基于世界卫生组织康复胜任力架构的康复人力资源管理理论与应用

doi:10.3969/j.issn.1006-9771.2022.03.003

Abstract

Abstract: Objective To explore the application and method of World Health Organization Rehabilitation Competency Framework (RCF) in rehabilitation human resource management, and provide theoretical and practical reference for rehabilitation human resource management.Methods Based on the International Standard Classification of Occupations issued by the International Labour Organization, the application scope of RCF was systematically analyzed. The theoretical framework of rehabilitation human resource management based on RCF was constructed in combination with competency-based human resource management framework. On this basis, taking rehabilitation nurses as an example, the corresponding management methods and paths are proposed from four aspects of human resource management, including career management, recruitment and selection, training and development, and performance appraisal and salary management.Results Based on RCF, the theoretical framework of human resource management for rehabilitation nursing positions was constructed, and the main contents and processes of human resource management based on RCF were clarified from four aspects: recruitment and selection, training and development, performance appraisal and salary management, and career management. Occupational competency of rehabilitation professionals in International Standard Classification of Occupations was analyzed by RCF.Conclusion The rehabilitation competency framework constructed by WHO can be used to supplement the responsibilities of rehabilitation-related professionals in the International Standard Classification of Occupations issued by the International Labour Organization. RCF serves as a tool for practice managers and rehabilitation professionals in identifying selection criteria, learning objectives, and professional title assessment criteria. It can also be used in recruitment and selection, training and development, performance appraisal, salary management and career management in the field of rehabilitation human resource management.

Key words: World Health Organization, rehabilitation competence framework, human resources for rehabilitation, theory and application

WU Fang, JING Qi, QIU Zhuoying, SUN Hongwei, LI Anqiao, DUAN Mingxue, GAO Qianqian, CAI Weiqin, ZHENG Wengui. Conceptual framework and its application of World Health Organization rehabilitation competency framework in rehabilitation human resource management[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 275-284.

Figures/Tables 6

ISCO编码	职业分类	主要职责	胜任力	活动
2211	普通全科医生	(a)评估患者;(b)对检查结果进行分析;(c)开具处方,实施诊治;(d)外科手术;(e)向患者及其家人、社区提供健康咨询;(f)转诊;(g)提供分娩前后并发症的转诊;(h)记录病史;(i)向政府当局报告出生、死亡和应报告的疾病;(j)健康及医疗研究;(k)规划方案	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2212	执业专科医生	(a)评估患者;(b)参考转诊医生的医疗信息;(c)对检查结果进行分析;(d)评估诊疗效果;(e)专科外科手术;(f)处理分娩前后的并发症;(g)记录病史;(h)向政府当局报告出生、死亡和应报告的疾病;(i)向患者及家人、社区提供健康咨询;(j)健康及医疗研究;(k)尸体解剖;(l)规范方案	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2240	医疗助理人员	(a)评估患者,记录病史;(b)基本的内外科手术;(c)安排检查;(d)治疗操作：注射、缝合等;(e)协助复杂的外科手术;(f)评估诊疗效果;(g)向患者及其家人提供健康咨询;(h)转介;(i)向政府当局报告出生、死亡和应报告的疾病	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3. MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2634	临床心理学家	(a)专业评估及治疗;(b)分析个体思想行为的影响因素;(c)针对疾病提供面谈服务;(d)与家庭成员、教育当局等保持联系给出建议;(e)研究专业知识;(f)编写论文及报告;(g)为规划教学方法和内容提供参考;(h)调查和研究;(i)发展解释和描述人类行为的理论、模型和方法	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2221	护理人员	(a)护理评估;(b)与其他卫生人员制定护理计划;(c)实施护理计划;(d)评估护理计划;(e)清创;(f)疼痛监测;(g)在临床和社区环境提供健康教育;(h)为患者及其家属提供护理健康咨询;(i)相互监督;(j)护理研究	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2230	传统和辅助医学相关专业人员	(a)评估患者;(b)利用针灸治疗等制定治疗计划;(c)评估和记录治疗效果;(d)向患者及其家庭、社区提供健康咨询;(e)开具处方,药物配置;(f)与其他工作者交流治疗信息;(g)研究	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3
3214	医疗和牙科假体技师	(a)评估患者,确定需求;(b)与医生或牙医确定用具规格及处方;(c)确定用具材料;(d)制作模型;(e)为患者安装并调试用具;(f)制作辅助装置;(g)指导患者	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3
3255	物理治疗师及助理	(a)进行物理治疗;(b)实施仪器治疗;(c)指导功能锻炼;(d)与其他治疗师共同制定治疗计划,并评估效果;(e)记录病史;(f)为患者安装辅助装置,并指导使用	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2635	社会工作和咨询专业人员	(a)评估服务需求;(b)提出解决办法;(c)为法院和其他法律程序编制案件记录或报告;(d)提供辅导、治疗和调解服务;(e)规划并执行服务方案;(f)担任倡导者;(g)制定预防和干预方案;(h)与其他社会服务机构、教育机构保持联系	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PAM4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2264	物理治疗师	(a)专业评估患者;(b)确定治疗目标;(c)利用物理疗法,制定并实施治疗方案;(d)指导患者及其家属;(e)记录病史;(f)制定和执行疾病预防方案;(g)同行监督	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2266	听力学家和言语治疗师	(a)专业评估患者;(b)确定治疗目标;(c)利用专业设备制定并执行治疗方案;(d)指导患者及其家属;(e)辅导和指导患者及其家属、教师;(f)提供额外的医疗和教育服务;(g)开具辅助器具的处方,并指导使用	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LAD2 MLA1、MLA2、MLA3 RA1、RA2、RA3
2269	其他健康相关专业人员	(a)评估患者;(b)制定和实施治疗计划;(c)评估并记录治疗效果;(d)提供健康咨询;(e)建议并协助日常活动;(f)治疗足部疾病;(h)进行小的外科手术,例如在脚和脚踝上	PC1、PC2、PC3、PC4、PC5 PMC1、PMC2、PMC3、PMC4 LDC1、LDC2、LDC3 MLC1、MLC2、MLC3 RC1、RC2	PA1、PA2、PA3、PA4、PA5、PA6、PA7、PA8 PMA1、PMA2、PMA3、PMA4 LDA1、LDA2 MLA1、MLA2、MLA3 RA1、RA2、RA3

