《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (7): 755-762.doi: 10.3969/j.issn.1006-9771.2025.07.002

• 专题 残疾标准研究 • 上一篇    下一篇

基于ICF和ICD-11的中国6种视力残疾相关标准比较研究

吕雪丽1,2, 杨亚茹2,3,4, 邱卓英2,4, 王忠彦2,4, 田益凡1, 刘叶1, 李晨1(), 陈迪1,2()   

  1. 1.中国康复科学所，北京市 100068
    2.世界卫生组织国际分类家族中国合作中心，北京市 100068
    3.华东师范大学体育与健康学院，上海市 200241
    4.康复大学社会发展学院/国际康复政策和ICF研究中心，山东青岛市 266113
  • 收稿日期:2025-03-27 修回日期:2025-06-09 出版日期:2025-07-25 发布日期:2025-07-30
  • 通讯作者: 李晨(1973-)，女，汉族，河南信阳市人，硕士，主任技师，主要研究方向：科研管理、微生物免疫、康复科学，E-mail： lilycrrc@sina.com； 陈迪(1982-)，男，汉族，北京市人，博士，副研究员，主要研究方向：ICF、残疾研究、康复科学、康复大数据、康复信息，E-mail： cindino80@126.com。
  • 作者简介:吕雪丽(1996-)，女，汉族，河北定州市人，硕士，助理编辑，主要研究方向：康复政策、残疾人标准。
  • 基金资助:
    中国康复科学所中央级公益性科研院所基本科研业务费项目(CRSI2023CZ-16);中国康复科学所中央级公益性科研院所基本科研业务费项目(CRSI2024CZ-1)

Comparative study of six visual disability-related standards in China based on ICF and ICD-11

LÜ Xueli1,2, YANG Yaru2,3,4, QIU Zhuoying2,4, WANG Zhongyan2,4, TIAN Yifan1, LIU Ye1, LI Chen1(), CHEN Di1,2()   

  1. 1. China Rehabilitation Science Institute, Beijing 100068, China
    2. WHO-FIC Collaborating Center in China, Beijing 100068, China
    3. College of Physical Education and Health, East China Normal University, Shanghai 200241, China
    4. School of Social Development/International Center for Rehabilitation Policy and ICF Research, University of Health and Rehabilitation Sciences, Qingdao, Shandong 266113, China
  • Received:2025-03-27 Revised:2025-06-09 Published:2025-07-25 Online:2025-07-30
  • Contact: LI Chen, E-mail: lilycrrc@sina.com;CHEN Di, E-mail: cindino80@126.com
  • Supported by:
    The Fundamental Research Funds for Central Public Welfare Research Institutes, conducted by China Rehabilitation Science Institute(CRSI2023CZ-16);The Fundamental Research Funds for Central Public Welfare Research Institutes, conducted by China Rehabilitation Science Institute(CRSI2024CZ-1)

RichHTML

PDF (PC)

摘要：

目的 系统比较中国现行6种视力残疾相关标准：《人身保险伤残评定及代码》(保险标准)、《老年人能力评估规范》(老年规范)、《人体损伤致残程度分级》(司法标准)、《劳动能力鉴定 职工工伤与职业病致残等级》(工伤标准)、《军人残疾等级评定标准》(军残标准)和《残疾人残疾分类和分级》(残疾分类分级标准)。

方法 采用《国际功能、残疾和健康分类》(ICF)和《国际疾病分类第十一次修订版》(ICD-11)视觉相关疾病和损伤的类目，并参照《世界视觉报告》(WRV)，聚焦于视力残疾的定义、分类、分级、评估方法和编码体系5个核心维度，对上述6种标准进行结构化比较分析。

结果 在定义方面，保险标准、工伤标准、军残标准和残疾分类分级标准侧重于视觉功能和结构，如视力和视野；保险标准和老年规范则融合活动与参与的评估概念，关注功能性视力；司法标准缺乏视力残疾的专门定义。在分级方式上，各标准依据不同的功能指标，分为不同的级别。在编码体系方面，仅保险标准使用ICF编码，其余多采用独立数码编码或不设编码。评估方法方面，除老年规范使用自制评分系统外，其余以常规视力检测为主。

结论 当前我国视力残疾标准多聚焦于视觉功能损害，较少涵盖个体的活动与参与限制。应基于ICF架构并参照WRV，引入“功能性视力”概念，构建统一的视力残疾定义、分级与编码体系，推动科学、全面的评估模式，以更真实地反映个体功能状态与环境交互影响。

关键词: 视力残疾, 分类, 分级, 功能性视力, 国际功能、残疾和健康分类

Abstract:

Objective To compare six existing Chinese standards related to visual disability, including Disability Assessment and Code for Life Insurance (Insurance Standard), Specification for Ability Assessment of Older Adults (Elderly Standard), Grading of Disability due to Human Body Injury (Judicial Standard), Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases (Work Injury Standard), Standard for Assessment of Disability Grades of Military Personnel (Military Standard), and Classification and Grading Criteria of Disability (Disability Classification Standard).

Methods Based on the theoretical framework of International Classification of Functioning, Disability and Health (ICF) and International Classification of Diseases, the 11th Revision (ICD-11), and with reference to World Report on Vision(WRV), this study analyzed and compared five key dimensions of visual disability across the six standards: definition, classification, grading, assessment methods and coding systems.

Results In terms of definition, the insurance, work injury, military, and disability classification standards emphasized visual structure and function, focusing on visual acuity and visual field; the insurance and elderly standards incorporated activities and participation, reflecting the concept of functional vision; the judicial standard lacked a dedicated definition of visual disability. In terms of grading, each standard graded visual disability into different levels acoording to different functional indicators. In terms of coding, only the insurance standard adopted the ICF framework, while others used non-ICF numeric codes or lacked standardized coding. In terms of assessment tools, the elderly standard employed a customized perceptual and participation scoring system, while others relied primarily on vision charts.

Conclusion Most current Chinese standards focus on impairments in visual function, with limited attention to activity limitations and participation restrictions. It is needed for incorporating the concept of functional vision, aligned with ICF and WRV, to establish a unified conceptual framework, terminology, coding system for visual disability, and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and environmental interaction.

Key words: visual disability, classification, grading, functional vision, International Classification of Functioning, Disability and Health

中图分类号: