“«– ÿ¢¿“æ‡∑à“‡∑’¬¡°—π

¥—ßπ—Èπ  ”À√—∫®ÿ¥¡ÿàßÀ¡“¬∑“ß°“√·æ∑¬å °“√„™â√à«¡°—π®–™à«¬‡ √‘¡§ÿ≥¿“æ¢ÕߢâÕ¡Ÿ≈ ·µà‰¡à§«√≈–‡≈¬°√–∫«π°“√«‘π‘®©—¬‚√§ª°µ‘ πÕ°

‡Àπ◊Õ®“°π’È„π°“√„™â√Ÿª·∫∫Õ◊Ëπ Õ“®„™â ICF ‡æ’¬ßÕ¬à“߇¥’¬«‰¥â

5

ICF ∫∑π”

5

2. ®ÿ¥¡ÿàßÀ¡“¬¢Õß ICF

ICF ‡ªìπ°“√®”·π°∑’ˉ¥âÕÕ°·∫∫‡æ◊ËÕ„™â„π “¢“Õ“™’æµà“ßÊ °—π ‚¥¬¡’®ÿ¥¡ÿàßÀ¡“¬‚¥¬‡©æ“–

 √ÿª‰¥â¥—ßπ’È

ë

„ÀâÀ≈—°‡°≥±å¡“µ√∞“π‡æ◊ËÕ„™â„π°“√∑”§«“¡‡¢â“„® ·≈–»÷°…“∑“ߥâ“π ÿ¢¿“æ √«¡∑—Èß ¿“«–

 ÿ¢¿“æ∑’ˇ°’ˬ«¢âÕß º≈≈—æ∏å ·≈–µ—«°”Àπ¥

ë

®—¥„Àâ¡’¿“…“∑’Ë®–„™â√à«¡°—π„π°“√Õ∏‘∫“¬∂÷ß ÿ¢¿“æ  ¿“«–∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ‡æ◊ËÕ„™â„π

°“√ ◊ËÕ “√√–À«à“ߺŸâ„™âµà“ßÊ ‰¥â·°à ∫ÿ§≈“°√¥â“π “∏“√≥ ÿ¢, π—°«‘®—¬, π—°°”Àπ¥π‚¬∫“¬

·≈–ª√–™“™π∑—Ë«‰ª √«¡∑—ÈߺŸâæ‘°“√

ë

‡æ◊ËÕ°“√‡ª√’¬∫‡∑’¬∫¢âÕ¡Ÿ≈√–À«à“ߪ√–‡∑», „π¥â“π«‘∏’°“√¥Ÿ·≈ ÿ¢¿“æ, °“√„Àâ∫√‘°“√·≈–

√–¬–‡«≈“

ë

®—¥„Àâ¡’·ºπ°“√∫—π∑÷°√À— ∑’ˇªìπ√–∫∫  ”À√—∫ “√ π‡∑»¥â“π ÿ¢¿“æ

®ÿ¥¡ÿàßÀ¡“¬‡À≈à“π’ȇ°’ˬ«¢âÕß´÷Ëß°—π·≈–°—π ‡π◊ËÕß®“°§«“¡®”‡ªìπ·≈–§«“¡µâÕß°“√/°“√„™â ICF

∑”„Àâ¡’°“√®—¥∑”§«“¡À¡“¬·≈–√–∫∫∑’Ë “¡“√∂„™â‰¥â„π∑“ߪؑ∫—µ‘ „π°“√«“ßπ‚¬∫“¬¥â“π ÿ¢¿“æ,

°“√√—∫√Õߧÿ≥¿“æ, ·≈–°“√ª√–‡¡‘πº≈ —¡ƒ∑∏‘Ï „π«—≤π∏√√¡∑’˵à“ßÊ °—π

2.1 ª√–‚¬™πå¢Õß ICF

π—∫µ—Èß·µà∑’ˉ¥â¡’°“√®—¥æ‘¡æå©∫—∫∑¥≈Õß„πªï §.». 1980 ICIDH ‰¥â∂Ÿ°π”¡“„™â ”À√—∫

«—µ∂ÿª√– ß§åµà“ßÊ ¥—ßµàÕ‰ªπ’È

ë

‡ªìπ‡§√◊ËÕß¡◊Õ∑“ß ∂‘µ‘ - „π°“√‡°Á∫√«∫√«¡·≈–∫—π∑÷°¢âÕ¡Ÿ≈ (µ—«Õ¬à“߇™àπ„π°“√»÷°…“

°“√ ”√«®¥â“πª√–™“°√, À√◊Õ√–∫∫°“√®—¥°“√ “√ π‡∑»‡æ◊ËÕ°“√∫√‘À“√)

ë

‡ªìπ‡§√◊ËÕß¡◊Õ„π°“√«‘®—¬ - ‡æ◊ËÕ«—¥º≈≈—æ∏å, §ÿ≥¿“æ™’«‘µÀ√◊Õªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡

ë

‡ªìπ‡§√◊ËÕß¡◊Õ¥â“π°“√∫”∫—¥√—°…“ - ‡æ◊ËÕª√–‡¡‘𧫓¡µâÕß°“√, °“√‡ª√’¬∫‡∑’¬∫«‘∏’°“√√—°…“

„π‡ß◊ËÕπ‰¢∑’Ë°”Àπ¥, °“√ª√–‡¡‘π∑“ߥâ“π«‘™“™’æ, °“√ª√–‡¡‘π°“√øóôπøŸ ¡√√∂¿“æ·≈–

º≈≈—æ∏å

ë

‡ªìπ‡§√◊ËÕß¡◊Õ„π°“√«“ßπ‚¬∫“¬∑“ß —ߧ¡ - °“√«“ß·ºπª√–°—π —ߧ¡, √–∫∫°“√®à“¬§à“

™¥‡™¬ °“√«“ßπ‚¬∫“¬ °“√π”π‚¬∫“¬‰ª Ÿà°“√ªØ‘∫—µ‘

ë

‡ªìπ‡§√◊ËÕß¡◊Õ¥â“π°“√»÷°…“ - ‡æ◊ËÕ°“√«“ßÀ≈—° Ÿµ√·≈–‡æ◊ËÕ„À⇰‘¥°“√√—∫√Ÿâ·≈–¡’

°“√¥”‡π‘π°“√∑“ß —ߧ¡

πÕ°®“° ICF ®–‡ªìπ°“√®”·π°¥â“π ÿ¢¿“æ·≈– à«π∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ·≈â« ¬—߉¥â¡’°“√𔉪

„™â„πß“π¥â“πÕ◊ËπÊ ¥â«¬ ‡™àπ °“√ª√–°—π¿—¬, °“√ª√–°—π —ߧ¡, °“√∑”ß“π, °“√»÷°…“, ‡»√…∞°‘®, π‚¬∫“¬ —ߧ¡·≈–°“√æ—≤π“¥â“π𑵑∫—≠≠—µ‘∑—Ë«‰ª ·≈–°“√ª√—∫‡ª≈’ˬπ¥â“π ‘Ëß·«¥≈âÕ¡ ICF ‰¥â√—∫

