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3 발간등록번호 한국표준건강분류제정 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 2016 통계청

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5 머리말 노인인구증가와의학의발달로인해질병의치료보다예방이나재활, 생활환경개선과같은건강관리의중요성이대두되면서건강의개념이신체뿐만아니라사회적, 정신적으로행복한삶의영위로확대되었습니다. 이러한변화와수요에선제적으로대응하기위해서는건강과관련된객관적인통계와그통계를생산하기위한합리적기준이마련되어야합니다. 이런흐름에발맞춰세계보건기구 (WHO) 는신체적, 사회적, 환경적측면을종합적으로고려해개인의전반적인건강상태를측정하는국제기능 장애 건강분류 (International classification of functioning, disability and health) 를 2001년에국제적인공통기준으로제정하고, 각회원국에도입을권고하였습니다. 이에통계청은국제기능 장애 건강분류를기반으로 2009 년부터 7 년간의기초연구와각분야별 전문가와의협업을통해국내보건현실을반영하여금번에한국표준건강분류로제정하기에 이르렀습니다. 새로운보건분류인한국표준건강분류가우리나라국민의보건상태를객관적으로파악하는 유용한도구로써성공적으로정착되고한국표준질병 사인분류와상호보완적으로활용되어합리적 정책수립에기여할수있기를기대합니다. 끝으로제정작업에헌신적으로참여하신한국건강분류개발연구자들, 한국건강분류자문위원님들, 보건분야관계기관여러분께깊은감사의말씀을드립니다 통계청장유경준

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7 차 례 서론 1 1. 배경 3 2. 한국표준건강분류의목표 한국표준건강분류의적용 5 3. 한국표준건강분류의특성 한국표준건강분류의보편성 한국표준건강분류의영역 분류단위 한국표준건강분류의발행 9 4. 한국표준건강분류구성요소개요 신체기능과구조, 그리고장해 활동과참여 / 활동제한과참여제약 배경요인 기능수행과장애의모형 기능수행과장애의과정 의학적모형과사회적모형 한국표준건강분류의사용 20

8 1 단계분류 25 2 단계분류 29 정의에의한세부분류 49 신체기능 (Body functions) 51 신체구조 (Body structures) 115 활동과참여 (Activities and participation) 130 환경요인 (Environmental factors) 189 부록 분류와용어 한국표준건강분류코드적용지침 활동과참여목록활용 사례예제 한국표준건강분류사용에대한윤리적지침 최소한의이상적데이터수집을위한한국표준건강분류권고사항 WHO의장애가있는사람에관한고찰 270

9 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 서 Introduction 론

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11 서론 서 1 배경 론 이책은한국표준건강분류 (Korean Standard Classification of Functioning, Disability and Health, 이하 KCF 1) ) 를다루고있다. KCF의전반적인목적은건강과건강관련상태를표현하기위해통일된표준언어와체계를제공하는것이다. KCF는건강과건강관련웰빙 (well-being) 상태의구성요소 ( 예를들면, 교육, 노동 ) 를정의하고있다. 따라서 KCF는건강영역 (health domains) 과건강관련영역 (health-related domains) 으로구성된다. 이러한 KCF 영역은신체, 개인, 사회의관점에서 (1) 신체기능과구조, (2) 활동과참여 2) 라는두개의기본분류목록을통해기술된다. 분류로서 KCF는개인의특정한건강상태 ( 질병이있거나장애를가진사람이하거나할수있는것 ) 에대해서로다른영역 3) 을체계적으로분류한다. 기능수행 (functioning) 은모든신체기능, 활동과참여를, 장애 (disability) 는장해, 활동제한과참여제약을망라하는포괄적용어다. 또한 KCF 분류목록에는이런모든구성개념과상호작용하는환경요인도포함되어있다. 이런방식으로사용자는 KCF의여러영역을통해개인의기능수행, 장애, 건강을설명할수있다. KCF의근간인국제기능장애건강분류 (International classification of functioning, disability and health, 이하 ICF) 는세계보건기구 -보건의료분류표준 (WHO-FIC) 중하나로다양한측면에서건강을분류한다. WHO-FIC는진단, 기능수행, 장애, 보건서비스접촉사유등광범위한건강관련정보를분류하는틀을제공하며전세계적으로여러학문과과학분야에서건강과보건의료에관한지식이소통될수있도록표준화된공통언어로사용한다. 국내보건분류중에서질환, 장애, 손상과같은건강상태는병인론적틀을제공하는한국표준질병 사인분류 (Korean standard classification of diseases, 이하 KCD) 4) 를사용하여우선적으로분 류하며, 건강상태와관련된기능수행과장애는 KCF 로분류한다. 이처럼 KCD 와 KCF 는상호보완 적 5) 이므로함께활용할것을권장한다. KCD 는질환, 장애또는기타건강상태의 " 진단 " 을제공하며 여기에 KCF 분류로기능수행이추가되면정보의내용이풍부해진다. 6) 진단에기능수행이추가된 1) 국제기능장애분류 (International classification of functioning, disability and health, ICF) 를근간으로하여작성되었으며 ICF 는 WHO 의국제장애분류 (ICIDH) 의개정판이다. WHO 는 1980 년에시험용으로 ICIDH 를최초발행했다. 그후 5 년에걸친체계적현장시험적용과국제적협의를거쳐 2001 년 5 월 22 일제 54 차세계보건총회에서 ICIDH 의국제적사용을승인했다. ( 결의안 WHA54.21) 2) 이용어들은이전에사용하던 장해, 장애, 사회적불리 를대신하는것으로, 분류영역을확장하여긍정적경험을기술하도록하였다. 이새로운용어들은서론에서추가로정의하였고분류내에서상세히설명하였다. 이용어들은일상생활에서의사용과는다른특수한의미로사용된다는점에주목해야한다. 3) 영역 (domain) 이라는것은서로관련이있는생리적기능, 해부적구조, 행위, 과제, 생활영역의실질적이고의미있는조합이다. 4) WHO 국제질병분류 (International Statistical Classification of Diseases) 를 1952 년부터국내에서한국표준질병 사인분류로제정 5) KCD 와 KCF 간의중복사항을파악하는것도중요하다. 두분류모두신체계통으로시작한다, 장해는신체구조와신체기능에관련된것으로 질병의과정 중일부이므로 KCD 에서도다루어진다. 다만 KCD 에서장해 ( 징후또는증상으로서 ) 는질병을구성하는수많은요소의일부이거나보건서비스를접촉하는이유로보는데반해 KCF 에서는건강상태와연관된신체기능과신체구조의문제로간주한다. 6) 동일한질병을앓고있더라도사람에따라기능수행의수준이다를수있으며, 기능수행수준이같다고해서건강상태가반드시같은것도아니다. 따라서질병과기능수행을결합하여사용하면의료를목적으로하는자료의질을향상시킨다. KCF 를사용한다고정상적진단절차를무시해서는안된다. 기타다른목적으로 KCF 를단독으로사용하기도한다. 통계청 3

12 한국표준건강분류 정보는사람또는인구집단의건강을더광범위하고의미있게설명해주므로의사결정목적으로사용할수있다. 보건분류는인구집단의건강을국제적맥락에서설명하고비교하는가치있는도구이다. KCD에의한사망정보와 KCF에의한건강결과정보가결합된건강수준지표로인구집단의건강과그분포를관찰하고사망과질병에이르게한여러원인의기여정도를평가하는도구이다. KCF의근간인 WHO의 ICF는 질병의결과 분류 (1980년판 ) 에서 건강의구성요소 분류로변화하였다. 질병의결과 는질병의파급효과또는질병으로인한건강상태를강조하는반면에 건강의구성요소 는건강을이루고있는것이무엇인가를파악하는데중점을둔다. 그러므로연구자가적합한과학적방법을통해인과적추론을이끌어내기위해 KCF는병의원인에관해서는중립적인입장을취한다. 이러한접근법은 건강결정요인 또는 위험요인 접근방식과도다르다. 즉, 결정요인또는위험요인연구를용이하게수행할수있도록, KCF는개인들이살아가는상황을기술한환경요인목록을가지고있다. 4

13 서론 서 2 건강분류의목표 론 KCF 는다양한원칙과서로다른분야에사용할수있도록고안된다목적분류이다. 세부적인목적은 다음과같이요약할수있다. 국가간자료, 보건의료학문, 서비스및시점간자료비교가능 건강과건강관련상태, 결과, 결정요인의이해와연구를위한과학적기초제공 보건의료인력, 연구자, 정책결정자, 장애를가진사람을포함한일반대중과같이, 서로다른사용자들간의사소통의향상을위해건강및건강관련상태기술용공통언어구축 건강정보시스템을위한체계적인코딩시스템제공 다양한문화권에서보건정책, 질관리, 결과평가를위해여러사용자들이사용할수있는의미 있고실용적인시스템구축하는데 KCF 가필요하고사용될것이므로이러한목표들은서로밀접하게 관련되어있다. 2.1 한국표준건강분류의적용 KCF 는다음과같은여러가지목적으로사용할수있다. 예를들면 ; 통계적도구 - 자료수집과기록 ( 예 : 인구집단연구 조사또는정보시스템관리 ) 연구용도구 결과, 삶의질또는환경요인측정 임상도구 요구분석, 특정상태의치료적합성평가, 직업평가, 재활및결과평가 사회정책도구 - 사회보장정책, 보상체계와정책설계및실행 교육도구 - 교과과정설계, 인식향상, 사회적행동의실행 KCF 는본질적으로건강과건강관련분류이기때문에보험, 사회보장, 노동, 교육, 경제, 사회정책 및법령개발, 환경개선과같은분야에서도이용하고있다. KCF 의근간인 ICF 는 UN 의사회분류 기준으로채택되었으며, 장애인의기회균등에관한표준규칙 (The Standard Rules on the 통계청 5

14 한국표준건강분류 Equalization of Opportunities for Persons with Disabilities 7) ) 에인용및포함되어있다. 따라서 KCF 는국가법령뿐만아니라공식적인국제인권규약을이행하는데적합한도구이다. KCF는사회보장, 보건관리평가, 지역ㆍ국가ㆍ국제수준에서의인구조사와같이폭넓고다양한적용현장에서사용하기에유용한도구다. KCF는예방, 건강증진, 사회적방해요인제거또는완화및사회적지원과협력제공장려를통한참여개선등개인의건강관리에적용할수있는정보를위한개념적틀을제공한다. 또한평가및정책수립과관련하여, 건강관리시스템의연구에서도 KCF를유용하게사용할수있다 7) 장애인의기회균등에관한표준규칙 (The Standard Rules on the Equalization of Opportunities for Persons with Disabilities) 은 1993 년 12 월 20 일제 48 차 UN 총회 ( 결의안 48/96) 에서채택되었다. UN 출판국 (1994) 에서발행 6

