基于ICF和康复胜任力架构建设物理治疗本科教育

doi:10.3969/j.issn.1006-9771.2022.03.005

Abstract

Abstract: Objective To develop programmes and curriculum of physical therapy competency for undergraduate education for the training of competent physical therapy.Methods Using World Health Organization Rehabilitation Competency Framework (RCF) and International Classification of Functioning, Disability and Health (ICF) as framework, a discipline of physical therapy, and programmes and curriculum for undergraduate education were developed.Results The basic concepts of rehabilitation and disability, laws, regulations and ethics and physical therapy of functioning and disability were explored within RCF. The contents, core values and beliefs of physical therapy competencies were developed using RCF. Results -oriented and backward strategy was used to develop programmes and curriculum of undergraduate education in physical therapy based on competency. Conclusion The theory of ICF and RCF is important for developing programmes and curriculum of physical therapy competency. Based on RCF, the physical therapy competency domain, principles, strategies and educational framework for undergraduate education in physical therapy are constructed, helping for developing competency-based undergraduate education standards for physical therapy and professional competency standards in China.

Key words: competency, physical therapy, programmes and curriculum, International Classification of Functioning, Disability and Health, rehabilitation competency framework

XIAO Xiaofei, QIU Zhuoying, SUN Hongwei, LI Anqiao. Development of programmes and curriculum of physical therapy at undergraduate level using ICF and rehabilitation competency framework[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 295-305.

Figures/Tables 6

领域	胜任力及行为	熟练程度：初级/准入	活动及任务	熟练程度：初级/准入
物理治疗实践	C1在物理治疗实践中以用户及其家庭为中心	C1.1支持用户及其家庭积极参与功能康复和决策 C1.2寻求支持以识别和解决个人及其家庭参与功能障碍、康复预期结果,满足不同情景下的需求和偏好	A1获得物理治疗知情同意	A1.1在常规物理治疗背景下,提供可能涉及患者功能康复最大化的基本说明,包括预后、禁忌证和危害
	C1在物理治疗实践中以用户及其家庭为中心			A1.2根据法律、政策确认同意,在不明确的情况下寻求支持
	C2与用户及其家庭建立合作关系	C2.1在法律、政策、道德、伦理许可范围内,认识并接受用户及其家庭的态度、信念和情感	A2记录信息	A2.1清晰、准确、标准化地记录、安全地存储物理治疗相关信息
		C2.2以自信、同理心和信任为特征,与用户及其家庭建立并保持积极的关系 C2.3认识并最大限度减少用户与康复团队和家庭决定权不对等,并促进实现个人的自主权	A3进行物理治疗评定	A3.1获得用户健康信息,包括环境和病史、需求、健康风险,识别、分析用户现存的典型障碍和促进功能康复因素
				A3.2评估用户身体结构和功能
	C3与用户、家庭及康复团队进行有效沟通	C3.1了解用户及其家庭的沟通需求 C3.2使用适合用户及其家庭的沟通方式,清晰简洁地沟通,积极倾听,包括使用、解释和适当回应 C3.3寻求不同环境下都能有效沟通,提高用户自我管理能力		A3.3通过观察和询问,评估用户在社会活动中的参与和表现
	C3与用户、家庭及康复团队进行有效沟通		A4制定和调整物理治疗计划	A4.1提供建议,指导用户及家庭制定物理治疗目标 A4.2参与制定和协调多学科的康复计划,确定物理治疗方案
	C4在解决个体功能障碍和决策时采取严谨的方法	C4.1在明晰问题和确定物理治疗方案时,寻求支持以确定个体、环境和健康因素,确保安全、舒适		A4.3需要时建议调整物理治疗计划
		C4.2在与用户及其家庭一起实施治疗方案过程中,通过寻求支持考虑多源信息 C4.3寻求支持,以确定应对用户及其家庭挑战的创新方法	A5转介	A5.1按照规定的流程转介到更适合用户功能康复的机构 A5.2在转介时按规定提供必要信息 A5.2对转诊进行跟踪随访,以确保个人及其家庭能够获得需要的服务
			C5在物理治疗实践和胜任力范围内工作		C5.1与用户及其家庭共同实施治疗方案过程中,保持对自身胜任力局限性的清醒认识	A6实施物理治疗	A6.1为用户及其家庭提供常规物理治疗教育,支持、促进自我管理
	C5.2遇到超出物理治疗实践和个人胜任力范围,能主动寻求他人支持和指导		C5在物理治疗实践和胜任力范围内工作	A6.2指导用户及其家庭使用辅助器具,并根据需要进行调整
					A6.3指导用户及其家庭进行环境改造,提高安全性、可及性和功能性
				A6.4实施物理治疗方案
			A7评定预期结果	A7.1使用常规物理治疗评定方法评定预期功能康复进展
				A8.1与用户及其家庭一起制定出院计划,并根据需要提供支持
			A8出院并确保健康服务延续性	A8.2编制标准化出院报告及相关信息
			A8出院并确保健康服务延续性	A8.3出院后对用户及其家庭进行跟踪随访,以便在用户需要时提供进一步物理治疗相关服务
物理治疗专业精神	C1遵守法律、法规、伦理、道德规范 C2保持专业精神 C3协作 C4担当	C1.1遵守专业标准、法律、法规和组织程序及指南,尊重用户隐私,为其保密 C1.2认识并努力消除个体偏见、信仰等对功能康复的潜在有害影响 C2.1给服务对象传递信心 C2.2与同行和利益相关方明确各自专业界限 C2.3采用策略并寻求支持以维持自身健康和福祉 C3.1接受、尊重和应用优秀的专业经验 C3.2开展多学科、多角色合作 C3.3积极开展物理治疗实践,寻求循证支持,以预防、并解决突发状况 C4.1积极承担专业工作,根据需要提供或寻求支持	A1管理健康风险和危害 A2采取专业对策改进物理治疗措施 A3参与本团队专业讨论 A4提出专业化的建议	A1.1评估、报告日常危害、健康风险、事故 A1.2主动应对日常危险、事故和错误,必要时寻求支持 A2.1按指示采取专业对策,改进物理治疗措施 A3.1致力于团队小组会议和多学科康复治疗案例会议 A4.1作为第三方解决有关物理治疗的问题,并根据需要提供支持
物理治疗学习与发展	C1继续学习与发展 C2支持他人学习与发展 C3加强物理治疗教育和培训工作	C1.1寻求支持,以确定和解决自己的学习需求 C1.2根据需要在支持下将所学应用于物理治疗实践,寻求、反思结果 C2.1根据学习者需求和偏好确定学习机会 C2.2分享适合学习者需求的信息和物理治疗实践 C3.1鼓励和激励同伴追求持续的学习和发展 C3.2倡导扩大物理治疗教育和培训的机会、质量和监管	A1管理自我专业发展 A2监督和培训他人	A1.1参加规定的物理治疗专业教育和培训活动,以实现个人专业发展 A1.2定期参加物理治疗相关学术会议,以满足学习和发展需要 A2.1参与同行评议,了解他人的学习需要 A2.2致力于物理治疗专业教育和培训活动,提供同伴支持以鼓励学习,提供建设性意见
物理治疗管理与领导力	C1致力于提高物理治疗团队服务绩效 C2成为功能康复理念倡导者	C1.1认可并且重视团队所有成员的角色和贡献,参与和支持团队合作 C1.2接受并开发同行在提供服务方面的需求和爱好,认识到环境、系统和结构性不平等对功能康复服务的影响 C2.1参与、促进、倡导为全体健康需求者提供物理治疗服务 C2.2提升物理治疗在健康服务中的作用和价值	A1管理物理治疗团队和服务 A2监测和评估功能康复服务提供情况	A1.1促进物理治疗任务、职责分配、沟通、服务目标 A1.2确定和报告团队对人力、财力和物力资源的需求 A1.3遵守有关安全、包容、保密等服务对应的规章制度并提出建议 A2.1协助确定康复服务评定、数据收集 A2.2记录和报告团队的人力、财力和物力资源的使用,遵守和支持服务审计
物理治疗研究	C1在物理治疗实践中整合证据 C2强化循证研究	C1.1保持对当前物理治疗循证实践的认识 C1.2遵循当前物理治疗循证准则和方案 C1.3寻求支持临床证据的获得与分享 C2.1倡导获得物理治疗临床实践更多的证据及机会 C2.2协助分析物理治疗临床实践需求和研究重点	A1设计和实施研究方案 A2传播、分享研究结果 A3加强物理治疗科学研究能力	A1.1致力于参与制定、实施研究方案,获取研究资源 A1.2遵守伦理道德 A1.3客观、科学进行定量和定性数据分析 A2.1致力于研究结果发表 A2.2专业会议交流研究结果 A2.3向物理治疗服务需求者展示研究成果,并根据需要提供支持 A3.1遵守学术道德规范,提升研究投入和研究成果质量 A3.2倡导为物理治疗科学研究提供更多的资助,加强团队、机构的科学研究能力