°“√¬Õ¡√—∫«à“‡ªìπÀπ’Ëß„π°“√®—¥®”·π°∑“ß —ߧ¡¢ÕßÕߧ尓√ Àª√–™“™“µ‘·≈–‰¥â√—∫°“√Õâ“ßÕ‘ß

6

ICF ∫∑π”

·≈–√«¡Õ¬Ÿà„π°Ø‡°≥±å¡“µ√∞“π¢Õß°“√„Àâ‚Õ°“ ∑’ˇ∑à“‡∑’¬¡°—π ·°àºŸâæ‘°“√⁷

¥—ßπ—Èπ ICF ®÷߇ªìπ

‡§√◊ËÕß¡◊Õ∑’ˇÀ¡“– ¡  ”À√—∫°“√ªØ‘∫—µ‘µ“¡À≈—° ‘∑∏‘¡πÿ…¬™π “°≈·≈–„π°“√√à“ß°ÆÀ¡“¬¢Õß ª√–‡∑»

ª√–‚¬™πå¢Õß ICF  “¡“√∂𔉪„™âß“π‰¥â„πÀ≈“¬Ê ¥â“π µ—«Õ¬à“߇™àπ ¥â“π°“√ª√–°—π —ߧ¡,

°“√ª√–‡¡‘πº≈¥â“π°“√∫√‘À“√®—¥°“√°“√¥Ÿ·≈ ÿ¢¿“æ °“√ ”√«®¥â“πª√–™“°√∑—Èß„π√–¥—∫∑âÕß∂‘Ëπ,

√–¥—∫™“µ‘·≈–√–¥—∫π“π“™“µ‘´÷Ëß ICF ¬—ß„Àâ°√Õ∫§«“¡§‘¥ ”À√—∫¢âÕ¡Ÿ≈¢à“« “√∑’Ëπ”¡“„™â„π°“√

¥Ÿ·≈ ÿ¢¿“æ à«π∫ÿ§§≈, °“√ªÑÕß°—π, °“√ à߇ √‘¡ ÿ¢¿“æ °“√ à߇ √‘¡°“√¡’ à«π√à«¡ ‚¥¬°“√¢®—¥

À√◊Õ≈¥°“√°’¥°—π∑“ß —ߧ¡·≈– à߇ √‘¡°“√ π—∫ πÿπ∑“ß —ߧ¡ πÕ°®“°π’È ¬—߇ªìπª√–‚¬™πå„π°“√

»÷°…“√–∫∫°“√„Àâ°“√¥Ÿ·≈ ÿ¢¿“æ„π‡™‘ß¢Õß°“√ª√–‡¡‘πº≈ ·≈–°“√«“ßπ‚¬∫“¬

7°Ø‡°≥±å¡“µ√∞“π¢Õß°“√„Àâ‚Õ°“ ∑’ˇ∑à“‡∑’¬¡°—π·°àºŸâæ‘°“√ ‰¥â√—∫°“√‡ÀÁπ™Õ∫„π ¡—™™“„À≠àÕߧ尓√ Àª√–™“™“µ‘  ¡—¬ª√–™ÿ¡∑’Ë 48

‡¡◊ËÕ 20 ∏—𫓧¡ §.». 1993 (¡µ‘ 48/96) 𑫬Õ√å°, NY, United Nations Department  ”À√—∫ “√– π‡∑» “∏“√≥–, 1994

6

3. Properties of ICF

A classification should be clear about what it classifies: its universe, its scope, its units of classification, its organization, and how these elements are structured in terms of their relation to each other. The following sections explain these basic properties of ICF.

3.1 Universe of ICF

ICF encompasses all aspects of human health and some health-relevant components of well-being and describes them in terms of health domains and health-related domains. ⁸ The classification remains in the broad context of health and does not cover circumstances that are not health-related, such as those brought about by socioeconomic factors. For example, because of their race, gender, religion or other socioeconomic characteristics people may be restricted in their execution of a task in their current environment, but these are not health- related restrictions of participation as classified in ICF.

There is a widely held misunderstanding that ICF is only about people with disabilities; in fact, it is about all people. The health and health-related states associated with all health conditions can be described using ICF. In other words, ICF has universal application.⁹

3.2 Scope of ICF

ICF provides a description of situations with regard to human functioning and its restrictions and serves as a framework to organize this information. It structures the information in a meaningful, interrelated and easily accessible way.

ICF organizes information in two parts. Part 1 deals with Functioning and Disability, while Part 2 covers Contextual Factors. Each part has two components:

1. Components of Functioning and Disability

TheBody component comprises two classifications, one for functions of body systems, and one for body structures. The chapters in both classifications are organized according to the body systems.

8 Examples of health domains include seeing, hearing, walking, learning and remembering, while examples of health-related domains include transportation, education and social interactions.

9 Bickenbach JE, Chatterji S, Badley EM, Üstün TB. Models of disablement, universalism and the ICIDH,Social Science and Medicine, 1999, 48:1173-1187.

7

3. §ÿ≥ ¡∫—µ‘¢Õß ICF

°“√®”·π°ª√–‡¿∑®–µâÕß¡’§«“¡™—¥‡®π„π ‘Ëß∑’Ë®”·π° ‰¥â·°à ¢Õ∫¢à“¬ß“π∑—ÈßÀ¡¥, ¢Õ∫‡¢µ°“√

®—¥®”·π°, Àπ૬∑’Ë„™â„π°“√®”·π°, °“√®—¥√–‡∫’¬∫ ·≈–Õߧåª√–°Õ∫‡À≈à“π’È ¡’°“√‡°’ˬ«¢âÕß

°—πÕ¬à“߉√  à«πµàÕ‰ªπ’È®–Õ∏‘∫“¬∂÷ߧÿ≥ ¡∫—µ‘æ◊Èπ∞“π¢Õß ICF

3.1 ¢Õ∫¢à“¬ß“π∑—ÈßÀ¡¥¢Õß ICF

ICF §√Õ∫§≈ÿ¡∑ÿ°¥â“π¢Õß ÿ¢¿“æ¡πÿ…¬å·≈– à«πª√–°Õ∫∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ¢Õߧ«“¡‡ªìπÕ¬Ÿà

∑’Ë¥’∫“ßÕ¬à“ß ·≈–Õ∏‘∫“¬∂÷ß ‘Ë߇À≈à“π—Èπ„π à«π¢ÕߢÕ∫‡¢µ ÿ¢¿“æ ·≈–¢Õ∫‡¢µ à«π∑’ˇ°’ˬ«¢âÕß