15 서론 서 3 한국표준건강분류의특성 론 분류는무엇을분류하는지가명확해야한다. 즉, 분류의세계, 영역, 분류단위, 구성그리고이러한 요소들이서로의관계상에서어떻게구조화되었는지명확해야한다. 다음은이러한 KCF 의기본특성에 관한설명이다. 3.1 한국표준건강분류의보편성 KCF는인간건강의모든면그리고일부건강관련웰빙의구성요소를포함하며이들을건강영역및건강관련영역 8) 에서기술한다. KCF 분류는광범위한건강의맥락을다루며사회경제적요인에의한정황과같이건강과관련이없는상황은다루지않는다. 이를테면사람이인종, 성별, 종교또는기타사회경제적특성때문에그들이처한환경에서과제수행에제약을받을경우는 KCF에서분류한건강관련참여의제한에해당되지않는다. KCF는장애를가진사람들만을다룬다는오해가널리퍼져있지만사실 KCF는모든사람을대상으로하는분류이다. 모든건강과건강관련상태는 KCF를사용하여설명할수있다. 즉, KCF는보편적으로적용된다 9). 3.2 한국표준건강분류의영역 KCF 는인간의기능수행과제약상황을기술하고이정보를조직화하는틀을제공한다. KCF 를 통해이정보는의미있고상호관련되며쉽게접근할수있는방식으로구조화된다. KCF 는정보를두가지부분으로체계화한다. 제 1 부는기능수행 (Functioning) 과장애 (Disability), 제 2 부는배경요인 (Contextual factors) 을다룬다. 그리고각각두개의구성요소가있다. 1. 기능수행 (functioning) 과장애 (disability) 의구성요소 신체 (body) 요소는두가지분류, 즉신체계통의기능분류와신체구조분류로구성된다. 두분류에 해당하는장 (chapter) 은신체계통에따라체계화되어있다. 8) 건강영역에는보기, 듣기, 걷기, 학습과기억등이있고, 건강관련영역에는교통, 교육, 사회적상호작용등이있다. 9) Bickenbach JE, Chatterji S, Badley EM, Üstün TB. Models of Disablement, universalism and the ICIDH, Social Science and Medicine, 1999, 48: 통계청 7

16 한국표준건강분류 활동과참여 (activities and participation) 요소는개인및사회적관점에서기능수행의측면을 나타내는전체영역을다룬다. 2. 배경요인 (contextual factor) 의구성요소 환경요인 (environmental factors) 목록이배경요인의첫번째구성요소다. 환경요인은기능수행과 장애의모든구성요소에영향을미치고개인이직면한환경에서부터일반적환경의순서로체계화되어 있다. 개인요인 (personal factors) 역시배경요인의구성요소이나개인과관련된사회문화적차이가크기 때문에 KCF 분류에포함되지않는다. KCF의제1부 기능수행과장애 의구성요소는두가지방식으로표현된다. 하나의방식은문제를표시하기위해사용할수있다. 예를들어, 손상, 활동제한, 참여제약은장애라는포괄적용어로요약된다. 다른하나는문제가없는 ( 중립적 ) 측면을나타낼수있다. 예를들어건강과건강관련상태의측면은기능수행이라는포괄적용어로요약된다. 기능수행과장애의이러한구성요소들은독립적이지만서로연관된네가지개념 (constructs) 을통해설명된다. 그리고이구성개념은 평가값 (qualifier) 을사용하여의미를가진다. 신체기능과구조는생리적계통또는해부학적구조내의변화에의해설명된다. 활동과참여구성요소에서는두가지구성개념, 즉능력 (capacity) 과수행 (performance) 을사용한다. (4.2 참조 ) 한사람의기능수행과장애는건강상태 ( 질환, 장애, 손상, 외상등 ) 와배경요인간의역동적인상호작용 10) 이다. 위에서지적한바와같이 배경요인 은개인및환경요인모두를포함한다. KCF는분류의필수요소로서포괄적인환경요인을포함한다. 환경요인은기능수행과장애의모든구성요소와상호작용한다. 환경요인구성요소의기본구성개념은물리적, 사회적및태도적측면의특징에의한촉진효과이거나저해효과이다. 3.3 분류단위 KCF는건강과건강관련상태를분류한다. 따라서분류단위는건강영역과건강관련영역내의범주들이다. 그러므로 KCF에서사람은분류단위가아니라는것을명심해야한다. 즉 KCF는사람을분류하는것이아니라건강영역또는건강관련영역에속한개개인의상황을기술한다. 또한그기술은언제나환경적맥락과개인요인내에서이루어진다. 10) 이상호작용은이용자에따라과정으로볼수도있고결과로볼수도있다. 8

17 서론 서 3.4 KCF 의발행 론 KCF 는다양한수준의세분화를원하는이용자들의요구를충족시키기위해두가지버전을제공 한다. 이책에서담고있는 KCF 상세버전은 4 단계분류가제시된다. 이 4 단계분류는 2 단계에서모든 영역을포함하는상위단계분류로통합될수있다. 즉 2 단계분류는 KCF 요약버전으로사용가능하다. 통계청 9

18 한국표준건강분류 4 한국표준건강분류구성요소개요 정의 11) 건강이라는관점에서 : 신체기능 (body functions) 은신체계통의생리적기능이다.( 심리적기능포함 ). 신체구조 (body structures) 는기관 (organ), 사지및그구성기관과같은신체의해부학적부위이다. 장해 (impairments) 는의미있는변형이나손실과같은신체기능또는구조의이상이다. 활동 (activity) 은개인이과제나행위를수행하는것이다. 참여 (participation) 는일상생활상황에관여하는것이다. 활동제한 (activity limitation) 은활동수행에서개인이겪을수있는어려움이다. 참여제약 (participation restriction) 은일상생활상황에관여할때개인이경험할수있는문제를 의미한다. 환경요인 (environmental factors) 은사람들이살아가는물리적, 사회적, 태도적환경을형성한다. 이개념들의개요는 [ 표 1] 에있다. [ 표 1] 에나타난바와같이, KCF 는두부분으로구성되며, 각부분에는두개의구성요소가있다. 제 1 부. 기능수행과장애 (a) 신체기능과구조 (b) 활동과참여 11) [ 부록 1] 분류와용어참조 10

19 서론 제 2 부. 배경요인 (a) 환경요인 (b) 개인요인 각구성요소는긍정적인측면과부정적인측면으로표현가능하다. 각구성요소는여러개의영역들과각영역내의범주들로이루어진다. 이범주들이분류단위다. 한개인의건강및건강관련상태는적절한하나의범주코드또는다수의코드들을부여하고평가값을추가하는방식으로기록한다. 평가값은숫자로이루어진코드이며해당범주내기능수행또는장애의영향범위, 심각성정도, 환경요인이촉진요인또는저해요인으로작용하는정도를명시한다. 표 1. 한국표준건강분류개요 제 1 부 : 기능수행과장애 제 2 부 : 배경요인 구성요소신체기능과구조활동과참여환경요인개인요인 영역 신체기능신체구조 생활영역 ( 과제, 행위 ) 기능수행과장애에대한외적영향 기능수행과장애에대한내적영향 구성개념 신체기능의변화 ( 생리학적 ) 신체구조의변화 ( 해부학적 ) 능력 (capacity) 표준환경에서의과제수행 수행 (performance) 실제환경에서의과제수행 물리적 사회적 태도적측면의특성이미치는촉진또는저해효과 개인의특성이미치는효과 긍정적 측면 기능적구조적통합 기능수행 활동참여 촉진요인 해당없음 부정적 측면 장해 장애 활동제한참여제약 저해요인 / 방해요인 해당없음 통계청 11

20 한국표준건강분류 4.1 신체기능과구조, 그리고장해 정의 : 신체기능은신체계통의생리적기능이다 ( 심리적기능포함 ). 신체구조는기관, 사지및그구성요소와같은신체의해부학적부위를말한다. 장해는의미있는변형이나손실과같은신체기능또는구조의이상이다. (1) 신체기능과신체구조는두가지의다른부분으로분류된다. 이두분류는병행하여사용하도록되어있다. 예를들어, 신체기능에는 시각기능 과같이기본적인인체감각이있으며이기능은 눈과관련구조 와구조적으로연결된다. (2) 신체 는인체의유기적조직체전체를말한다. 그러므로뇌와뇌의기능을모두포함하는데그예가정신이다. 따라서정신적 ( 또는심리적 ) 기능도신체기능에포함된다. (3) 신체기능과구조는신체계통에따라분류된다. 따라서신체구조는기관 (organ) 이아니다. 12) (4) 신체구조의장해는신체구조의이상, 결함, 손실, 또는기타의미있는변형을말한다. 장해는조직또는세포, 아세포 (subcellular) 또는분자단계에서생물학적지식과함께개념화되었다. 하지만현실적인이유로이단계들을열거하지않았다. 13) 장해는생물학적근거에따라분류했으며세포또는분자단계로분류가확장될여지가있다. 의료분야사용자들은장해는병리적원인이아니라손상에대한병리적발현이라는것을명심해야한다. (5) 장해는신체와신체기능의생의학적상태에서볼때통상적인특정인구표준에서이탈한것이고장해의구성요소는이러한기준에따라신체적 정신적기능수행을판단할자격을갖춘사람이정의내린다. (6) 장해는일시적이거나영구적일수도있으며진행성, 퇴행성, 고착상태또는간헐적이거나지속적일수도있다. 표준인구집단으로부터이탈정도가경미할수도있고심할수도있으며시간이감에따라변동을거듭할수있다. 이러한장해의특징은점 (.) 이하에서주로평가값코드로분명하게표현된다. (7) 장해는병의원인또는그발병과정과관련이없다. 예를들면, 시력이나사지상실은유전적이상또는후천적손상으로인해발생할수있다. 장해에는그원인이있기마련이다. 그러나그원인이결과로발생한장해를충분히설명하지못할수도있다. 또한장해는신체기능이나구조에장애가수반하는데이때이장애는여러질병, 장애또는생리적상태와관련있을수있다. 12) ICIDH 1980 년판에는기관수준에서언급되는경우가있으나 기관 이라는용어는정의가분명하지않다. 눈과귀는관례적으로기관으로간주되고있으나그범위를정의하기가곤란하고사지나내부기관도마찬가지다. 신체내부의하나의개체나단위인 기관 대신에, KCF 에서는 신체구조 라는용어를사용한다. 13) KCF 의상세버전을사용해분류한장해는타인이나직접관찰한사람, 또는관찰로부터의추정에의해발견되거나인정할수있어야한다. 12

21 서론 (8) 장해는건강상태의일부이거나건강상태의표현일수있지만그렇다고반드시어떤질병이존재한다거나병을앓고있어야하는것은아니다. (9) 장해는그범위가장애나질병보다더넓고포괄적이다. 예를들어하지상실은신체구조의장해이지장애나질환이아니다. (10) 장해는다른장해를초래할수있다. 예를들어근력감소는운동기능을손상시킬수있고, 심장기능은호흡기능의결손과관련있을수있으며, 손상된인지능력은사고기능과관련될수있다. (11) 신체기능과구조 (body functions and structures) 구성요소와 KCD의일부범주가, 특히증상과징후와관련해서중복되어보이지만두분류는목적이다르다. KCD의증상분류는질병이환또는서비스의이용수준을기록하기위한것인반면에 KCF 증상분류는신체기능의일부를나타내는것이며예방또는환자의요구사항파악을위해이용한다. 무엇보다도 KCF의신체기능과구조 (body functions and structures) 분류는활동과참여 (Activities and Participation) 범주와함께사용하기위한것이다. (12) 장해는규정된식별기준을통해적절한범주로분류한다.( 예 : 한계수준에따라존재또는부재 ) 이기준은신체기능과구조에도동일하게적용된다. 이기준은 (a) 손실또는결여, (b) 감소, (c) 추가또는과잉, (d) 변형이다. 일단장해가있으면 KCF의일반평가값을사용해장해의중증도에대해척도화한다. (13) 환경요인은신체기능과상호작용한다. 이는공기의질과숨쉬기, 빛과보기, 소리와듣기, 집중과방해, 지면상태와균형, 주변온도와체온조절사이의상호작용과같다. 4.2 활동과참여 / 활동제한과참여제약 정의 : 활동 (Activity) 은개인의과제나행위를수행하는것이다. 참여 (Participation) 는일상생활상황에관여하는것이다. 활동제한 (Activity limitation) 은활동수행에서개인이겪을수있는어려움이다. 참여제약 (Participation restriction) 은일상생활상황에관여할때개인이경험할수있는문제이다. (1) 활동과참여의구성요소영역은생활영역전범위 ( 기본적인학습이나보는것에서부터대인관계나고용과같은복합적인영역에이르는 ) 를다루는단일목록으로제시된다. 그구성요소는활동 (a) 이나참여 (p) 또는두가지모두를표현하기위해사용할수있다. 이구성요소의영역은수행평가값과능력평가값에의해규정된다. 따라서이목록을통해수집된정보는중복이나중첩이없는자료매트릭스이다. ([ 표 2] 참고 ) 통계청 13

