Evaluaition of ADLs日常生活活动能力评定

1、Evaluation of Activities of Daily Living日常生活活动能力评定,武若雯，OT Teaching and research section of Rehabilitation Medicine The Second Peoples Hospital of Yunnan Province,Introduction,Why must we discuss about daily living in the field of medicine? 为什么我们需要在医学范畴中讨论关于日常生活的问题,Introduction,Evaluation of ADL is a

2、 way to describe the functional status of a person ADL评定用于评定个体关于日常生活的功能情况 It is a tool in the biopsychosocial model of medcine 它正符合生物一心理一社会医学模式,What is ADLs,Activities of daily living (ADLs) : the things we normally do in daily living,including activities we perform for the care of ourselves without

3、 any assistance 狭义:指人们为独立生活而每天必须反复进行的、最基 本的、具有共性的活动,What is ADLs,In a broad sense： 指个体在家庭、工作环境及社区里自己管理自己 包括：与他人交往，以及在经济上、社会上、职业上合理安排自己的能力,What is ADLs,Self-care,mobility,Communication,housework,recreation,What is ADLs,Basic/Physical activities of daily living 基础性日常生活活动（或躯体性日常生活活动） Instrumental activ

4、ities of daily living 工具性日常生活活动,Basic/Physical activities of daily living (BADL/PADL),Personal hygiene and grooming 个人卫生及修饰 Dressing and undressing 更衣 Feeding 进食 Functional transfers 转移 Voluntarily controlling of Bladder and Bowels 二便控制 Ambulation (Walking or in a wheelchair) 步行或轮椅活动,Instrumental ac

5、tivities of daily living（IADL）,Housework 家务劳动 Community integration 社会交际 Shopping 购物 Financial management 财务管理 Telephone use 使用电话 Recreation 娱乐消遣 Using technology (as applicable) 恰当地运用技术,Purpose,Evaluate the status of independence 确定患者生活自理的程度 Find out the reasons 分析日常生活功能障碍的原因 Set individualized reh

6、abilitation goals and plans 拟定合适的治疗目标，并确定针对性的治疗方案 Assess rehabilitation outcomes and discharge arrangement 评价治疗效果并为患者提供出院指导,Steps,Collect related information 收集资料,Interview 与患者及家属进行交谈,Set about measurement scales 运用评定量表进行评定,Common used scales,BI/MBI Barthel 指数/改良Barthel指数 Katz index Katz 指数 FIM 功能独立

7、性评定量表 Functional comprehensive assessment 综合评定量表,Barthel index,10 items 10个项目 Measure a persons ADL 专门用于评定ADL Determine a baseline level of functioning 确定功能状况的基础 Monitor improvement in ADL 评价ADL的改善情况,Functional Independence Measure(FIM),Assess physical and cognitive disability 评估患者的躯体运动功能和认知功能 Used

8、extensively in rehabilitation 应用广泛 18 items 共有6大项其中包含18个小项,FIM18 items,1、Self-care 自理活动,FIM18 items,1、Self-care 自理活动,FIM18 items,2、 Transfers 转移,FIM18 items,3、Mobility 运动,FIM 18 items,4、Sphincters 括约肌控制,FIM 18 items,5、Communication 交流,FIM 18 items,6、Cognition 社会认知,Functional Independence Measure(FIM

9、),Be scored from 1 to 7 each item 每一个项目最低分为1分，最高分为7分 1 represents total dependence 一分表示完全依赖 7 indicates complete independence 七分表示完全独立,FIMSeven levels for each item,FIMSeven levels for each item,FIM,Scores range from 18 to 126 总分从18-126分 Higher scores indicates more independence 分值越高代表对象的独立程度越高,Summary,ADL指人们为独立生活而每天必须反复进行的、最基本的、具有共性的活动。广义ADL还包括与他人交往、以及在经济上、社会上、职业上合理安排自己的能力 ADL包括自我照顾、功能性移动、交流、家务、娱乐 A