°—∫ ÿ¢¿“æ⁸ °“√®—¥®”·π°ª√–‡¿∑§√Õ∫§≈ÿ¡„π¥â“π ÿ¢¿“æ·µà‰¡à§√Õ∫§≈ÿ¡ ¿“«–·«¥≈âÕ¡∑’ˉ¡à

‡°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ‡™àπ ªí®®—¬¥â“π‡»√…∞°‘® —ߧ¡ µ—«Õ¬à“߇™àπ ∫ÿ§§≈Õ“®®–∂Ÿ°®”°—¥‰¡à„Àâ

∑”ß“π∫“ßÕ¬à“ß„π ‘Ëß·«¥≈âÕ¡ªí®®ÿ∫—π∑’ËÕ“»—¬Õ¬Ÿà‡π◊ËÕß¡“®“°‡™◊ÈÕ™“µ‘, ‡æ», »“ π“ À√◊Õ≈—°…≥–

∑“߇»√…∞°‘® —ߧ¡π—ÈπÊ ·µà ‘Ëßµà“ßÊ ‡À≈à“π’È ‡ªìπ¢âÕ®”°—¥¢Õß°“√¡’ à«π√à«¡∑’ˉ¡à‡°’ˬ«¢âÕß°—∫

 ÿ¢¿“æ∑’ˉ¥â®”·π°‰«â„π ICF

¡’°“√‡¢â“„®º‘¥Õ¬à“ß·æ√àÀ≈“¬«à“ ICF ‡°’ˬ«¢âÕ߇©æ“–°—∫§πæ‘°“√ : „𧫓¡‡ªìπ®√‘ß·≈â« ICF

‡°’ˬ«¢âÕß°—∫§π∑ÿ°§π  ∂“π– ÿ¢¿“æ ·≈– ∂“π–∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ¡’§«“¡‡°’ˬ«‚¬ß°—∫¿“«–

 ÿ¢¿“æ∑—ÈßÀ¡¥ ´÷Ëß “¡“√∂Õ∏‘∫“¬‰¥â‚¥¬„™â ICF : Õ’°π—¬Àπ÷Ëß ICF  “¡“√∂„™â‰¥â°—∫∑ÿ° ‘Ëß⁹

3.2 ¢Õ∫‡¢µ¢Õß ICF

ICF °”À𥧔Õ∏‘∫“¬¢Õß ∂“π°“√≥å∑’ˇ°’ˬ«¢âÕß°—∫°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬¡πÿ…¬å ·≈–¢âÕ®”°—¥

„™â‡ªìπµ—«°”Àπ¥°√Õ∫„π°“√®—¥√–‡∫’¬∫¢âÕ¡Ÿ≈¢à“« “√ ∑”„Àâ¢âÕ¡Ÿ≈¢à“« “√‡À≈à“π’ȉ¥â∂Ÿ°®—¥‰«â„π

≈—°…≥–∑’Ë¡’§«“¡À¡“¬, ¡’§«“¡‡°’ˬ«¢âÕß´÷Ëß°—π·≈–°—π ·≈–ßà“¬µàÕ°“√§âπÀ“

ICF ®—¥√–∫∫¢ÕߢâÕ¡Ÿ≈¢à“« “√‰«â‡ªìπ Õß à«π  à«π∑’Ë 1 ‡°’ˬ«¢âÕß°—∫‡√◊ËÕß°“√∑”Àπâ“∑’Ë¢Õß

√à“ß°“¬·≈–§«“¡æ‘°“√ „π¢≥–∑’Ë à«π∑’Ë 2 ®–§√Õ∫§≈ÿ¡ªí®®—¬·«¥≈âÕ¡ ´÷Ëß„π·µà≈– à«π®–·∫àß  à«πª√–°Õ∫ÕÕ° Õß à«π ¥—ßπ’È

1.  à«πª√–°Õ∫¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬·≈–§«“¡æ‘°“√

 à«πª√–°Õ∫¢Õß √à“ß°“¬ ª√–°Õ∫¥â«¬°“√®”·π°ª√–‡¿∑ Õß à«π  à«π∑’ËÀπ÷Ëß §◊Õ√–∫∫°“√

∑”ß“π¢Õß√à“ß°“¬ ·≈–Õ’° à«πÀπ÷Ëß §◊Õ‚§√ß √â“ߢÕß√à“ß°“¬ ∫∑µà“ßÊ „π°“√®”·π°¢Õß∑—Èß Õß

‰¥â®—¥µ“¡√–∫∫¢Õß√à“ß°“¬

7

8

µ—«Õ¬à“ߢÕߢÕ∫‡¢µ ÿ¢¿“æª√–°Õ∫¥â«¬°“√¡Õ߇ÀÁπ, °“√‰¥â¬‘π, °“√‡¥‘π, °“√‡√’¬π√Ÿâ ·≈–°“√®¥®” „π¢≥–∑’˵—«Õ¬à“ߢÕß

¢Õ∫‡¢µ∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ À¡“¬√«¡∂÷ß °“√¢π àß, °“√»÷°…“ ·≈–°“√ªØ‘ —¡æ—π∏å„π —ߧ¡

9 Bickenback JE, Chatterji s, Badley EM, Üstün TB. ·∫∫Õ¬à“ߢÕß¿“«–∑ÿææ≈¿“æ  “°≈π‘¬¡·≈– ICIDH,  —ߧ¡»“ µ√å·≈–°“√

ᾷŒ, 1999, 48:1173-1187

ICF ∫∑π”

TheActivities and Participation component covers the complete range of domains denoting aspects of functioning from both an individual and a societal perspective.

2. Components of Contextual Factors

A list of Environmental Factors is the first component of Contextual Factors.

Environmental factors have an impact on all components of functioning and disability and are organized in sequence from the individual’s most immediate environment to the general environment.

Personal Factors is also a component of Contextual Factors but they are not classified in ICF because of the large social and cultural variance associated with them.

The components of Functioning and Disability in Part 1 of ICF can be expressed in two ways. On the one hand, they can be used to indicate problems (e.g.

impairment, activity limitation or participation restriction summarized under the umbrella term disability); on the other hand they can indicate nonproblematic (i.e. neutral) aspects of health and health-related states summarized under the umbrella term functioning).

These components of functioning and disability are interpreted by means of four separate but related constructs. These constructs are operationalized by using qualifiers. Body functions and structures can be interpreted by means of changes in physiological systems or in anatomical structures. For the Activities and Participation component, two constructs are available: capacity andperformance (see section 4.2).

A person's functioning and disability is conceived as a dynamic interaction¹⁰ between health conditions (diseases, disorders, injuries, traumas, etc.) and contextual factors. As indicate above, Contextual Factors include both personal and environmental factors. ICF includes a comprehensive list of environmental factors as an essential component of the classification. Environmental factors interact with all the components of functioning and disability. The basic construct of the Environmental Factors component is the facilitating or hindering impact of features of the physical, social and attitudinal world.