22 한국표준건강분류 표 2. 활동과참여 : 자료매트릭스 영역 수행 평가값 능력 d1 학습과지식의적용 d2 일반적과제와요구 d3 의사소통 d4 움직임 d5 자기관리 d6 가정생활 d7 대인상호작용과관계 d8 주요생활영역 d9 지역사회생활, 사회생활및시민으로서의생활 (2) 수행평가값은개인이자신의현재환경속에서무엇을하고있는지를나타낸다. 현재환경은사회적맥락을포함하므로수행은 일상생활상황에관여하는것 또는실제상황속에서사람들이살아가는 삶의경험 일수있다. 14) 이상황은환경을이루는신체 사회 태도의모든측면이포함되는데이러한내용은 환경요인 이라는구성요소를이용하여분류할수있다. (3) 능력평가값은과제나행위를수행하는개인의능력을설명한다. 이구성개념은제한된시간에주어진영역속에서개인이발휘할수있는기능수행의최대능력을나타내는것이다. 개인의최대능력을평가하려면개인의능력에영향을미치는다른환경의다양한영향력을통제한표준화된환경이필요하다. 이표준화된환경은 (a) 능력평가를위해통상적으로사용되는실제환경이거나 (b) (a) 가불가능할경우, 동일한영향을갖는다고생각되는가상환경이다. 이환경은 동일한 환경또는 표준 환경이라불린다. 따라서능력 (capacity) 은환경적으로보정된개인의능력을반영한다. 이러한환경적조정의내용은모든국가모든사람들을국제적으로비교할수있도록동일해야한다. 동일하거나표준화된환경의특징은 환경요인 분류항목을사용해코드화할수있다. 능력과수행사이의격차는실제환경과표준환경의영향간차이를반영하므로수행능력을향상시키기위해개인환경에어떤변화를줄수있는지에관한유용한지침을제공한다. (4) 능력평가값과수행평가값은더나아가보조기구나인적지원유무에상관없이사용할수있다. 14) 참여 를정의할때는관여의개념을사용한다. 관여 는역할을맡거나어떤생활영역에포함되거나종사하는것, 또는필요로하는것에수용되거나접근하는것을뜻한다. [ 표 2] 의자료매트릭스상에서유일하게참여를나타내는지표는수행분류다. 그렇다고참여가곧수행을뜻하지않는다. 관여의개념은주관적인경험 ( 즉, 소속된다는의미 ) 과는구별되어야한다. 관여를별도로분류하려면 [ 부록 2] 의지침을참조해야한다. 14

23 서론 도구나인적지원이있다고하여장해를완전히없앨수는없지만, 특정영역의기능수행에대한제한을 일부 제거할수있다. 이런유형의분류는보조기구가없을때개인의기능수행에어느정도제한이있는가를파악하는데특히유용하다. [ 부록 2] 참조 (5) 개인이이러한영역의기능을수행하는방식에있어양적또는질적변화가있을때, 문제나어려움이발생할수있다. 제한또는제약은통상적으로인정되는인구표준을기준으로평가한다. 개인의능력과수행을비교하는척도인표준또는기준은질환, 장애, 손상을비롯해그와유사한건강상태를갖지않은개인의능력과수행을말한다. 제한또는제약은관찰된수행과기대된수행간의불일치를의미한다. 기대된수행은인구표준으로특정한병태가없는사람들의경험을의미한다. 능력평가값에동일한표준을사용하여수행을증진시키기위해개인의환경에무엇을할지를추론할수있다. (6) 개인이장해가없는경우에도수행과관련된문제가사회적환경으로부터직접적으로초래될수있다. 예를들어, 어떠한증상과질환이없는 HIV가양성인사람또는특정질병에걸리기쉬운유전적소인을가진사람은장해가없고아무런지장없이역할을충분히수행할수있지만서비스이용을거부당하고차별받거나오명이붙기때문에능력을발휘하지못할수있다. (7) 활동과참여구성요소의영역을기반으로 활동 과 참여 를구분하기어렵다. 마찬가지로, 전문가들의접근방식과이론적체계의국제적다양성과이질성을고려할때, 영역에근거한 개인적 관점과 사회적 관점을구분하는것이가능하지않다. 따라서 KCF는사용자가원한다면그들이원하는방식으로활동과참여를구분하기위해사용할수있는단일목록을제공한다. 이에대해서는 [ 부록3] 에더자세하게설명되어있다. 활동과참여를구분할수있는네가지방법은다음과같다. (a) 일부영역은 활동 으로, 다른영역은 참여 로지정하되상호영역이중복되지않도록한다. (b) (a) 와동일하나, 일부중복을허용한다. (c) 모든세부범주는 활동 으로, 포괄적범주는 참여 로지정한다. (d) 모든영역을 활동 과 참여 로사용한다. 4.3 배경요인 배경요인은개인의삶과생활의전체적인배경을의미한다. 배경요인은환경요인과개인요인의두 가지로이루어지며, 이는특정건강상태를가진개인과그개인의건강및건강관련상태에영향을 미친다. 통계청 15

24 한국표준건강분류 환경요인은사람들이삶을영위하는신체적 사회적 태도적환경을형성한다. 이들요인은개인의 외부요소이며, 사회구성원으로서개인의과제수행, 행위나과제를수행하는능력또는개인의신체 기능과구조에긍정적이거나부정적인영향을미칠수있다. (1) 환경요인은다음두가지상이한수준의관점에서체계화된다. (a) 개인적수준 - 가정, 직장, 학교와같은주변환경을포함한개인과밀접한환경을의미한다. 이수준에는가족, 지인, 동료, 낯선사람과같은타인과의직접접촉과개인이이들과의대면하는환경의물리적 물질적특징이포함된다. (b) 사회적수준 - 개인에게영향을미치는지역사회나사회의공식적 비공식적사회구조, 서비스, 접근방식또는제도를의미한다. 이수준에는법, 법규, 공식적 비공식적규칙, 태도와이념뿐만아니라업무환경, 지역사회활동, 정부기관, 통신 교통서비스와비공식적인사회적연결망과관련된조직과서비스를포함한다. (2) 환경요인은신체기능과구조의구성요소및참여와활동의구성요소와상호작용한다. 각구성요소에있어서그상호작용의특성과정도는향후과학적인연구를통해더욱구체화될것이다. 장애 는개인의건강상태와개인요인간복잡한관계및개인이살고있는환경인외적요소의결과나산출물로나타난다고할수있다. 이런관계때문에, 상이한환경은동일한건강상태의사람에게다른영향을끼칠수있다. 저해요인이있거나촉진요인이없는환경은개인의 수행 을제한하고더많이촉진하는환경에서는개인의수행이증가할수있다. 사회가장애물을만들거나 ( 예 : 접근이어려운건물 ) 촉진제 ( 예 : 보조기구 ) 를제공하지않기때문에사회가개인의 수행 을방해할수있다. 개인요인은한개인만이가진자신의삶과생활방식의배경으로서, 건강상태나건강수준의일부가아닌개인의특징으로구성된다. 이요인은성별, 인종, 나이, 기타건강상태, 체력, 생활방식, 습관, 양육, 상황대처방식, 사회적배경, 교육, 직업, 과거와현재의경험 ( 과거생활사건과현재사건 ), 전반적인행동유형과성격유형, 개인의심리학적특성과기타성격등으로이루어지며, 이것들중일부또는전부는장애의모든수준에서영향을미칠수있다. 개인요인은 KCF에서분류하지않는다. 하지만중재활동의결과에영향을주는개인요인이어떻게기여하는지보여주기위해 [ 그림 1] 에포함시켰다. 16

25 서론 5 기능수행과장애의모형 5.1 기능수행과장애의과정 하나의분류로써 KCF는기능수행과장애의과정을모형화하지않는다. 그러나구성개념과영역을지도화할수있는수단을제공함으로써기능수행과장애의과정을기술할수있다. KCF는상호적이고혁신적인과정으로서기능수행과장애를분류하는다양한관점의접근방식을제공한다. KCF는이러한과정의모형을만들고그과정의서로다른측면의연구를원하는사용자를위해구성요소를제공한다. 이런점에서 KCF는언어라할수있으며, KCF를활용하여만들수있는글은사용자의창의력과과학적성향에영향을받는다. 다양한구성요소간상호작용 15) 에대한일반적이해를시각화하는데 [ 그림 1] 에제시되어있는도표가도움이될수있다. 그림 1. 한국표준건강분류구성요소간의상호관계 건강상태 ( 장애또는질병 ) 신체기능및구조 활동 참여 환경요인 개인요인 위그림에따르면, 특정영역에서개인의기능수행은건강상태와배경요인 ( 환경요인과개인요인 ) 간의복잡한관계또는상호작용이다. 역동적상호작용이각개체들사이에서이루어진다. 한개체 내중재작용은하나또는그이상의다른개체를변화시킬수있다. 이런상호작용은특별하며항상 15) KCF 는기능수행과장애의상호관계를다룬다는점에서 1980 년판 ICIDH 와근본적으로다르다. 다차원모형은상호관계가복잡하여그림으로나타낼경우완전하지못하고잘못해석될가능성이있다. 여기에제시한모형도복합적인상호관계를나타내고있는데다른측면에중점을두어나타낼수도있을것이다. 서로다른요소나구성인자들사이의상호관계를해석하는방법도다양하다.( 예를들면, 신체기능에대한환경요인의영향은참여에대한환경요인의영향과물론다르다.) 통계청 17

26 한국표준건강분류 예측할수있는일대일관계로존재하는것은아니다. 상호작용은양방향으로작용하며 장애 의존재가건강상태자체를변화시킬수도있다. 하나이상의장해로인한능력의제한또는하나이상의제한으로인한수행의제약은당연히생각할수있을것이다. 그러나중요한것은, 이러한구성개념에대한자료를독립적으로수집하고모아진자료들간의연관성과인과관계를탐구하는것이다. 전체건강경험을기술하고자한다면 KCF의모든구성요소가유용하다. 예시는아래와같다 : 장해가있어도능력에는제한을받지않을수있다. ( 예 : 개인의능력에영향을미치지않는한센병으로인한외모손상 ) 뚜렷한장해없이수행문제와능력제한이있을수있다. ( 예 : 여러가지질환으로인해일상활동의수행저하 ) 장해나능력제한없이수행문제가생길수있다. ( 예 : 대인관계나직장에서편견이나차별을받는 HIV 양성판정을받은사람이나정신질환이완치된사람 ) 도움이없으면능력이제한되나현재환경에서수행의문제는없는사람 ( 예 : 이동에제한이있는개인이이동을위한보조도구를사회로부터제공받음 ) 역효과를경험할수있다. ( 예 : 팔다리를사용하지않음으로근육위축, 시설에수용됨으로써사회성을상실 ) [ 부록 4] 의사례는구성개념간의가능한상호작용을상세히보여준다. [ 그림 1] 은기능수행과장애의과정에서배경요인 ( 즉, 환경요인과개인요인 ) 이어떠한역할을하는지보여준다. 이런요인들은특정건강상태를가진개인과상호작용을하여그개인의기능수행의수준과정도를결정한다. 환경요인은개인에게외적인요소이고 ( 예 : 사회의태도, 건축물의구조, 사법제도등 ) 환경요인 범주에서분류된다. 반면에개인요인은현재 KCF버전에분류되어있지않다. 개인요인은성별, 인종, 연령, 건강, 생활방식, 습관, 대처방식및기타유사한요인을포함한다. 필요한경우사용자가개인요인을평가할수있다. 5.2 의학적모형과사회적모형 다양한개념적모형 16) 들이장애와기능수행을이해하고설명하기위해제시되었다. 이것은 의학적모형 과 사회적모형 의변증법적논리로표현할수있다. 의학적모형은장애를한개인의문제로간주하며질병, 외상또는다른건강상태로인하여발생한것으로전문가로부터의학적차원의치료를필요로한다. 장애관리는장애의치료, 개인의적응, 행동변화를목표로진행된다. 의학적치료가 16) 여기에서의 모형 은앞에서와는달리구성요소또는패러다임을뜻한다. 18

