ZHANG YONGAN, President of Guangdong Disabled Persons’ Federation
I have proudly designed and built the Guangdong Rehabilitation Base for Persons with Disabilities after more than three decades of research in supporting persons with disabilities. The infrastructure meets the criteria set by the International Classification of Functioning, Disability and Health (ICF), a framework approved by WHO states in 2001, with the support of the government.
The Guangdong Rehabilitation Base for Persons with Disabilities
The Guangdong Rehabilitation Base for Persons with Disabilities has a total construction area of 120,000 square meters. It is to be developed in a three-phase process, made available by a total investment of 850 million yuan ($127.45 million). The first phase has been completed and put into use. It has a children’s rehabilitation area and an assistive device area. The children’s rehabilitation area focuses on providing educational rehabilitation services to 600 children having disabilities related to hearing, vision, intelligence, cerebral palsy and autism. The assistive device area has an assistive device museum with engineering rehabilitation, occupational rehabilitation and social rehabilitation facilities. It provides prosthetics, orthotics and other assistive devices as well as occupational ability appraisal services.
The second phase involves the construction of a 300-bed rehabilitation hospital and an institution of rehabilitation sciences (a scientific research institution), a rehabilitation academy focusing on medical rehabilitation, and is expected to be completed in 2023. With the existing 200 beds in the assistive device area, a total of more than 500 beds will be available.
The third phase will be a cultural and sports rehabilitation area focusing on sports and art rehabilitation, providing 300 types of cultural and sports rehabilitation training services. This is now under planning. These facilities will be connected by corridors and the rehabilitation service in each area will be integrated. Various rehabilitation therapies such as PT, OT, ST, AT and RT as well as educational, social, occupational and other measures will be applied in a comprehensive and coordinated manner in order to enable optimal rehabilitation.
The Rehabilitation Base features a terraced, green design. Every plant, every brick and every tile is designed to be part of the rehabilitation processes. The Rehabilitation Base is jointly operated and managed by the Guangdong Educational Rehabilitation Center for Children with Disabilities (Category I institution of public welfare) and the Guangdong Rehabilitation Hospital (Category II institution of public welfare).
The core of ICF is a modern comprehensive model combining psychological, social and environmental factors based on biomedical model (see the relationship diagram of ICF, ICD, and ICIDH). ICD attempts to address health problems by eliminating symptoms, curing diseases, achieving recovery, and restoring health, while ICF is designed to tackle health problems caused by factors other than diseases, aiming to remove barriers, slowing down functional decline, regaining and maintaining optimal functional status. In health services, ICF and ICD are inseparable and complimentary.
The Relationship Diagram of ICF, ICD and ICIDH
There are two concepts: disability and rehabilitation. Disability is a dynamic and evolving process, assessed by the impairment of the interaction between biological individuals and the environment. Rehabilitation refers to the acquisition and maintenance of an optimal state of functions in a person who is or may be suffering disabilities, through assistance including the comprehensive and coordinated use of a range of medical, educational, social and occupational measures.
University of Health and Rehabilitation Sciences
China has made two major innovations based on WHO’s ICF framework, namely setting up the University of Health and Rehabilitation Sciences and the Rehabilitation Base. The University, established at the initiative of Zhang Haidi, president of China Disabled Persons’ Federation and located in Qingdao, Shandong province, will apply ICF to education. The Rehabilitation Base established by Guangdong province in Guangzhou as a base for clinical teaching and internship involves the practice of the framework in the clinical field. China will also continue to explore the development of disciplines in education based on the ICF framework, and advance the building of a new discipline system for rehabilitation sciences.
Guangdong province has stepped up efforts to develop an international model for ICF application in China, and contribute to China’s endeavors to create a new discipline system of rehabilitation sciences and take the lead in international rehabilitation services.
ICF系統理論的中國實踐：廣東省殘疾人康復基地
廣東省殘疾人聯合會理事長 張永安
在政府重視支持下，康復基地是按照2001年WHO公布的ICF系統理論所倡導的國際先進理念而設計建造的，也是我從事殘疾人工作30年實踐思考并潛心打造的得意之作。
康復基地總建筑面積12萬平方米，投資8.5億元，分為三期建設，首期工程以教育康復為主的兒童康復區，為聽力、視力、智力、腦癱、孤獨癥五類600個殘疾兒童提供康復服務，以及以融合工程康復、職業康復和社會康復為一體的輔具資源區，提供假肢矯形器等輔具適配服務、職業能力鑒定和輔具科普館服務，已建成投入使用。二期工程以醫療康復為主的康復醫院（300張床位）和康復科學院（科研機構），整合輔具資源區（200張床位）和文體康復區，總床位達500張以上，2023年竣工。三期工程以體育康復和藝術康復為主的文體康復區，提供300人文體康復訓練服務，籌建之中。三期工程全部建成后將以連廊的形式連成一體，各個區域的康復學科有機整合，綜合協調運用PT、OT、ST、AT、RT等多種醫療康復治療手段，以及教育的、社會的、職業的等一系列措施，以求最佳康復效果。
建筑風格為梯田式綠色主題，蓬勃向上，一草一木，一磚一瓦都具有園藝治療康復功效。康復基地將由廣東省殘疾兒童教育康復中心（公益一類）和廣東省康復醫院（公益二類）兩個公益機構負責運營管理。
ICF系統理論的核心內容就是在生物醫學模式的基礎上，整合心理、社會和環境等因素形成現代綜合模式。ICD研究解決疾病引起的健康問題，ICF研究解決非疾病引起的健康問題。在健康服務領域，離開ICD講ICF靠不住，只講ICD不講ICF遠遠不夠。兩個基本概念，即殘疾概念與康復概念。殘疾概念：殘疾是個動態演變過程，用生物個體與環境相互作用的障礙結果來評判。康復概念：康復的本義是指恢復到健康狀態，其最新定義是指綜合地和協調地運用醫學的、教育的、社會的和職業的等一系列措施，幫助經歷殘疾或可能經歷殘疾的個體，在與環境相互作用的過程中獲得并維持最佳功能狀態。
2001年WHO年發布的ICF系統理論在中國實踐和具體應用產生兩大創新成果：康復大學和康復基地。在中國殘聯主席張海迪倡導下，國家在山東青島建立的康復大學是ICF系統理論在教育領域的實踐應用成果，廣東省在廣州建立的康復基地作為康復大學臨床教學實習基地是ICF系統理論在臨床領域的實踐應用成果。在兩大創新成果的基礎上，我們將依據ICF系統理論在教育領域的學科體系建設上繼續探索，推動創建康復科學新學科體系。廣東省正在潛心打造ICF系統理論中國實踐的國際樣板，為國家創建康復科學新學科體系、示范引領國際康復服務作出貢獻。