3.3 Unit of classification

ICF classifies health and health-related states. The unit of classification is, therefore,categories within health and health-related domains. It is important to note, therefore, that in ICF persons are not the units of classification; that is, ICF does not classify people, but describes the situation of each person within an array of health or health-related domains. Moreover, the description is always made within the context of environmental and personal factors.

10 This interaction can be viewed as a process or a result depending on the user.

8

ICF ∫∑π”

 à«πª√–°Õ∫¢Õß °‘®°√√¡·≈–°“√¡’ à«π√à«¡ §√Õ∫§≈ÿ¡¢Õ∫‡¢µ∑—ÈßÀ¡¥∑’ˇ°’ˬ«¢âÕß°—∫°“√

∑”Àπâ“∑’Ë„π¡ÿ¡¡ÕߢÕßªí®‡®°∫ÿ§§≈·≈–¡ÿ¡¡Õß∑“ß —ߧ¡

2.  à«πª√–°Õ∫¢Õßªí®®—¬·«¥≈âÕ¡

 à«πª√–°Õ∫Õ¬à“ß·√°¢Õßªí®®—¬·«¥≈âÕ¡ §◊Õªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡ ´÷Ëßªí®®—¬ ‘Ëß·«¥≈âÕ¡π’È

®–¡’º≈°√–∑∫µàÕ à«πª√–°Õ∫¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬·≈–§«“¡æ‘°“√ ‚¥¬∂Ÿ°®—¥≈”¥—∫®“° ‘Ëß

·«¥≈âÕ¡∑’Ë„°≈âµ—«∑’Ë ÿ¥¢Õßªí®‡®°∫ÿ§§≈‰ª®π∂÷ß ‘Ëß·«¥≈âÕ¡∑—Ë«Ê ‰ª

ªí®®—¬ à«π∫ÿ§§≈ ‡ªìπ à«πª√–°Õ∫Àπ÷ËߢÕßªí®®—¬·«¥≈âÕ¡ ·µà‰¡à‰¥â®—¥Õ¬Ÿà„π ICF ‡π◊ËÕß®“°

§«“¡·µ°µà“ß∑“ß —ߧ¡·≈–«—≤π∏√√¡ ¡’§«“¡‡°’ˬ«¢âÕß°—∫ªí®®—¬π’È

 à«πª√–°Õ∫¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–§«“¡æ‘°“√„π à«π∑’Ë 1 ¢Õß ICF  “¡“√∂· ¥ß‰¥â  Õß∑“ß „π∑“ß∑’ËÀπ÷Ëß “¡“√∂π”¡“„™â‡æ◊ËÕ°“√∫àß∫Õ°∂÷ߪí≠À“ (‡™àπ ¿“«–∫°æ√àÕß, °“√®”°—¥„π

°“√∑”°‘®°√√¡À√◊Õ°“√¡’ à«π√à«¡ ´÷Ëß √ÿªÕ¬Ÿà¿“¬„µâ§«“¡§√Õ∫§≈ÿ¡¢Õß §«“¡æ‘°“√) „πÕ’°∑“ß Àπ÷Ë߬—ß “¡“√∂∫àß∫Õ°∂÷ß à«π¢Õß ¿“π– ÿ¢¿“æ À√◊Õ ∂“π–∑’ˇ°’ˬ«¢âÕß∑“ߥâ“π ÿ¢¿“æ∑’ˉ¡à‡ªìπ ªí≠À“ (µ—«Õ¬à“߇™à𠇪ìπ°≈“ß) ´÷Ë߉¥â √ÿª‰«â¿“¬„µâ§«“¡§√Õ∫§≈ÿ¡¢Õß °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬

 à«πª√–°Õ∫¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–§«“¡æ‘°“√ Õ∏‘∫“¬‚¥¬°“√„™â 4  à«π∑’Ë·¬°°—π ·µà

‡°’ˬ«¢âÕß°—∫ à«πª√–°Õ∫¬àÕ¬‚¥¬ à«πª√–°Õ∫¬àÕ¬‡À≈à“π’È¡’µ—«∫àߧÿ≥≈—°…≥–, ‡ªìπµ—««—¥°“√

∑”ß“π¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ߢÕß√à“ß°“¬ “¡“√∂Õ∏‘∫“¬‰¥â ‚¥¬°“√„™â§«“¡‡ª≈’ˬπ·ª≈ß∑“ß

¥â“π√–∫∫ √’√–«‘∑¬“ ·≈–‚§√ß √â“ߥâ“𰓬«‘¿“§  ”À√—∫ à«πª√–°Õ∫¢Õß °‘®°√√¡ ·≈–°“√¡’

 à«π√à«¡ ª√–°Õ∫¥â«¬ 2  à«πª√–°Õ∫¬àÕ¬ §◊Õ §«“¡ “¡“√∂ ·≈– ¡√√∂¿“æ (¥ŸµÕπ∑’Ë 4.2)

°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬·≈–§«“¡æ‘°“√¢Õß∫ÿ§§≈®–¥Ÿ‰¥â®“°ªØ‘ —¡æ—π∏å√à«¡¹⁰ √–À«à“ߪí≠À“

 ÿ¢¿“æ (‚√§, §«“¡º‘¥ª°µ‘, °“√∫“¥‡®Á∫, ¡’∫“¥·º≈ œ≈œ) ·≈–ªí®®—¬·«¥≈âÕ¡µ“¡∑’ˉ¥â°≈à“«‰«â

¢â“ßµâπ ªí®®—¬∑—ÈßÀ¡¥ ®–√«¡∂÷ßªí®®—¬ à«π∫ÿ§§≈·≈–ªí®®—¬ ‘Ëß·«¥≈âÕ¡ ICF ®–ª√–°Õ∫¥â«¬

√“¬°“√∑’Ë ”§—≠Õ¬à“ߧ√∫∂â«π¢Õßªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡ ´÷Ëß∂◊Õ«à“‡ªìπ à«πª√–°Õ∫∑’Ë®”‡ªìπ¢Õß°“√

®”·π°Õߧåª√–°Õ∫¥â“πªí®®—¬ ‘Ëß·«¥≈âÕ¡ ®–¡’ªØ‘ —¡æ—π∏å°—∫ à«πª√–°Õ∫ ¥â“π°“√∑”ß“π¢Õß

√à“ß°“¬ ·≈–§«“¡æ‘°“√∑—ÈßÀ¡¥ æ◊Èπ∞“π¢Õß à«πª√–°Õ∫¬àÕ¬  à«πª√–°Õ∫ªí®®—¬ ‘Ëß·«¥≈âÕ¡

‡ªìπº≈°√–∑∫∑’ˇ°◊ÈÕÀπÿπ À√◊Õ‡ªìπÕÿª √√§¢Õß≈—°…≥–¥â“𰓬¿“æ,  —ߧ¡À√◊Õ∑—»π§µ‘

3.3 Àπ૬∑’Ë„™â„π°“√®”·π°

ICF ‡ªìπ°“√®”·π° ∂“π– ÿ¢¿“æ ·≈– ∂“π–∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æÀπ૬∑’Ë„™â„π°“√®”·π°§◊Õ ª√–‡¿∑„π¢Õ∫‡¢µ ÿ¢¿“æ·≈– à«π∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ  ‘Ëß ”§—≠∑’˧«√®–∑√“∫°Á§◊Õ ICF ¡‘‰¥â

„™âµ—«∫ÿ§§≈‡ªìπÀπ૬„π°“√®”·π° π—Ëπ§◊Õ ICF ‰¡à‰¥â®”·π°ª√–‡¿∑¢Õß∫ÿ§§≈ ·µà„™â„π°“√

Õ∏‘∫“¬∂÷ß ∂“π°“√≥å¢Õß·µà≈–∫ÿ§§≈„π‡¢µ¢Õß ÿ¢¿“æ À√◊Õ à«π∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ πÕ°®“°

π’È °“√Õ∏‘∫“¬¥—ß°≈à“«¬—ߧ”π÷ß∂÷ßªí®®—¬ ‘Ëß·«¥≈âÕ¡·≈–ªí®®—¬ à«π∫ÿ§§≈

8

10

ªØ‘ —¡æ—π∏åπ’È “¡“√∂‡ªìπ°√–∫«π°“√À√◊Õº≈≈—æ∏å·≈â«·µàºŸâ„™â

3.4 Presentation of ICF

ICF is presented in two versions in order to meet the needs of different users for varying levels of detail.

Thefull version of ICF, as contained in this volume, provides classification at four levels of detail. These four levels can be aggregated into a higher-level

classification system that includes all the domains at the second level. The two- level system is also available as a short version of ICF.

9

ICF ∫∑π”

3.4 °“√𔇠πÕ¢Õß ICF

ICF ‰¥â𔇠πÕ‡ªìπ 2 ·∫∫©∫—∫ ‡æ◊ËÕ„Àâµ√ßµ“¡§«“¡µâÕß°“√¢ÕߺŸâ„™â∑’Ë·µ°µà“ß°—π ‚¥¬¡’§«“¡

·µ°µà“ß°—π„π√–¥—∫¢Õß√“¬≈–‡Õ’¬¥

ICF ©∫—∫ ¡∫Ÿ√≥套ß∑’Ë∫√√®ÿÕ¬Ÿà„π‡≈à¡π’È ‰¥â®—¥°“√®”·π°√“¬≈–‡Õ’¬¥‡ªìπ 4 √–¥—∫ ´÷Ëß∑—Èß 4

√–¥—∫π’È  “¡“√∂∑’Ë®–‰ª Ÿà√–∫∫°“√®”·π°„π√–¥—∫∑’Ë Ÿß¢÷Èπ∑’˧√Õ∫§≈ÿ¡¢Õ∫‡¢µ∑—ÈßÀ¡¥¢Õß√–¥—∫∑’Ë  Õß´÷Ëß√–∫∫°“√®—¥·∫∫ Õß√–¥—∫¡’Õ¬Ÿà„π ICF ©∫—∫ —Èπ

9

4. Overview of ICF components

DEFINITIONS¹¹ In the context of health:

Body functions are the physiological functions of body systems (including psychological functions).

Body structuresare anatomical parts of the body such as organs, limbs and their components.

Impairments are problems in body function or structure such as a significant deviation or loss.

Activity is the execution of a task or action by an individual.

Participation is involvement in a life situation.

Activity limitations are difficulties an individual may have in executing activities.

Participation restrictions are problems an individual may experience in involvement in life situations.

Environmental factorsmake up the physical, social and attitudinal environment in which people live and conduct their lives.

An overview of these concepts is given in Table 1; they are explained further in operational terms in section 5.1. As the table indicates:

• ICF has two parts, each with two components:

Part 1. Functioning and Disability (a) Body Functions and Structures (b) Activities and Participation Part 2. Contextual Factors

(c) Environmental Factors (d) Personal Factors

• Each component can be expressed in both positive and negative terms.

• Each component consists of various domains and, within each domain, categories, which are the units of classification. Health and health-related states of an individual may be recorded by selecting the appropriate category

11 See also Annex 1, Taxonomic and Terminological Issues.

10

ICF ∫∑π”

10

11

¥Ÿ¿“§ºπ«° 1 À≈—°°“√·∫àß·¬°ª√–‡¿∑·≈–§”®”°—¥§«“¡

4. Õߧåª√–°Õ∫¢Õß ICF ‚¥¬ —߇¢ª

§”®”°—¥§«“¡¹¹

„π à«π∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ

°“√∑”ß“π¢Õß√à“ß°“¬ (Body Functions) À¡“¬∂÷ß °“√∑”ß“π¥â“π √’√«‘∑¬“¢Õß√–∫∫

√à“ß°“¬ (√«¡∂÷ß°“√∑”ß“π¥â“𮑵„®)

‚§√ß √â“ߢÕß√à“ß°“¬ (Body Structure) À¡“¬∂÷ß  à«π¢Õß√à“ß°“¬∑“ß°“¬«‘¿“§

µ—«Õ¬à“߇™àπ  à«π¢ÕßÕ«—¬«–µà“ßÊ ·¢π ¢“ ·≈– à«πª√–°Õ∫¢Õß·µà≈–Õ«—¬«–π—ÈπÊ

§«“¡∫°æ√àÕß (Impairment) À¡“¬∂÷ß Àπâ“∑’Ë¢Õß°“√∑”ß“π‰¡àª°µ‘ À√◊Õ°“√ Ÿ≠‡ ’¬¢Õß°“√

∑”ß“π¢Õß√à“ß°“¬À√◊Õ‚§√ß √â“ߢÕß√à“ß°“¬

°‘®°√√¡ (Activity) À¡“¬∂÷ß °“√ªØ‘∫—µ‘ß“π À√◊Õ°“√°√–∑”¢Õß·µà≈–∫ÿ§§≈

°“√¡’ à«π√à«¡ (Participation) À¡“¬∂÷ß §«“¡ “¡“√∂„π°“√‡¢â“√à«¡°‘®°√√¡∑“ß —ߧ¡

¢âÕ®”°—¥„π°“√∑”°‘®°√√¡ (Activity limitations) À¡“¬∂÷ß §«“¡¬“°≈”∫“°„π°“√∑”