27 서론 주된문제이고, 정치적으로보건의료정책의개정과개혁에관심이있다. 반면에사회적모형은장애를주로사회적으로야기된문제로간주하며, 근본적으로개인이사회에완전히통합되는문제로본다. 사회적모형에서장애는한개인의특성이아니라, 여러가지상황이복합적으로모아진것으로대다수는사회적환경에의해만들어진다. 이런이유로장애관리에는사회적행동이필요하고, 장애인이사회생활전반에자유롭게참여할수있도록환경을재정립시키는것은통상적으로사회전체의책임이다. 따라서이것은사회변화를요구하는태도적또는이념적문제이며정치적측면에서는인권문제다. 이사회적모형에서장애는정치적문제이다. KCF 는대조적인이두가지모형의통합을근간으로한다. 기능수행에관한다양한관점을통합 하기위해 생물심리사회적 (biopsychosocial) 접근방법을활용한다. 따라서, KCF 는건강에대한 생물학적, 개인적, 사회적으로상이한건강에대한관점을일관된시각으로통합하고자한다. 17) 17) [ 부록 7] WHO 의장애가있는사람에관한고찰참조 통계청 19

28 한국표준건강분류 6 한국표준건강분류의사용 KCF는인간의기능수행과장애에대한분류로, 건강과건강관련영역을체계적으로분류한다. 각구성요소내에서, 영역은원인, 유형, 유사성같은공통적인특성에따라세부적으로분류하였고의미있는순서로정렬하였다. KCF는일련의원칙에따라체계화되며 [ 부록 1. 참조 ], 이들원칙은분류단계사이의밀접한관계와분류상계층구조를제시한다. 그러나 KCF의일부범주는비계층적방식, 즉수직적인방식이아닌수평적인방식으로정렬되어있다. 사용과관련하여, 분류의구조적특징은다음과같다. (1) KCF는 통속적인 건강의정의가아니라건강과건강관련영역에대한표준화된조작적정의를제공한다. 이정의는각영역의필수속성 ( 예 : 본질, 특성, 관계 ) 을설명하고각영역에포함되는내용과제외되는내용에대한정보를제공한다. 이정의들은평가를위해통상적으로사용되는기준점을가지고있어서설문지로변환될수있다. 반대로기존평가도구를이용해얻어낸결과들은 KCF 용어로분류할수있다. 예를들면 시각기능 을한쪽또는양쪽눈으로거리의변화에따라형태와윤곽을감지하는기능측면에서정의한다. 그러므로시력이상의중증도를이러한매개변수와연관지어경도 (mild), 중등도 (moderate), 중증 (severe), 또는완전 (complete) 이상단계로분류할수있다. (2) KCF는문자와숫자조합체계를사용하며알파벳 b, s, d, e는신체기능, 신체구조, 활동과참여, 환경요인을의미한다. 알파벳뒤에숫자를사용하며, 숫자는한자리숫자인장 (chapter) 번호로시작하고, 그뒤에 2단계분류 ( 두자리숫자 ) 그리고 3단계및 4단계 ( 각한자리숫자 ) 가배치된다. (3) KCF범주는상위범주가그아래세분화된하위범주를포함한다. ( 예를들면 활동과참여 구성요소의 4장 움직임 (mobility) 에는 서기, 앉기, 보행, 물건옮기기 등별개의범주를포함한다. 요약버전은 2단계로이루어져있는반면, 상세버전은 4단계를포함하고있다. 하지만요약버전과상세버전의코드는서로일치한다. 상세버전을사용하여요약버전으로축약할수있다. (4) 모든사람은각단계별로다양한코드를가질수있다. 이코드들은독립적일수도혹은서로관련있을수도있다. (5) KCF 코드는평가값이있어야만완성되며건강수준의정도를나타낸다 ( 예 : 문제의심각성 ). 평가값은점 (.) 또는분리기호다음에하나또는두자리이상의숫자로분류된다. 어떤코드를사용하든적어도하나의평가값을함께사용해야한다. 평가값이없는코드는담고있는의미가없다. 20

29 서론 (6) 신체기능과구조의제1평가값, 활동과참여의 수행과능력 평가값, 환경요인의제1평가값은모두각구성요소에서어느정도문제가있는지를설명한다. (7) KCF의모든세가지구성요소 ( 신체기능과구조, 활동과참여, 환경요인 ) 는동일한일반척도를이용해수치화할수있다. 문제가있다는것은구성개념에따라장해, 제한, 제약또는저해를의미한다. 아래괄호에제시된적절한한정어를관련된분류영역에따라선택해야한다 ( 여기서 xxx는 2단계영역을나타낸다 ). 보편적으로사용되는이러한측정법을마련하기위해연구를통한평가절차의개발이필요하다. 장해, 능력제한, 수행문제또는저해요인을수량화할수있는보정된평가도구나기타표준들이있을경우를위하여넓은범위의백분율을제공한다. 예를들면, 이상없음 이나 완전이상 은최대 5% 의오차범위를가진코드이다. 중등도이상 은완전이상의최대절반까지의기간또는수준으로정의한다. 백분율은백분위와같이관련있는인구표준을참고하여다양한영역에서조정할수있다. xxx.0 xxx.1 xxx.2 xxx.3 xxx.4 xxx.8 xxx.9 이상없음 (No problem) 경도이상 (Mild problem) 중등도이상 (Moderate problem) 중증이상 (Severe problem) 완전이상 (Complete problem) 명시되지않음 (Not specified) 해당없음 (Not applicable) 없는, 부재의, 사소한 0-4% 약간의, 낮은 5-24% 중간의, 보통의 25-49% 높은, 심각한 50-95% 전체 % (8) 환경요인의경우, 제1평가값은환경의긍정적인효과 ( 촉진요인 ) 또는부정적인효과 ( 저해요인 ) 의정도를가리키는데사용할수있다. 두가지모두 0에서 4로표시되지만촉진요인은점 (.) 대신덧셈기호 (+) 가사용된다.( 예 : e110+2) 환경요인은 (a) 각구성개념과관련하여개별적으로분류하거나, (b) 개별적구성개념과관계없이전체적으로분류할수있다. 환경요인의영향과속성을보다명확하게나타내기때문에 (a) 를선호한다. (9) 다양한사용자를위해, 각항목의코드에다른종류의정보를추가하는것은적절하고유용하다. 유용하게사용할수있는추가적인 평가값 은다양하다. [ 표 3] 은각구성요소별평가값의세부사항을나열하고개발된추가평가값을제시한다. 통계청 21

30 한국표준건강분류 (10) 건강영역과건강관련영역의설명은주어진시점에서해당영역을언급한것이다 ( 예를들면스냅사진처럼 ). 그러나여러시점에서영역들을사용하면시간경과와과정에따른진행을설명할수있다. (11) KCF에서개인의건강과건강관련상태는일련의코드로표현된다. 4개의구성요소에따라 1단계분류에서한사람에게부여되는최대코드수는 30개 ( 신체기능 8개, 신체구조 8개, 활동과참여 9개, 환경요인 5개 ) 이고, 2단계분류에서적용되는최대코드수는 370개로더세부적인단계는 1,141개이다. 실생활에 KCF를적용하는데 3~18개의코드조합이 2단계 ( 세자리수 ) 사례를정확하게기술하기에적합하다. 일반적으로더상세한 4단계분류, 즉상세버전은재활결과, 노인병치료등전문적인서비스에이용하는반면에 2단계분류인요약버전은설문조사와임상결과평가에이용할수있다. 더자세한코드부여지침은 [ 부록 2] 에소개하였다. KCF 분류이용자는사용하기전에통계청의 KCF 분류사용법에대한교육이수를권유한다. 22

31 서론 표 3. 평가값 (Qualifier) 구성요소제 1 평가값제 2 평가값 신체기능 (b) 장해정도또는규모를나타내는, 음 (-) 의척도를가진일반평가값 예 : b167.3 언어의정신기능에대한중증장해를의미 없음 신체구조 (s) 장해정도또는규모를나타내는음 (-) 의척도를가진일반평가값 예 : s730.3 상지의중증장해를의미 각신체구조변화의성질을나타낸다. 0 변화없음 1 완전결여 2 부분결여 3 부가부분 4 크기이상 5 불연속성 6 위치를벗어남 7 체액축적을포함한구조의질적변화 8 명시되지않음 9 해당없음 예 : s 상지의부분결여를의미 활동과참여 (d) 수행 일반평가값 실제환경에서의문제 예 : d5101.1_ 현재환경에서이용할수있는 보조기구를이용해 전신목욕을하는데경도의어려움이있음을의미 능력 일반평가값 도움이없으면제한됨 예 : d5101._2 전신목욕에중등도의어려움이있다. 즉, 보조기구나다른사람의도움이없으면목욕하는데중등도의어려움이있음을의미 환경요인 (e) 저해정도또는촉진정도를각각음 (-) 또는양 (+) 으로표시하는일반평가값 예 : e130.2 교육용제품이중등도저해요인이있음을의미한다. 반대로 e130+2 는교육용제품이중등도촉진요인이있음을의미 없음 통계청 23

32

33 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 1 단계분류 One Level Classification List of chapter headings in the classification

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35 1 단계분류 신체기능 Body functions 1 장정신기능 2 장감각기능과통증 3 장음성과말하기의기능 4 장심혈관계통, 혈액계통, 면역계통과호흡계통기능 5 장소화계통, 대사와내분비계통기능 6 장비뇨생식계통기능 7 장신경근골격계및운동과관련된기능 8 장피부와관련구조의기능 Mental Functions Sensor functions and pain Voice and speech functions Functions of the cardiovascular, haematological, immunological and respiratory systems Functions of the digestive, metabolic and endocrine systems Genitourinary and reproductive function Neuromusculoskeletal and movement related functions Functions of the skin and related structures 1 단계분류 신체구조 Body structures 1 장신경계통구조 2 장눈, 귀와관련구조 3 장음성및말하기와관련된구조 4 장심혈관계통, 면역계통과호흡계통구조 5 장소화계통, 대사계통및내분비계통과관련된구조 6 장비뇨생식계통과관련된구조 7 장움직임과관련된구조 8 장피부와관련구조 Structure of the nervous system The eye, ear and related structures Structures involved in voice and speech Structures of the cardiovascular, immunological and respiratory systems Structures related to the digestive, metabolic and endocrine systems Structure related to the genitourinary and reproductive systems Structures related to movement Skin and related structures 활동과참여 Activities and participation 1장 학습과지식의적용 2장 일반적과제와요구 3장 의사소통 4장 움직임 5장 자기관리 Learning and applying knowledge General tasks and demands Communication Mobility Self-care 통계청 27