活动	初级熟练程度	胜任力	初级熟练程度
PA1	1.在常规干预的背景下,提供可能涉及患者康复护理的基本说明,包括潜在的益处和危害; 2.明确个人及其家庭对康复护理期望的认识; 3.根据法律和/或组织政策确认同意,在个人的认知或法律同意能力不明确的情况下寻求支持	PC1	1.支持个人及其家庭积极参与康复护理,包括决策; 2.寻求支持使实践适应个人及其家庭的预期结果,满足不同环境下他们的需求、偏好和目标; 3.寻求支持以识别和解决个人及其家庭参与康复护理的障碍,以及他们获得服务的能力
PA2	1.遵循文档管理处理程序,清晰准确地记录康复护理信息; 2.安全地存储包含个人信息的文档	PC2	1.与个人及其家庭建立并保持积极的关系,以自信、同理心和信任为特征; 2.认识到并最大限度地减少个人与康复工作者和家庭关系中的权力不平衡,并促进实现个人的自主权; 3.与个人及其家庭保持道德界限; 4.认识并接受个人及其家庭的态度、信念和情感
PA3	1.获得基本的健康、环境和个人病史,明确将其与个人及其家庭的需求相关联; 2.观察个人是否可能有伤害自己和/或他人的风险,并寻求支持以做出适当的反应; 3.根据方案和/或指示对身体结构和功能进行常规和基本护理评估; 4.识别个人环境中的典型障碍和促进因素; 5.通过观察和询问,对个人在相关活动中的表现及其参与有意义的事件和生活角色进行基本评估	PC3	1.认识到个人及其家庭的沟通需求和实践,例如与年龄、教育、文化、健康状况或语言相关的需求和实践; 2.使沟通适应经常遇到的需求和实践,包括通过使用口译、辅助技术和相关合理便利设施; 3.使用适合本人及其家庭的术语和语言,清晰简洁地说明; 4.积极倾听,包括使用、解释和适当回应肢体语言; 5.管理环境以支持有效的沟通,同时考虑噪音、隐私、舒适和空间
PA4	1.提供意见以促进个人及其家庭完成目标设定; 2.致力于确定实现个人及其家庭目标所需的康复护理措施; 3.参与制定和协调多学科的康复护理计划; 4.建议何时对个人的康复护理计划作出调整	PC4	1.在明晰问题和确定解决方案时,寻求支持以确定个人、环境和健康因素; 2.在与个人及其家庭一起解决问题和做出决定时,通过寻求支持以考虑来自多个来源的信息; 3.寻求支持,以确定应对个人及其家庭挑战的创新方法
PA5	1.按照规定的流程转介到既定服务机构; 2.在转介个人及其家庭时向服务机构提供所有必要信息; 3.对转诊进行跟踪随访,以确保个人及其家庭获得所需的服务或干预	PC5	1.与个人及其家庭一起工作时,保持对自身局限性的认识; 2.在遇到超出实践和胜任力范围的情况时寻求支持和指导
PA6	1.为个人及其家庭提供常规教育和培训,以促进自我效能和自我管理; 2.提供日常辅助产品,指导个人及其家庭使用,并根据需要进行微调; 3.促进对个人及其家庭环境的改造方案,以提高安全性、可及性和功能性; 4.遵循处方和/或常规的预防性、恢复性和补偿性锻炼、技术和物理治疗方案	PMC1	1.尊重隐私和保密; 2.遵守专业标准、法律法规和组织程序及指南; 3.寻求支持以确定和管理实际或潜在的利益冲突; 4.认识到并努力消除个人偏见和信仰的潜在有害影响
PA7	使用常规评估措施来评估实现预期结果的进展	PMC2	1.传递给服务对象信心; 2.与同事和利益攸关方明确专业界限; 3.采用策略并寻求支持以维持自身健康和福祉
PA8	1.与个人及其家庭一起制定出院康复护理计划,并根据需要提供支持; 2.编制基本和标准化出院报告中的康复护理信息; 3.促进成功的过渡交接过程; 4.出院后与个人及其家庭进行跟踪随访,寻求支持,以便在必要时提供进一步服务	PMC3	1.接受、尊重和利用他人的专业经验; 2.与相关同事和外部利益攸关方分享和获得信息; 3.在学科、角色、文化和组织等级制度方面与其他人合作; 4.以尊重和建设性的态度开展实践,寻求支持以防止和解决冲突
PMA1	1.对日常危害和风险进行基本评估; 2.报告危险、事件和错误; 3.主动应对实际或潜在的日常危险、事故和错误,必要时寻求支持或咨询	PMC4	1.优先考虑分配工作负荷并根据需要提供支持; 2.在遇到不确定性和不断变化的情况方面寻求支持
PMA2	按指示促进质量改进活动
PMA3	致力于小组会议和多学科案例会议
PMA4	作为第三方解决有关康复护理的问题和关注,并根据需要提供支持