°‘®°√√¡¢Õß·µà≈–∫ÿ§§≈

Õÿª √√§„π°“√¡’ à«π√à«¡ (Participation restrictions) À¡“¬∂÷ß ªí≠À“∑’Ë∫ÿ§§≈ª√– ∫

„π°“√‡¢â“√à«¡°‘®°√√¡∑“ß —ߧ¡

ªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡ (Environmental factors) À¡“¬∂÷ß  ¿“«–·«¥≈âÕ¡∑“ß°“¬¿“æ  —ߧ¡ ·≈–∑—»π§µ‘ ´÷Ëß∫ÿ§§≈¥”√ß™’«‘µ ·≈–¥”‡π‘π™’«‘µÕ¬Ÿà

¿“æ√«¡¢Õß·π«§‘¥π’È · ¥ß„Àâ‡ÀÁπÕ¬Ÿà„πµ“√“ß∑’Ë 1 : ·≈–∫√√¬“¬‡æ‘Ë¡‡µ‘¡Õ’°„π‡™‘ßªØ‘∫—µ‘ß“π„π  à«π∑’Ë 5.1 µ“¡∑’Ë√–∫ÿ‰«â„πµ“√“ß:

ë

ICF ·∫àßÕÕ°‡ªìπ Õß à«π „π·µà≈– à«π®–¡’ à«πª√–°Õ∫ 2  à«π  à«π∑’Ë 1 °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–§«“¡æ‘°“√

(a) °“√∑”ß“π¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ߢÕß√à“ß°“¬

(b) °‘®°√√¡ ·≈–°“√¡’ à«π√à«¡

 à«π∑’Ë 2 ªí®®—¬·«¥≈âÕ¡

(c) ªí®®—¬¥â“π ‘Ëß·«¥≈âÕ¡

(d) ªí®®—¬ à«π∫ÿ§§≈

ë

 à«πª√–°Õ∫·µà≈– à«π  “¡“√∂Õ∏‘∫“¬‰¥â∑—È߇™‘ß∫«°·≈–‡™‘ß≈∫

ë

 à«πª√–°Õ∫·µà≈– à«π ª√–°Õ∫¥â«¬¢Õ∫‡¢µµà“ßÊ ´÷Ëß„π·µà≈–¢Õ∫‡¢µÀ√◊Õ·µà≈–

ª√–‡¿∑®–ª√–°Õ∫¥â«¬Àπ૬∑’Ë„™â„π°“√®”·π°  ∂“π– ÿ¢¿“æ ·≈– ∂“π–∑’ˇ°’ˬ«¢âÕß ∑“ß  ÿ¢¿“æ¢Õßªí®‡®°∫ÿ§§≈®–∂Ÿ°∫—π∑÷°≈”¥—∫™—Èπ‚¥¬°“√‡≈◊Õ°√À— ª√–‡¿∑À√◊Õ√À— ∑’Ë

code or codes and then adding qualifiers, which are numeric codes that specify the extent or the magnitude of the functioning or disability in that category, or the extent to which an environmental factor is a facilitator or barrier.

Table 1. An overview of ICF

Part 1: Functioning and Disability Part 2: Contextual Factors

Components Body Functions and Structures

Activities and Participation

Environmental

Factors Personal Factors

Domains

Body functions

Body structures Life areas (tasks, actions)

External influences on functioning and

disability

Internal influences on functioning and

disability

Constructs

Change in body functions (physiological) Change in body structures (anatomical)

Capacity Executing tasks in a standard environment

Performance Executing tasks in the

current environment

Facilitating or hindering impact of

features of the physical, social, and

attitudinal world

Impact of attributes of the person

Functional and structural integrity

Activities Participation Positive aspect

Functioning

Facilitators not applicable

Impairment Activity limitation Participation

restriction Negative aspect

Disability

Barriers / hindrances not applicable

11

ICF ∫∑π”

11

 à«π∑’Ë 1 °“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬ ·≈–§«“¡æ‘°“√  à«π∑’Ë 2 ªí®®—¬·«¥≈âÕ¡

 à«πª√–°Õ∫ °“√∑”ß“π¢Õß√à“ß°“¬

·≈–‚§√ß √â“ߢÕß√à“ß°“¬

°‘®°√√¡

·≈–°“√¡’ à«π√à«¡ ªí®®—¬ ‘Ëß·«¥≈âÕ¡ ªí®®—¬ à«π∫ÿ§§≈

¢Õ∫‡¢µ °“√∑”ß“π¢Õß√à“ß°“¬

‚§√ß √â“ߢÕß√à“ß°“¬

ª√–‡¥Áπ¢Õß™’«‘µ (ß“π, °“√°√–∑”)

Õ‘∑∏‘æ≈¿“¬πÕ°∑’Ë¡’º≈

µàÕ°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬

·≈–§«“¡æ‘°“√

Õ‘∑∏‘æ≈¿“¬„π∑’Ë¡’º≈

µàÕ°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬

·≈–§«“¡æ‘°“√

 à«πª√–°Õ∫¬àÕ¬

°“√‡ª≈’ˬπ·ª≈ß°“√

∑”ß“π¢Õß√à“ß°“¬

(¥â“π √’√«‘∑¬“)

°“√‡ª≈’ˬπ·ª≈ß‚§√ß  √â“ߢÕß√à“ß°“¬

(¥â“𰓬«‘¿“§)

§«“¡ “¡“√∂°“√∑”ß“π

„π ‘Ëß·«¥≈âÕ¡¡“µ√∞“π  ¡√√∂¿“æ„π°“√∑”ß“π

„π ‘Ëß·«¥≈âÕ¡ ªí®®ÿ∫—π

º≈°√–∑∫∑’ˇªìπ°“√

‡°◊ÈÕÀπÿπÀ√◊Õ‡ªìπ Õÿª √√§¢Õß≈—°…≥–

¥â“𰓬«‘¿“§  —ߧ¡

·≈–∑—»π§µ‘

º≈°√–∑∫®“°≈—°…≥–

¢Õßµ—«∫ÿ§§≈

≈—°…≥–‡™‘ß∫«°

§«“¡ ¡∫Ÿ√≥å¢Õß°“√∑”ß“π

¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ß

¢Õß√à“ß°“¬

°‘®°√√¡

°“√¡’ à«π√à«¡

 ‘Ë߇°◊ÈÕÀπÿπ ‰¡à‡°’ˬ«¢âÕß

°“√∑”ß“π¢Õß√à“ß°“¬

≈—°…≥–‡™‘ß≈∫

§«“¡∫°æ√àÕß °“√®”°—¥„π°“√∑”°‘®°√√¡

·≈–¢âÕ®”°—¥„π°“√¡’ à«π√à«¡ Õÿª √√§/ ‘Ëß°’¥¢«“ß ‰¡à‡°’ˬ«¢âÕß

§«“¡æ‘°“√

‡À¡“– ¡·≈â«®÷߇æ‘Ë¡µ—«∫àߧÿ≥≈—°…≥– ´÷Ë߇ªìπ√À— µ—«‡≈¢∑’Ë√–∫ÿ∂÷ߢÕ∫‡¢µÀ√◊Õ§«“¡

 ”§—≠¢Õß°“√∑”Àπâ“∑’Ë¢Õß√à“ß°“¬À√◊Õ§«“¡æ‘°“√„πª√–‡¿∑π—ÈπÀ√◊Õ¢Õ∫‡¢µªí®®—¬

 ‘Ëß·«¥≈âÕ¡∑’ˇªìπ ‘Ë߇°◊ÈÕÀπÿπÀ√◊ÕÕÿª √√§

µ“√“ß∑’Ë 1 ¿“æ√«¡¢Õß ICF

4.1 Body Functions and Structures and impairments

Definitions: Body functionsare the physiological functions of body systems (including psychological functions).