36 한국표준건강분류 6장 가정생활 7장 대인상호작용과관계 8장 주요생활영역 9장 지역사회생활, 사회생활및시민으로서의생활 Domestic life Interpersonal interactions and relationships Major life areas Community, social and civic life 환경요인 Environmental factors 1장 제품과기술 2장 자연환경과인위적환경변화 3장 지원과관계 4장 태도 5장 서비스, 제도와정책 Products and technology Natural environment and human-made changes to environment Support and relationships Attitudes Services, systems and policies 28

37 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 2 단계분류 Two Level Classification List of chapter headings and first branching level in the classification

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39 2 단계분류 신체기능 제 1 장정신기능 전반적정신기능 (b110-b139 ) BODY FUNCTIONS Mental Functions Global mental functions b110 b114 b117 b122 b126 b130 b134 b139 의식기능지남력기능지적기능전반적정신사회적기능기질과인격기능에너지와욕동기능수면기능기타명시된및상세불명의전반적정신기능 Consciousness functions Orientation functions Intellectual functions Global psychosocial functions Temperament and personality functions Energy and drive functions Sleep functions Global mental functions, other specified and unspecified 특정정신기능 (b140-b189) b140 주의력기능 b144 기억기능 b147 정신운동기능 b152 정서기능 b156 지각기능 b160 사고기능 b164 고위인지기능 b167 언어의정신기능 b172 계산기능 b176 복잡한동작의순서를매기는정신기능 b180 자아와시간의경험기능 b189 기타명시된및상세불명의특정정신기능 b198 기타명시된정신기능 b199 상세불명의정신기능 Specific mental functions Attention functions Memory functions Psychomotor functions Emotional functions Perceptual functions Thought functions Higher-level cognitive functions Mental functions of language Calculation functions Mental function of sequencing complex movements Experience of self and time function Specific mental functions, other specified and unspecified Mental functions, other specified Mental functions, unspecified 2 단계분류 제 2 장감각기능과통증 시각과관련기능 (b210-b229) Sensor functions and pain Seeing and related functions b210 시각기능 Seeing functions 통계청 31

40 한국표준건강분류 b215 b220 b229 안구주변구조의기능 눈및주변구조와관련된감각 기타명시된및상세불명의시각과관련기능 Functions of structures adjoining the eye Sensations associated with the eye and adjoining structures Seeing and related functions, other specified and unspecified 청각과전정기능 (b230-b249) Hearing and vestibular functions b230 b235 b240 b249 청각기능 전정기능 청각및전정기능과관련된감각 기타명시된및상세불명의청력및전정기능과관련된감각 Hearing functions Vestibular functions Sensations associated with hearing and vestibular function Hearing and vestibular functions, other specified and unspecified 부가적감각기능 (b250-b279) Additional sensory functions b250 b255 b260 b265 b270 b279 미각기능후각기능고유감각기능촉각기능온도및기타자극과관련된감각기능기타명시된및상세불명의부가적감각기능 Taste function Smell function Proprioceptive function Touch function Sensory functions related to temperature and other stimuli Additional sensory functions, other specified and unspecified 통증 (b ) Pain b280 b289 b298 b299 통증감각기타명시된및상세불명의통증감각기타명시된감각기능과통증상세불명의감각기능과통증 Sensation of pain Sensation of pain, other specified and unspecified Sensory functions and pain, other specified Sensory functions and pain, unspecified 제 3 장음성과말하기의기능 Voice and speech functions b310 b320 b330 b340 음성기능조음기능말하기기능의유창성과리듬대체음성기능 Voice functions Articulation functions Fluency and rhythm of speech functions Alternative vocalization functions 32

41 2 단계분류 b398 기타명시된음성과말하기의기능 b399 상세불명의음성과말하기의기능 Voice and speech functions, other specified Voice and speech functions, unspecified 제 4 장심혈관계통, 혈액계통, 면역계통과 호흡계통기능 심혈관계통기능 (b410-b429) Functions of the cardiovascular, haematological, immunological and respiratory systems Functions of the cardiovascular system b410 b415 b420 b429 심장기능혈관기능혈압기능기타명시된및상세불명의심혈관계통기능 Heart functions Blood vessel functions Blood pressure functions Functions of the cardiovascular system, other specified and unspecified 혈액계통과면역계통기능 (b430-b439) b430 b435 b439 혈액계통기능 면역계통기능 기타명시된및상세불명의혈액계통과면역계통기능 호흡계통기능 (b440-b449) Functions of the haematological and immunological systems Haematological system functions Immunological system functions Functions of the haematological and immunological systems, other specified and unspecified Functions of the respiratory system 2 단계분류 b440 b445 b449 호흡기능 호흡근육기능 기타명시된및상세불명의호흡계통기능 Respiration functions Respiratory muscle functions Functions of the respiratory system, other specified and unspecified 심혈관계통과호흡계통의부가적인기능과감각 (b450-b469) Additional functions and sensations of the cardiovascular and respiratory systems b450 b455 b460 b469 부가적인호흡기능 운동내성기능 심혈관및호흡기능과관련된감각 기타명시된및상세불명의심혈관과호흡의부가적인기능과감각 Additional respiratory functions Exercise tolerance functions Sensations associated with cardiovascular and respiratory functions Additional functions and sensations of the cardiovascular and respiratory systems, other specified and unspecified 통계청 33

42 한국표준건강분류 b498 기타명시된심혈관계통, 혈액계통, 면역계통과호흡계통기능 b499 상세불명의심혈관계통, 혈액계통, 면역계통과호흡계통기능 Functions of the cardiovascular, haematological, immunological and respiratory systems, other specified Functions of the cardiovascular, haematological, immunological and respiratory systems, unspecified 제 5 장소화계통, 대사와내분비계통기능 소화계통과관련된기능 (b ) Functions of the digestive, metabolic and endocrine systems Functions of related to the digestive systems b510 b515 b520 b525 b530 b535 b539 섭취기능 소화기능 동화기능 배변기능 체중유지기능 소화계통과관련된감각 기타명시된및상세불명의소화계통과관련된기능 Ingestion functions Digestive functions Assimilation functions Defecation functions Weight maintenance functions Sensations associated with the digestive system Functions related to the digestive system, other specified and unspecified 대사및내분비계통과관련된기능 (b540-b559) Functions related to metabolism and the endocrine system b540 b545 b550 b555 b559 b598 b599 전반적대사기능 수분, 무기질과전해질의균형기능 체온조절기능 내분비선기능 기타명시된및상세불명의대사및내분비계통과관련된기능 기타명시된소화계통, 대사와내분비계통기능 상세불명의소화계통, 대사와내분비계통기능 General metabolic functions Water, mineral and electrolyte balance functions Thermoregulatory functions Endocrine gland functions Functions related to metabolism and the endocrine system, other specified and unspecified Functions of the digestive, metabolic and endocrine systems, other specified Functions of the digestive, metabolic and endocrine systems, unspecified 34

43 2 단계분류 제 6 장비뇨생식계통기능 비뇨기능 (b610-b639) Genitourinary and reproductive function Urinary function b610 b620 b630 b639 소변배설기능배뇨기능비뇨기능과관련된감각기타명시된및상세불명의비뇨기능 Urinary excretory functions Urination functions Sensations associated with urinary functions Urinary functions, other specified and unspecified 생식기능 (b640-b679) b640 성기능 b650 월경기능 b660 출산기능 b670 생식기능과관련된감각 b679 기타명시된및상세불명의생식기능 b698 기타명시된비뇨생식기능 b699 상세불명의비뇨생식기능 제7장신경근골격계및운동과관련된기능관절과뼈의기능 (b710-b729) Genital and reproductive functions Sexual functions Menstruation functions Procreation functions Sensations associated with genital and reproductive functions Genital and reproductive functions, other specified and unspecified Genitourinary and reproductive functions, other specified Genitourinary and reproductive functions, unspecified Neuromusculoskeletal and movement related functions Functions of the joints and bones 2 단계분류 b710 b715 b720 b729 관절의가동기능 관절의안정기능 뼈의가동기능 기타명시된및상세불명의관절과뼈의기능 Mobility of joint functions Stability of joint functions Mobility of bone functions Functions of the joints and bones, other specified and unspecified 근육기능 (b730-b749) Muscle functions b730 b735 b740 b749 근력기능근긴장도기능근지구력기능기타명시된및상세불명의근육기능 Muscle power functions Muscle tone functions Muscle endurance functions Muscle functions, other specified and unspecified 통계청 35

44 한국표준건강분류 운동기능 (b750-b789) Movement functions b750 b755 b760 b761 b765 b770 b780 b789 b798 b799 반사운동기능 불수의운동반응기능 수의운동의조절기능 자발적동작 불수의운동기능 보행형태기능 근육및운동기능과관련된감각 기타명시된및상세불명의운동기능 기타명시된신경근골격계및운동과관련된기능 상세불명의신경근골격계및운동과관련된기능 Motor reflex functions Involuntary movement reaction functions Control of voluntary movement functions Spontaneous movements Involuntary movement functions Gait pattern functions Sensations related to muscles and movement functions Movement functions, other specified and unspecified Neuromusculoskeletal and movement-related functions, other specified Neuromusculoskeletal and movement-related functions, unspecified 제 8 장피부와관련구조의기능 피부의기능 (b810-b849) Functions of the skin and related structures Functions of the skin b810 b820 b830 b840 b849 피부의보호기능피부의수복기능피부의기타기능피부와관련된감각기타명시된및상세불명의피부의기능 Protective functions of the skin Repair functions of the skin Other functions of the skin Sensation related to the skin Functions of the skin, other specified and unspecified 모발과손발톱의기능 (b850-b869) Functions of the hair and nails b850 b860 b869 b898 b899 모발의기능 손발톱의기능 기타명시된및상세불명의모발과손발톱의기능 기타명시된피부와관련구조의기능 상세불명의피부와관련구조의기능 Functions of hair Functions of nails Functions of the hair and nails, other specified and unspecified Functions of the skin and related structures, other specified Functions of the skin and related structures, unspecified 36

45 2 단계분류 신체구조 제 1 장신경계통구조 Body Structures Structure of the nervous system s110 s120 s130 s140 s150 s198 s199 뇌구조척수와관련구조수막구조교감신경계통구조부교감신경계통구조기타명시된신경계통구조상세불명의신경계통구조 Structure of brain Spinal cord and related structures Structure of meninges Structure of sympathetic nervous system Structure of parasympathetic nervous system Structure of the nervous system, other specified Structure of the nervous system, unspecified 제 2 장눈, 귀와관련구조 The eye, ear and related structures s210 s220 s230 s240 안와구조안구구조눈주위구조외이구조 Structure of eye socket Structure of eyeball Structures around eye Structure of external ear 2 단계 s250 중이구조 Structure of middle ear s260 s298 s299 내이구조기타명시된눈, 귀와관련구조상세불명의눈, 귀와관련구조 Structure of inner ear Eye, ear and related structures, other specified Eye, ear and related structures, unspecified 분류 제 3 장음성및말하기와관련된구조 Structures involved in voice and speech s310 s320 s330 s340 s398 s399 코구조입구조인두구조후두구조기타명시된음성및말하기와관련된구조상세불명의음성및말하기와관련된구조 Structure of nose Structure of mouth Structure of pharynx Structure of larynx Structures involved in voice and speech, other specified Structures involved in voice and speech, unspecified 통계청 37