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	World Health Organization. Adapting the WHO rehabilitation competency framework to a specific context: a stepwise guide for competency framework developers, version for field testing (Chinese Version)[R]. [2022-02-27].https://apps.who.int/iris/handle/10665/339078.
[20]	李炳桥, 庞灵, 王昊, 等. 康复专科护士核心能力评价指标构建[J]. 护理学杂志, 2021,36(7):104-106.
	LI B Q, PANG L, WANG H, et al. Constrution of an evaluation index system for rehabilitation specialist nurses based on core competence[J]. J Nurs Sci, 2021,36(7):104-106.

领域	胜任力	编码	活动	编码
实践(P)	C1 以个人及其家庭为中心的实践	PC1	A1 获得康复知情同意	PA1
	C2 与个人及其家庭建立合作关系	PC2	A2 记录信息	PA2
	C3 与个人、家庭及其健康保健团队进行有效沟通	PC3	A3 进行康复评估	PA3
	C4 在解决问题和做出决策时采取严谨的方法	PC4	A4 制定和调整康复计划	PA4
	C5 在实践和胜任力范围内工作	PC5	A5 转介给其他服务机构	PA5
			A6 实施康复干预措施	PA6
			A7 评价实现预期结果的进展情况	PA7
			A8 出院并确保获得健康保健服务连续性	PA8
专业精神(PM)	C1 展现道德规范	PMC1	A1 应对风险和危害	PMA1
	C2 保持专业精神	PMC2	A2 采取质量改进措施	PMA2
	C3 协作工作	PMC3	A3 参与团队讨论会	PMA3
	C4 担负专业职责	PMC4	A4 提出康复建议	PMA4
学习与发展(LD)	C1 持续学习与发展	LDC1	A1 管理自我专业发展	LDA1
	C2 支持他人学习与发展	LDC2	A2 督导和培训他人	LDA2
	C3 加强康复教育和培训工作	LDC3
管理与领导力(ML)	C1 致力于提高康复团队绩效	MLC1	A1 管理康复团队	MLA1
	C2 致力于提高康复服务绩效	MLC2	A2 管理康复服务提供	MLA2
	C3 成为康复倡导者	MLC3	A3 监测和评估康复服务提供情况	MLA3
研究(R)	C1 在实践中整合证据	RC1	A1 设计和实施研究	RA1
	C2 研究强化康复证据	RC2	A2 传播证据	RA2
			A3 加强康复研究能力	RA3

Conceptual framework and its application of World Health Organization rehabilitation competency framework in rehabilitation human resource management

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