Body structures are anatomical parts of the body such as organs, limbs and their components.

Impairments are problems in body function or structure as a significant deviation or loss.

(1) Body functions and body structures are classified in two different sections.

These two classifications are designed for use in parallel. For example, body functions include basic human senses such as “seeing functions” and their structural correlates exist in the form of “eye and related structures”.

(2) “Body” refers to the human organism as a whole; hence it includes the brain and its functions, i.e. the mind. Mental (or psychological) functions are therefore subsumed under body functions.

(3) Body functions and structures are classified according to body systems;

consequently, body structures are not considered as organs.¹²

(4) Impairments of structure can involve an anomaly, defect, loss or other significant deviation in body structures. Impairments have been conceptualized in congruence with biological knowledge at the level of tissues or cells and at the subcellular or molecular level. For practical reasons, however, these levels are not listed.¹³ The biological foundations of

impairments have guided the classification and there may be room for expanding the classification at the cellular or molecular levels. For medical users, it should be noted that impairments are not the same as the underlying pathology, but are the manifestations of that pathology.

(5) Impairments represent a deviation from certain generally accepted

population standards in the biomedical status of the body and its functions, and definition of their constituents is undertaken primarily by those qualified to judge physical and mental functioning according to these standards.

(6) Impairments can be temporary or permanent; progressive, regressive or static; intermittent or continuous. The deviation from the population norm may be slight or severe and may fluctuate over time. These characteristics are captured in further descriptions, mainly in the codes, by means of qualifiers after the point.

12 Although organ level was mentioned in the 1980 version of ICIDH, the definition of an “organ” is not clear. The eye and ear are traditionally considered as organs; however, it is difficult to identify and define their boundaries, and the same is true of extremities and internal organs. Instead of an approach by “organ”, which implies the existence of an entity or unit within the body, ICF replaces this term with “body structure”.

13 Thus impairments coded using the full version of ICF should be detectable or noticeable by others or the person concerned by direct observation or by inference from observation.

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4.1 °“√∑”ß“π ‚§√ß √â“ß ·≈–§«“¡∫°æ√àÕߢÕß√à“ß°“¬

§”®”°—¥§«“¡ °“√∑”ß“π¢Õß√à“ß°“¬ À¡“¬∂÷ß °“√∑”ß“π¥â“π √’√«‘∑¬“¢Õß√–∫∫¢Õß

√à“ß°“¬ (√«¡∂÷ß°“√∑”ß“π∑“ߥâ“𮑵„®¥â«¬)

‚§√ß √â“ߢÕß√à“ß°“¬ À¡“¬∂÷ß  à«π¢Õß√à“ß°“¬∑“ß°“¬«‘¿“§µ—«Õ¬à“߇™àπ Õ«—¬«–µà“ßÊ, ·¢π¢“ ·≈– à«πª√–°Õ∫¢Õß·µà≈–Õ«—¬«–π—ÈπÊ

¿“«–∫°æ√àÕß ‡ªìπªí≠À“¢Õß°“√∑”ß“π¢Õß√à“ß°“¬ À√◊Õ‚§√ß √â“ߢÕß

√à“ß°“¬ ‡™àπ °“√∑”ß“π∑’ˉ¡àª°µ‘ À√◊Õ Ÿ≠‡ ’¬°“√∑”ß“π

(1) °“√∑”ß“π¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ߢÕß√à“ß°“¬®”·π°ÕÕ°‡ªìπ Õß à«π∑’Ë·µ°µà“ß°—π ´÷Ëß

‰¥âÕÕ°·∫∫„Àâ„™â∑—Èß Õß à«π§«∫§Ÿà°—π‰ª µ—«Õ¬à“߇™àπ °“√∑”ß“π¢Õß√à“ß°“¬√«¡∂÷ߪ√– “∑

 —¡º— æ◊Èπ∞“π¢Õß¡πÿ…¬å ‡™àπ ç°“√∑”ß“π¢Õß°“√¡Õ߇ÀÁπé ·≈–‚§√ß √â“ß∑’ˇ°’ˬ«¢âÕß°—π

§◊Õ çµ“ ·≈–‚§√ß √â“ß∑’ˇ°’ˬ«¢âÕßé

(2) ç√à“ß°“¬é À¡“¬∂÷ß Õ«—¬«–∑—ÈßÀ¡¥¢Õß¡πÿ…¬å √«¡∂÷ß ¡Õß ·≈–°“√∑”ß“π¢Õß ¡Õß ‡™àπ

§«“¡§‘¥ °“√∑”ß“π¢Õß®‘µ (À√◊Õ®‘µ«‘∑¬“) ®÷ß∂Ÿ°√«¡‰«â¿“¬„µâ°“√∑”ß“π¢Õß√à“ß°“¬

(3) °“√∑”ß“π¢Õß√à“ß°“¬ ·≈–‚§√ß √â“ߢÕß√à“ß°“¬‰¥â®”·π°µ“¡√–∫∫¢Õß√à“ß°“¬ ¥—ßπ—Èπ ®÷ß

‰¡à‰¥âæ‘®“√≥“‚§√ß √â“ߢÕß√à“ß°“¬„π≈—°…≥–∑’ˇªìπÕ«—¬«–¹²

(4) §«“¡∫°æ√àÕߢÕß‚§√ß √â“߇°’ˬ«¢âÕß°—∫§«“¡º‘¥ª°µ‘, §«“¡‰¡à ¡∫Ÿ√≥å, °“√ Ÿ≠‡ ’¬ À√◊Õ

°“√‡∫’ˬ߇∫πÕ¬à“ß™—¥‡®π¢Õß‚§√ß √â“ß√à“ß°“¬ §«“¡∫°æ√àÕß¡’·π«§‘¥ Õ¥§≈âÕß°—∫ §«“¡

√Ÿâ∑“ß™’««‘∑¬“„π√–¥—∫‡π◊ÈÕ‡¬◊ËÕÀ√◊Õ‡´≈≈å ·≈–√–¥—∫ à«π∑’ˇ≈Á°°«à“‡´≈≈å À√◊Õ‚¡‡≈°ÿ≈  ”À√—∫