46 한국표준건강분류 제 4 장심혈관계통, 면역계통과호흡계통구조 Structures of the cardiovascular, immunological and respiratory systems s410 s420 s430 s498 s499 심혈관계통구조 면역계통구조 호흡계통구조 기타명시된심혈관계통, 면역계통과호흡계통구조 상세불명의심혈관계통, 면역계통과호흡계통구조 Structure of cardiovascular system Structure of immune system Structure of respiratory system Structures of the cardiovascular, immunological and respiratory systems, other specified Structures of the cardiovascular, immunological and respiratory systems, unspecified 제 5 장소화계통, 대사계통및내분비계통과 관련된구조 Structures related to the digestive, metabolic and endocrine systems s510 s520 s530 s540 s550 s560 s570 s580 s598 s599 침샘구조 식도구조 위구조 장구조 췌장구조 간구조 담낭과담관구조 내분비선구조 기타명시된소화계통, 대사계통및내분비계통과관련된구조 상세불명의소화계통, 대사계통및내분비계통과관련된구조 Structure of salivary glands Structure of oesophagus Structure of stomach Structure of intestine Structure of pancreas Structure of liver Structure of gall bladder and ducts Structure of endocrine glands Structures related to the digestive, metabolic and endocrine systems, other specified Structures related to the digestive, metabolic and endocrine systems, unspecified 제 6 장비뇨생식계통과관련된구조 Structure related to the genitourinary and reproductive systems s610 s620 s630 s698 s699 비뇨계통구조골반바닥구조생식계통구조기타명시된비뇨생식계통과관련된구조상세불명의비뇨생식계통과관련된구조 Structure of urinary system Structure of pelvic floor Structure of reproductive system Structures related to the genitourinary and reproductive systems, other specified Structures related to the genitourinary and reproductive systems, unspecified 38

47 2 단계분류 제 7 장움직임과관련된구조 Structures related to movement s710 s720 s730 s740 s750 s760 s770 s798 s799 머리와목부위의구조어깨부위의구조상지구조골반부위의구조하지구조몸통구조움직임과관련된부가적인근골격계통구조기타명시된움직임과관련된구조상세불명의움직임과관련된구조 Structure of head and neck region Structure of shoulder region Structure of upper extremity Structure of pelvic region Structure of lower extremity Structure of trunk Additional musculoskeletal structures related to movement Structures related to movement, other specified Structures related to movement, unspecified 제 8 장피부와관련구조 Skin and related structures s810 s820 s830 s840 s898 s899 피부부위의구조피부샘구조손발톱구조모발구조기타명시된피부와관련구조상세불명의피부와관련구조 Structure of areas of skin Structure of skin glands Structure of nails Structure of hair Skin and related structures, other specified Skin and related structures, unspecified 활동과참여 제 1 장학습과지식의적용 의도적감각경험 (d110-d129) ACTIVITIES AND PARTICIPATION Learning and applying knowledge Purposeful sensory experiences d110 d115 d120 d129 보기듣기기타의도적인지각기타명시된및상세불명의의도적감각경험 Watching Listening Other purposeful sensing Purposeful sensory experiences, other specified and unspecified 통계청 39

48 한국표준건강분류 기본적학습 (d130-d159) Basic learning d130 d132 d133 d135 d137 d138 d140 d145 d150 d155 d159 모방언어습득부가적인언어습득반복개념습득정보습득읽기학습쓰기학습계산학습기술습득기타명시된및상세불명의기본적학습 Copying Acquiring language Acquiring an additional language Rehearsing Acquiring concepts Acquiring information Learning to read Learning to write Learning to calculate Acquiring skills Basic learning, other specified and unspecified 지식의적용 (d160-d179) Applying knowledge d160 d163 d166 d170 d172 d175 d177 d179 d198 d199 주의집중사고읽기쓰기계산문제해결의사결정기타명시된및상세불명의지식의적용기타명시된학습과지식의적용상세불명의학습과지식의적용 Focusing attention Thinking Reading Writing Calculating Solving problems Making decisions Applying knowledge, other specified and unspecified Learning and applying knowledge, other specified Learning and applying knowledge, unspecified 제 2 장일반적과제와요구 General tasks and demands d210 d220 d230 d240 d298 d299 단일과제수행다중과제수행일상생활이행스트레스와기타심리적요구에대한대응기타명시된일반적과제와요구상세불명의일반적과제와요구 Undertaking a single task Undertaking multiple tasks Carrying out daily routine Handling stress and other psychological demands General tasks and demands, other specified General tasks and demands, unspecified 40

49 2 단계분류 제 3 장의사소통 의사소통 - 수용 (d310-d329) Communication Communicating - receiving d310 d315 d320 d325 d329 의사소통 구두메시지수용의사소통 비구어적메시지수용의사소통 표준수화수용의사소통 문자메시지수용의사소통 - 기타명시된및상세불명의수용 Communicating with - receiving - spoken messages Communicating with - receiving - nonverbal messages Communicating with - receiving - formal sign language messages Communicating with - receiving - written messages Communicating - receiving, other specified and unspecified 의사소통 - 표현 (d330-d349) Communicating - producing d330 d332 d335 d340 d345 d349 말하기노래부르기비구어적메시지표현표준수화로메시지표현메시지쓰기기타명시된및상세불명의의사소통 - 표현 Speaking Singing Producing nonverbal messages Producing messages in formal sign language Writing messages Communication - producing, other specified and unspecified 대화와의사소통기기및기술의이용 (d350-d369) d350 d355 d360 d369 d398 d399 대화 토론 의사소통기기와기술의이용 기타명시된및상세불명의대화와의사소통기기및기술의이용 기타명시된의사소통 상세불명의의사소통 Conversation and use of communication devices and techniques Conversation Discussion Using communication devices and techniques Conversation and use of communication devices and techniques, other specified and unspecified Communication, other specified Communication, unspecified 통계청 41

50 한국표준건강분류 제 4 장움직임 자세변경과유지 (d410-d429) d410 d415 d420 d429 기본적자세변경 신체의자세유지 자리이동 기타명시된및상세불명의자세변경과유지 Mobility Changing and maintaining body position Changing basic body position Maintaining a body position Transferring oneself Changing and maintaining body position, other specified and unspecified 물건나르기, 옮기기, 다루기 (d430-d449) Carrying, moving and handling objects d430 d435 d440 d445 d446 물건들어올려나르기 다리로물건옮기기 미세한손동작 손과팔의이용 미세한발동작 d449 기타명시된및상세불명의물건나르기, 옮기기, 다루기 Lifting and carrying objects Moving objects with lower extremities Fine hand use Hand and arm use Fine foot use Carrying, moving and handling objects, other specified and unspecified 보행과이동 (d450-d469) Walking and moving d450 d455 d460 d465 d469 보행이동다른장소로의이동장비를이용한이동기타명시된및상세불명의보행과이동 Walking Moving around Moving around in different locations Moving around using equipment Walking and moving, other specified and unspecified 운송수단을이용한이동 (d ) Moving around using transportation d470 d475 d480 d489 d498 d499 운송수단이용 운전 운송수단으로서동물등에타기 기타명시된및상세불명의운송수단을이용한이동 기타명시된이동 상세불명의이동 Using transportation Driving Riding animals for transportation Moving around using transportation, other specified and unspecified Mobility, other specified Mobility, unspecified 42

51 2 단계분류 제 5 장자기관리 Self-care d510 d520 d530 d540 d550 d560 d570 d598 d599 씻기신체부위관리대소변처리몸단장먹기마시기자신의건강돌보기기타명시된자기관리상세불명의자기관리 Washing oneself Caring for body parts Toileting Dressing Eating Drinking Looking after one's health Self-care, other specified Self-care, unspecified 제 6 장가정생활 생필품획득 (d610-d629) Domestic life Acquisition of necessities d610 d620 d629 주택획득 물품획득과서비스받기 기타명시된및상세불명의생필품획득 Acquiring a place to live Acquisition of goods and services Acquisition of necessities, other specified and unspecified 가사 (d630-d649) Household tasks d630 d640 d649 식사준비 가사돌보기 기타명시된및상세불명의가사 Preparing meals Doing housework Household tasks, other specified and unspecified 가사도구관리와다른사람돌보기 (d650-d669) Caring for household objects and assisting others d650 d660 d669 d698 d699 가사도구관리 다른사람돕기 기타명시된및상세불명의가사도구관리와다른사람돕기 기타명시된가정생활 상세불명의가정생활 Caring for household objects Assisting others Caring for household objects and assisting others, other specified and unspecified Domestic life, other specified Domestic life, unspecified 통계청 43

52 한국표준건강분류 제 7 장대인상호작용과관계 일반적대인상호작용과관계 (d ) Interpersonal interactions and relationships General interpersonal interactions and relationships d710 d720 d729 기본적대인상호작용 복잡한대인상호작용 기타명시된및상세불명의일반적대인상호작용 Basic interpersonal interactions Complex interpersonal interactions General interpersonal interactions, other specified and unspecified 특정대인상호작용과관계 (d730-d779) Particular interpersonal relationships d730 d740 d750 d760 d770 d779 d798 d799 낯선사람과의관계공식적관계비공식적사회적관계가족관계애정관계기타명시된및상세불명의특정대인관계기타명시된대인상호작용과관계상세불명의대인상호작용과관계 Relating with strangers Formal relationships Informal social relationships Family relationships Intimate relationships Particular interpersonal relationships, other specified and unspecified Interpersonal interactions and relationships, other specified Interpersonal interactions and relationships, unspecified 제 8 장주요생활영역 교육 (d810-d839) Major life areas Education d810 d815 d820 d825 d830 d835 d839 비공식적교육유치원교육학교교육직업교육고등교육교육관련활동기타명시된및상세불명의교육 Informal education Preschool education School education Vocational training Higher education Education life Education, other specified and unspecified 44

53 2 단계분류 일과고용 (d840-d859) d840 견습연수 ( 취업준비 ) d845 구직 근속 퇴직 d850 유급고용 d855 무급고용 d859 기타명시된및상세불명의일과고용 Work and employment Apprenticeship (work preparation) Acquiring, keeping and terminating a job Remunerative employment Non-remunerative employment Work and employment, other specified and unspecified 경제생활 (d860-d879) Economic life d860 d865 d870 d879 d898 d899 기본적경제적거래복잡한경제적거래경제적자립기타명시된및상세불명의경제생활기타명시된주요생활영역상세불명의주요생활영역 Basic economic transactions Complex economic transactions Economic self-sufficiency Economic life, other specified and unspecified Major life areas, other specified Major life areas, unspecified 제 9 장지역사회생활, 사회생활및시민으로서의 생활 Major life areas Community, social and civic life d910 d920 d930 d940 d950 d998 d999 지역사회생활 레크리에이션과여가 종교활동과영적활동 인권 정치생활과시민권행사 기타명시된지역사회생활, 사회생활및시민으로서의생활 상세불명의지역사회생활, 사회생활및시민으로서의생활 Community life Recreation and leisure Religion and spirituality Human rights Political life and citizenship Community, social and civic life, other specified Community, social and civic life, unspecified 환경요소 제 1 장제품과기술 ENVIRONMENTAL FACTORS Products and technology e110 e115 개인소비용제품또는물건 개인의일상생활용제품과기술 Products or substances for personal consumption Products and technology for personal use in daily living 통계청 45

54 한국표준건강분류 e120 e125 e130 e135 e140 e145 e150 e155 e160 e165 e198 e199 개인의실내 외이동및운송용제품과기술 커뮤니케이션용제품과기술 교육용제품과기술 업무용제품과기술 문화 레크리에이션 스포츠용제품과기술 종교활동과영적활동수행을위한제품과기술 공공건물설계 축조 건축관련제품및기술 민간건물설계 축조 건축관련제품및기술 지역개발관련제품과기술 자산 기타명시된제품과기술 상세불명의제품과기술 Products and technology for personal indoor and outdoor mobility and transportation Products and technology for communication Products and technology for education Products and technology for employment Products and technology for culture, recreation and sport Products and technology for the practice of religion and spirituality Design, construction and building products and technology of buildings for public use Design, construction and building products and technology of buildings for private use Products and technology of land development Assets Products and technology, other specified Products and technology, unspecified 제 2 장자연환경과인위적환경변화 Natural environment and human-made changes to environment e210 e215 e220 e225 e230 e235 e240 e245 e250 e255 e260 e298 e299 자연지리인구 주민식물상과동물상기후자연재해인재빛시간적변화소리진동공기의질기타명시된자연환경과인위적환경변화상세불명의자연환경과인위적환경변화 Physical geography Population Flora and fauna Climate Natural events Human-caused events Light Time-related changes Sound Vibration Air quality Natural environment and human-made changes to environment, other specified Natural environment and human-made changes to environment, unspecified 46