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指标	内涵
核心价值观
同情心与同理心	询问、理解患者及家庭的功能障碍过程后做出功能康复回应
敏感性与尊重差异性	平等、公正尊重所有客户(不论种族、民族、年龄、性别、残疾、信仰或经济状况等差异),提供可接受的物理治疗相关的健康服务
人权与尊严	认识到所有客户个体的内在价值,保障其人权,使其有尊严
自我决定权	寻求为所有客户提供选择和促进自身健康自主决定的权利
信念
良好的功能状态	个体有效融入和参与有意义的活动和生活角色,来保障健康和福祉
个人/家庭中心	物理治疗以个人/家庭为中心,以具体健康需要和功能康复为导向
协作	物理治疗需要与个人及其家庭协商合作,并积极参与功能康复
需求全覆盖	康复应该提供给所有健康需求者,纳入对任何有功能障碍、活动受限和参与受限的人的健康服务连续体中

学科门类	一级学科	二级学科	专业/方向
医学	医学技术		作业治疗学言语治疗学
	临床医学		运动医学儿科学老年医学神经病学康复医学与理疗学
	中医学		针灸推拿学
	基础医学		病理生理学免疫学人体解剖与组胚学
	护理学		临床护理学社区家庭护理学
工学	生物医学工程		假肢矫形工程智能医学工程康复辅助技术康复工程学
教育学	体育学	运动人体科学	运动康复
教育学	心理学	应用心理学	康复心理学
管理学	公共管理		健康服务与管理
管理学	公共卫生与预防医学		功能障碍预防
理学	药学		药理学
哲学	伦理学	医学伦理学	康复伦理学
法学	卫生法学		卫生法
	社会学		残疾人口学
	社会保障		残疾人法律保障

Development of programmes and curriculum of physical therapy at undergraduate level using ICF and rehabilitation competency framework

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