‡Àµÿº≈„π∑“ߪؑ∫—µ‘√–¥—∫‡À≈à“π’ȉ¡à‰¥â¡’°“√·®°·®ß√“¬≈–‡Õ’¬¥¹³ §«“¡∫°æ√àÕß„πæ◊Èπ∞“π

∑“ß™’««‘∑¬“‡ªìπ·π«∑“ß°“√®”·π°ª√–‡¿∑ ·≈–¬—߇ªî¥‚Õ°“ „À⢬“¬°“√®”·π°ª√–‡¿∑

‰ª Ÿà√–¥—∫‡´≈≈å À√◊Õ‚¡‡≈°ÿ≈  ”À√—∫ºŸâ„™â∑“ß°“√·æ∑¬å§«√ —߇°µ«à“ §«“¡∫°æ√àÕß„π∑’Ëπ’È

·µ°µà“ß®“°§«“¡À¡“¬∑“ß欓∏‘«‘∑¬“ ·µà‡ªìπ°“√· ¥ßº≈¢Õß欓∏‘«‘∑¬“

(5) §«“¡∫°æ√àÕß· ¥ß∂÷ß°“√‡∫’ˬ߇∫π‰ª®“°∫ÿ§§≈∑—Ë«‰ªµ“¡¡“µ√∞“π∑“ß ∂“π–¿“æ¢Õß°“√

·æ∑¬å™’«¿“æ¢Õß√à“ß°“¬ ·≈–°“√∑”ß“π¢Õß√à“ß°“¬ ·≈–§”®”°—¥§«“¡¢Õß à«πª√–°Õ∫

‡À≈à“π—Èπ ®–∂Ÿ°æ‘®“√≥“®“°§ÿ≥ ¡∫—µ‘¡“µ√∞“π¢Õß°“√∑”ß“π¢Õß√à“ß°“¬·≈–®‘µ„®‡ªìπ

‡∫◊ÈÕßµâπ

(6) §«“¡∫°æ√àÕßÕ“®®–¡’ ¿“æ™—Ë«§√“«À√◊Õ∂“«√, ‡æ‘Ë¡¢÷Èπ ≈¥≈ßÀ√◊Õ§ß∑’Ë : ‡ªìπ√–¬–

À√◊ÕµàÕ‡π◊ËÕß °“√‡∫’ˬ߇∫π‰ª®“°ª√–™“°√ª°µ‘Õ“®®–‡≈Á°πâÕ¬ À√◊Õ√ÿπ·√ß ·≈–Õ“®®–

‡ª≈’ˬπ·ª≈߉ªµ“¡√–¬–‡«≈“ ≈—°…≥–‡À≈à“π’È®–π”¡“Õ∏‘∫“¬µàÕ‰ª  à«π„À≠à„π≈—°…≥–¢Õß

√À—  ‚¥¬„™âµ—«∫àߧÿ≥≈—°…≥–∑’Ë„ à‰«âÀ≈—ß®ÿ¥

12 ·¡â«à“®–‰¥â¡’°“√√–∫ÿ‡°’ˬ«°—∫Õ«—¬«–„π ICIDH ©∫—∫ªï∑’Ë 1980 §”®”°—¥§«“¡¢Õߧ”«à“ çÕ«—¬«–é π—Èπ°Á¬—߉¡à™—¥‡®π µ“ ·≈– ÀŸ ‚¥¬

®“√’µ∂◊Õ«à“‡ªìπÕ«—¬«– Õ¬à“߉√°Áµ“¡ ‡ªìπ°“√¬“°∑’Ë®–®”°—¥¢Õ∫‡¢µ¢ÕßÕ«—¬«–·µà≈– à«π ‡ªìπµâπ«à“ Õ«—¬«– à«πª≈“¬µà“ßÊ À√◊ÕÕ«—¬«–

¿“¬„π√à“ß°“¬ ·∑π∑’Ë®–„™â·π«§‘¥∑’Ë°”Àπ¥„Àâ çÕ«—¬«–é ‡ªìπ à«πÀπ÷ËßÀ√◊ÕÀπ૬Àπ÷Ëß„π√à“ß°“¬ ICF ®÷߉¥â‡ª≈’Ë¬π§”‡À≈à“π’È„À⇪ìπ 炧√ß √â“ߢÕß√à“ß°“¬é

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¥—ßπ—Èπ°“√‡ ◊ËÕ¡ ¿“æ∑’Ë„ à√À— ‰«â„π ICF ©∫—∫ ¡∫Ÿ√≥å  “¡“√∂∑’Ë®–‡ªìπ∑’Ë —߇°µ‰¥â®“°ºŸâ„™â∑’ˇ°’ˬ«¢âÕßÕ◊ËπÊ ‰¡à«à“®–‡°‘¥®“°°“√

 —߇°µ‚¥¬µ√ß À√◊Õ‡°‘¥®“°°“√ª√–¡“≥°“√®“°°“√ —߇°µ

ICF ∫∑π”

(7) Impairments are not contingent on etiology or how they are developed; for example, loss of vision or a limb may arise from a genetic abnormality or an injury. The presence of an impairment necessarily implies a cause; however, the cause may not be sufficient to explain the resulting impairment. Also, when there is an impairment, there is a dysfunction in body functions or structures, but this may be related to any of the various diseases, disorders or physiological states.

(8) Impairments may be part or an expression of a health condition, but do not necessarily indicate that a disease is present or that the individual should be regarded as sick.

(9) Impairments are broader and more inclusive in scope than disorders or diseases; for example, the loss of a leg is an impairment of body structure, but not a disorder or a disease.

(10) Impairments may result in other impairments; for example, a lack of muscle power may impair movement functions, heart functions may relate to deficit in respiratory functions, and impaired perception may relate to thought functions.

(11) Some categories of the Body Functions and Structures component and the ICD-10 categories seem to overlap, particularly with regard to symptoms and signs. However, the purposes of the two classifications are different.

ICD-10 classifies symptoms in special chapters to document morbidity or service utilization, whereas ICF shows them as part of the body functions, which may be used for prevention or identifying patients’ needs. Most importantly, in ICF the Body Functions and Structures classification is intended to be used along with the Activities and Participation categories.

(12) Impairments are classified in the appropriate categories using defined identification criteria (e.g. as present or absent according to a threshold level). These criteria are the same for body functions and structures. They are: (a) loss or lack; (b) reduction; (c) addition or excess; and (d) deviation.

Once an impairment is present, it may be scaled in terms of its severity using the generic qualifier in the ICF.

(13) Environmental factors interact with body functions, as in the interactions between air quality and breathing, light and seeing, sounds and hearing, distracting stimuli and attention, ground texture and balance, and ambient temperature and body temperature regulation.

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