55 2 단계분류 제 3 장지원과관계 Support and relationships e310 e315 e320 e325 e330 e335 e340 e345 e350 e355 e360 e398 e399 직계가족확대가족친구지인, 동년배, 동료, 이웃, 지역사회구성원권위자하위위치에있는사람개인적도움제공자와개인보조자낯선사람애완동물보건전문가기타전문가기타명시된지원과관계상세불명의지원과관계 Immediate family Extended family Friends Acquaintances, peers, colleagues, neighbours and community members People in positions of authority People in subordinate positions Personal care providers and personal assistants Strangers Domesticated animals Health professionals Other professionals Support and relationships, other specified Support and relationships, unspecified 제 4 장태도 Attitudes e410 e415 e420 e425 e430 e435 e440 e445 e450 e455 e460 e465 e498 e499 직계가족구성원의태도 확대가족구성원의태도 친구의태도 지인, 동년배, 동료, 이웃과지역사회구성원의태도 권위자의태도 하위위치에있는사람의태도 개인돌봄제공자와보조원의태도 낯선사람의태도 보건전문가의태도 기타전문가의태도 사회적태도 사회적표준, 관행과이념 기타명시된태도 상세불명의태도 Individual attitudes of immediate family members Individual attitudes of extended family members Individual attitudes of friends Individual attitudes of acquaintances, peers, colleagues, neighbours and community members Individual attitudes of people in positions of authority Individual attitudes of people in subordinate positions Individual attitudes of personal care providers and personal assistants Individual attitudes of strangers Individual attitudes of health professionals Individual attitudes of other professionals Societal attitudes Social norms, practices and ideologies Attitudes, other specified Attitudes, unspecified 통계청 47

56 한국표준건강분류 제 5 장서비스, 제도와정책 e510 e515 e520 e525 e530 소비재생산을위한서비스, 제도와정책 건축및축조서비스, 제도와정책 야외공간계획과관련된서비스, 제도와정책 주택공급서비스, 제도와정책 공공사업서비스, 제도와정책 e535 커뮤니케이션서비스, 제도와정책 e540 e545 e550 e555 e560 e565 e570 e575 e580 e585 e590 e595 e598 e599 운송서비스, 제도와정책 시민보호서비스, 제도와정책 법률서비스, 제도와정책 협회및단체관련서비스, 제도와정책 미디어서비스, 제도와정책 경제서비스, 제도와정책 사회보장서비스, 제도와정책 일반적인사회지원서비스, 제도와정책 보건서비스, 제도와정책 교육및훈련서비스, 제도와정책 노동및고용서비스, 제도와정책 정치적서비스, 제도와정책 기타명시된서비스, 제도와정책 상세불명의서비스, 제도와정책 Services, systems and policies Services, systems and policies for the production of consumer goods Architecture and construction services, systems and policies Open space planning services, systems and policies Housing services, systems and policies Utilities services, systems and policies Communication services, systems and policies Transportation services, systems and policies Civil protection services, systems and policies Legal services, systems and policies Associations and organizational services, systems and policies Media services, systems and policies Economic services, systems and policies Social security services, systems and policies General social support services, systems and policies Health services, systems and policies Education and training services, systems and policies Labour and employment services, systems and policies Political services, systems and policies Services, systems and policies, other specified Services, systems and policies, unspecified 48

57 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 정의에의한세부분류 Detailed classification with definitions All categories within the classification with their definitions, inclusions and exclusions

58

59 정의에의한세부분류 신체기능 (Body functions) 정의 : 신체기능 (Body Function) 이란신체계통의생리적기능 ( 심리적기능을포함 ) 을말한다. 장해 (Impairments) 란의미있는변형이나손실과같은신체기능또는구조의이상이다. 평가값 장해의정도나규모를가리키는음 (-) 의척도를가지는일반평가값 : xxx.0 xxx.1 xxx.2 xxx.3 xxx.4 xxx.8 xxx.9 장해없음 (No impairment) 경도장해 (Mild impairment) 중등도장해 (Moderate impairment) 중증장해 (Severe impairment) 완전장해 (Complete impairment) 명시되지않음 (Not specified) 해당없음 (Not applicable) 없는, 부재의, 하찮은 (none, absent, negligible) 약간의, 낮은 (slight, low) 중간의, 보통의 (medium, fair) 높은, 심각한 (high, extreme) 전체 (total) 0-4% 5-24% 25-49% 50-95% % 몇단계로나눈백분율을제시함으로써보정된평가도구나기타표준을사용하여신체기능의장해를 수량화한다. 예를들면, 신체기능의 장해없음 이나 완전장해 는최대 5% 의오차범위를가진다. 일반적으로 중등도장해 는완전장해의절반수준미만을의미한다. 이백분율은표준인구백분위수를 참조하여다른영역에서조정할수있다. 이러한측정법을일관된방식으로사용하기위해서는, 향후 연구를통하여평가절차개발이필요하다. 정의에 의한 세부분류 KCF 분류규정에관한상세설명은 [ 부록 2] 를참조한다. 통계청 51

60 한국표준건강분류 제 1 장정신기능 (Mental functions) 이장에서는뇌의기능에대하여다룬다. 의식, 에너지및욕동과같은일반적정신기능과기억, 언어와계산같은명시된정신기능에대하여다루고있다. 전반적정신기능 (b110-b139) b110 의식기능 명료하고연속적인각성상태를포함하여인식과민첩의상태에대한일반적정신기능 포함 : 의식의상태, 연속성및의식의질에대한기능 ; 의식의소실, 혼수, 식물인간상태, 둔주, 몽환상태, 빙의상태, 약물 - 유도성의식변화, 섬망, 혼미 제외 : 지남력기능 (b114); 에너지와욕동 (b130); 수면기능 (b134) b1100 b1101 b1102 b1108 b1109 의식상태의식의혼탁, 혼미또는혼수와같은변형된상태를만들어내는정신기능 의식의연속성각성, 명료성및인지를지속하게하는정신기능으로, 이기능이두절되면기억상실이나몽환상태또는이와비슷한상태가야기됨 의식의질약물유발의식변형이나섬망처럼각성, 명료, 인지감각의특징이변하는효과를초래하는정신기능 기타명시된의식기능 상세불명의의식기능 Global mental functions Consciousness functions General mental functions of the state of awareness and alertness, including the clarity and continuity of the wakeful state. Inclusions : functions of the state, continuity and quality of consciousness; loss of consciousness, coma, vegetative states, fugues, trance states, possession states, drug-induced altered consciousness, delirium, stupor Exclusions : orientation functions (b114); energy and drive functions (b130); sleep functions (b134) State of consciousness Mental functions that when altered produce states such as clouding of consciousness, stupor or coma. Continuity of consciousness Mental functions that produce sustained wakefulness, alertness and awareness and when disrupted, may produce fugue, trance or other similar states. Quality of consciousness Mental functions that when altered effect changes in the character of wakeful, alert and aware sentience, such as drug-induced altered states or delirium. Consciousness functions, other specified Consciousness functions, unspecified b114 지남력기능 시간, 장소, 자신, 타인, 사물및공간에대한본인과의관계를식별하고확인할수있는일반적정신기능 Orientation functions General mental functions of knowing and ascertaining one's relation to time, to place, to self, to others, to objects and to space. 52

61 정의에의한세부분류 포함 : 시간, 장소, 사람에대한지남력기능, 본인과타인에대한지남력, 시간, 장소, 사람에대한지남력상실 제외 : 의식기능 (b110); 주의력기능 (b140); 기억기능 (b144) b1140 b1141 b1142 b11420 b11421 b11428 b11429 b1143 b1144 b1148 b1149 시간지남력시간, 요일, 날짜, 월, 연도를인지하는정신기능 장소지남력자신의가까운주변환경, 마을또는나라와같이자신의위치를인지하는정신기능 인물지남력자신의정체성과가까운주위환경에있는사람을인지하는정신기능 자아지남력자신의정체성을인지하는정신기능 타인지남력가까운주위환경속에서타인의정체성을인지하는정신기능 기타명시된인물에대한지남력 상세불명의인물에대한지남력 사물지남력사물의특징이나사물을인지하는정신기능 공간지남력가까운물리적공간과관련하여사람의신체를인지하는정신기능 기타명시된지남력기능 상세불명의지남력기능 Inclusions : functions of orientation to time, place and person; orientation to self and others; disorientation to time, place and person Exclusions : consciousness functions (b110); attention functions (b140); memory functions (b144) Orientation to time Mental functions that produce awareness of time of the day, day of the week, date, month and year. Orientation to place Mental functions that produce awareness of one's location, such as one's immediate surroundings, one's town or country. Orientation to person Mental functions that produce awareness of one's own identity and of individuals in the immediate environment. Orientation to self Mental functions that produce awareness of one's own identity. Orientation to others Mental functions that produce awareness of the identity of other individuals in one's immediate environment Orientation to person, other specified Orientation to person, unspecified Orientation to objects Mental functions that produce awareness of objects or features of objects. Orientation to space Mental functions that produce awareness of one s body in relation to the immediate physical space. Orientation functions, other specified Orientation functions, unspecified 정의에 의한 세부분류 b117 지적기능 모든인지기능과전생애에걸친발달상태를포함하는다양한정신기능을이해하고구조적으로통합할수있는 Intellectual functions General mental functions, required to understand and constructively integrate the various mental functions, including 통계청 53

62 한국표준건강분류 일반적정신기능 포함 : 지적성장기능 ; 지적지체, 정신지체, 치매 제외 : 기억기능 (b144); 사고기능 (b160); 고위인지기능 (b164) all cognitive functions and their development over the life span. Inclusions : functions of intellectual growth; intellectual retardation, mental retardation, dementia Exclusions : memory functions (b144); thought functions (b160); higher-level cognitive functions (b164) b122 포함 : 자폐증 전반적정신사회적기능 의미와목적측면에서사회적상호작용을이루어나가는데필요한대인관계기술을형성해나갈수있는정신기능을이해하고구조적으로통합할수있는일반적정신기능으로서전생애에걸쳐발달됨 Global psychosocial functions General mental functions, as they develop over the life span, required to understand and constructively integrate the mental functions that lead to the formation of the interpersonal skills needed to establish reciprocal social interactions, in terms of both meaning and purpose. Inclusion : such as in autism b126 기질과인격기능 다른사람과구별되는일련의정신적특징을포함하여상황에특정한방식으로반응하는개인의타고난성향의일반적정신기능 포함 : 외향성, 내향성, 협조성, 성실성, 정신적 감정적안정성, 경험에대한개방성, 낙천성, 호기심, 확신, 신뢰성 제외 : 지적기능 (b117); 에너지와욕동기능 (b130); 정신운동기능 (b147); 정서기능 (b152) b1260 b1261 외향성외향적이고사교적이며감정을드러내는개인의성향을나타내는정신기능으로, 수줍음을타고제한적이며억제적성향과는대립되는정신기능 협조성협조적이고우호적이며유연함등의 Temperament and personality functions General mental functions of constitutional disposition of the individual to react in a particular way to situations, including the set of mental characteristics that makes the individual distinct from others. Inclusions : functions of extraversion, introversion, agreeableness, conscientiousness, psychic and emotional stability, and openness to experience; optimism; novelty seeking; confidence; trustworthiness Exclusions : intellectual functions (b117); energy and drive functions (b130); psychomotor functions (b147); emotional functions (b152) Extraversion Mental functions that produce a personal disposition that is outgoing, sociable and demonstrative, as contrasted to being shy, restricted and inhibited. Agreeableness Mental functions that produce a personal 54

63 정의에의한세부분류 개인의성향을나타내는정신기능으로, 불친절하고대립적이며반항적인성향과는대립되는정신기능 disposition that is cooperative, amicable, and accommodating, as contrasted to being unfriendly, oppositional and defiant. b1262 성실성근면하고, 규칙을따르며신중한개인의성향을나타내는정신기능으로, 나태하고신뢰할수없으며무책임한성향과는대립되는정신기능 Conscientiousness Mental functions that produce personal dispositions such as in being hard-working, methodical and scrupulous, as contrasted to mental functions producing dispositions such as in being lazy, unreliable and irresponsible. b1263 정신적안정성온후하고침착하며차분한개인의성향을나타내는정신기능으로, 화를잘내고걱정이많고변덕이심하며시무룩한성향과는대립되는정신기능 Psychic stability Mental functions that produce a personal disposition that is even-tempered, calm and composed, as contrasted to being irritable, worried, erratic and moody. b1264 경험에대한개방성호기심이강하며상상력이풍부하고알고싶어하며새로운경험을추구하는개인의성향을나타내는정신기능으로, 정체되고태만하며감정적표현이없는성향과는대립되는정신기능 Openness to experience Mental functions that produce a personal disposition that is curious, imaginative, inquisitive and experience-seeking, as contrasted to being stagnant, inattentive and emotionally inexpressive. b1265 낙천성명랑하고쾌활하며희망에찬개인의성향을나타내는정신기능으로, 낙담하고우울하며절망하는성향과는대립되는정신기능 Optimism Mental functions that produce a personal disposition that is cheerful, buoyant and hopeful, as contrasted to being downhearted, gloomy and despairing. b1266 b1267 자신감자기확신이강하며, 과감하며자기주장이강한개인의성향을나타내는정신기능으로, 소심하고확신이없거나자기를내세우지않는성향과는대립되는정신기능 신뢰감믿을수있으며원칙에입각한개인적성향을나타내는정신기능으로, 기만적이며반사회적성향과는대립되는정신기능 Confidence Mental functions that produce a personal disposition that is self-assured, bold and assertive, as contrasted to being timid, insecure and self-effacing. Trustworthiness Mental functions that produce a personal disposition that is dependable and principled, as contrasted to being deceitful and antisocial. 정의에 의한 세부분류 b1268 기타명시된기질과인격기능 Temperament and personality functions, other specified b1269 상세불명의기질과인격기능 Temperament and personality functions, unspecified 통계청 55

64 한국표준건강분류 b130 에너지와욕동기능 특정한욕구의충족과전체적목표를향해일관성있게나아가는개인의신체적및심리적기전에대한일반적정신기능 포함 : 에너지수준, 동기부여, 식욕, 갈망 ( 남용될수있는물질에대한욕구포함 ), 충동억제 제외 : 의식기능 (b110); 기질과인격기능 (b126); 수면기능 (b134); 정신운동기능 (b147); 정서기능 (b152) b1300 b1301 b1302 b1303 b1304 b1308 b1309 에너지수준활력과스태미나를나타내는정신기능 동기부여행동을유발하는정신기능 ; 행동을위한의식적또는무의식적인행동추진력 식욕자연적갈망이나욕망, 특히음식물에대한자연적이며반복적인욕망을나타내는정신기능 갈망남용될수있는물질을포함하여물질을소비하려는절박감을일으키는정신기능 충동억제어떤것을하고자하는갑작스러운강한절박감을조절하고저지할수있는정신기능 기타명시된에너지와욕동기능 상세불명의에너지와욕동기능 Energy and drive functions General mental functions of physiological and psychological mechanisms that cause the individual to move towards satisfying specific needs and general goals in a persistent manner. Inclusions : functions of energy level, motivation, appetite, craving (including craving for substances that can be abused), and impulse control Exclusions : consciousness functions (b110); temperament and personality functions (b126); sleep functions (b134); psychomotor functions (b147); emotional functions (b152) Energy level Mental functions that produce vigour and stamina. Motivation Mental functions that produce the incentive to act; the conscious or unconscious driving force for action. Appetite Mental functions that produce a natural longing or desire, especially the natural and recurring desire for food and drink. Craving Mental functions that produce the urge to consume substances, including substances that can be abused. Impulse control Mental functions that regulate and resist sudden intense urges to do something. Energy and drive functions, other specified Energy and drive functions, unspecified b134 수면기능 특징적인생리적변화를동반한주변환경으로부터의주기적이고가역적이며선택적인신체적및정신적이탈을나타내는일반적정신기능 포함 : 수면의양과수면의시작, 수면유지와 Sleep functions General mental functions of periodic, reversible and selective physical and mental disengagement from one's immediate environment accompanied by characteristic physiological changes. Inclusions : functions of amount of 56

65 정의에의한세부분류 수면의질 ; 불면증, 수면과다와발작수면등수면주기에관련된기능 제외 : 의식기능 (b110); 에너지와욕동기능 (b130); 주의력기능 (b140); 정신운동기능 (b147) b1340 b1341 b1342 b1343 b1344 b1348 b1349 b139 수면의양하루주기나일간변화리듬에서수면상태에소요된시간과관련된정신기능 수면의시작각성상태에서수면으로이행하는정신기능 수면의유지수면상태를유지시키는정신기능 수면의질적절한신체적, 정신적안정과휴식을유도하는자연스러운수면상태를일으키는정신기능 수면주기와관련된기능급속안구운동 (REM) 수면 ( 꿈과관련된 ) 과비급속안구운동 (NREM) 수면 ( 감소된생리적및정신적활동을나타내는전통적수면의개념 ) 을일으키는정신기능 기타명시된수면기능 상세불명의수면기능 기타명시된및상세불명의전반적정신기능 특정정신기능 (b140-b189) sleeping, and onset, maintenance and quality of sleep; functions involving the sleep cycle, such as in insomnia, hypersomnia and narcolepsy Exclusions : consciousness functions (b110); energy and drive functions (b130); attention functions (b140); psychomotor functions (b147) Amount of sleep Mental functions involved in the time spent in the state of sleep in the diurnal cycle or circadian rhythm. Onset of sleep Mental functions that produce the transition between wakefulness and sleep. Maintenance of sleep Mental functions that sustain the state of being asleep. Quality of sleep Mental functions that produce the natural sleep leading to optimal physical and mental rest and relaxation. Functions involving the sleep cycle Mental functions that produce rapid eye movement (REM) sleep (associated with dreaming) and non-rapid eye movement sleep (NREM) (characterized by the traditional concept of sleep as a time of decreased physiological and psychological activity). Sleep functions, other specified Sleep functions, unspecified Global mental functions, other specified and unspecified Specific mental functions 정의에 의한 세부분류 b140 주의력기능 외부자극이나내부경험에대해일정시간집중할수있는특정정신기능 Attention functions Specific mental functions of focusing on an external stimulus or internal experience for the required period of time. 통계청 57

66 한국표준건강분류 포함 : 주의력유지, 주의력전환, 주의력분할, 주의력할당 ; 집중력 ; 주의산만 제외 : 의식기능 (b110), 에너지와욕동기능 (b130), 수면기능 (b134), 기억기능 (b144), 정신운동기능 (b147), 지각기능 (b156) b1400 b1401 b1402 b1403 b1408 b1409 주의력유지일정시간집중할수있는정신기능 주의력전환일정자극에서다른자극으로의재집중을가능하게하는정신기능 주의력배분동시에두가지또는그이상의자극에집중할수있는정신기능 주의력공유아동과보호자가모두하나의장난감에대해집중하는것과같이두사람이상이같은자극에대한집중을가능케하는정신기능 기타명시된주의력기능 상세불명의주의력기능 Inclusions : functions of sustaining attention, shifting attention, dividing attention, sharing attention; concentration; distractibility Exclusions : consciousness functions (b110); energy and drive functions (b130); sleep functions (b134); memory functions (b144); psychomotor functions (b147); perceptual functions (b156) Sustaining attention Mental functions that produce concentration for the period of time required. Shifting attention Mental functions that permit refocusing concentration from one stimulus to another. Dividing attention Mental functions that permit focusing on two or more stimuli at the same time. Sharing attention Mental functions that permit focusing on the same stimulus by two or more people, such as a child and a caregiver both focusing on a toy. Attention functions, other specified Attention functions, unspecified b144 기억기능 정보의등록및저장과필요시재생시킬수있는특정정신기능 포함 : 단기및장기기억, 직전기억, 최근기억과먼기억기능 ; 기억시간 ; 기억의재생 ; 떠올리기 ; 명칭기억상실 ; 선택적기억상실해리적기억상실에서이용되는기능 제외 : 의식기능 (b110), 지남력기능 (b114), 지적기능 (b117), 주의력기능 (b140), 지각기능 (b156), 사고기능 (b160), 고위인지기능 (b164), 언어의정신기능 (b167), 계산기능 (b172) Memory functions Specific mental functions of registering and storing information and retrieving it as needed. Inclusions : functions of short-term and long-term memory, immediate, recent and remote memory; memory span; retrieval of memory; remembering; functions used in recalling and learning, such as in nominal, selective and dissociative amnesia Exclusions : consciousness functions (b110); orientation functions (b114); intellectual functions (b117); attention functions (b140); perceptual functions (b156); thought functions (b160); 58

67 정의에의한세부분류 higher-level cognitive functions (b164); mental functions of language (b167); calculation functions (b172) b1440 b1441 b1442 b1443 b1448 b1449 단기기억장기기억으로강화되지않으면소실되는기억으로약 30 초정도지속되는일시적이고잃어버리기쉬운기억을일으키는정신기능 장기기억언어나실제의과거사건과의미있는기억들을단기기억과자서전적기억으로부터장기저장할수있도록하는기억체계로만드는정신기능 기억의재생과처리장기기억속에저장된정보를상기시키고이를인식시키는특정정신기능 작업기억단기기억과장기기억모두로부터재생된정보를비교하고처리하는정신기능 기타명시된기억기능 상세불명의기억기능 Short-term memory Mental functions that produce a temporary, disruptable memory store of around 30 seconds duration from which information is lost if not consolidated into long-term memory. Long-term memory Mental functions that produce a memory system permitting the long-term storage of information from short-term memory and both autobiographical memory for past events and semantic memory for language and facts. Retrieval and processing of memory Specific mental functions of recalling information stored in long-term memory and bringing it into awareness. Working memory Mental functions that compare and process information retrieved from both short-term and long-term memory. Memory functions, other specified Memory functions, unspecified b147 정신운동기능 운동과심리적사건을신체수준에서통제할수있는특정정신기능 포함 : 정신운동지연, 흥분과안절부절, 몸짓, 긴장증, 거부증, 양가성, 반향동작및반향언어와같은정신운동통제의기능 ; 정신운동기능의질 제외 : 의식기능 (b110); 지남력기능 (b114); 지적기능 (b117); 에너지와욕동기능 (b130); 주의력기능 (b140); 언어의정신기능 (b167); 복잡한동작의순서를매기는 Psychomotor functions Specific mental functions of control over both motor and psychological events at the body level. Inclusions : functions of psychomotor control, such as psychomotor retardation, excitement and agitation, posturing, catatonia, negativism, ambitendency, echopraxia and echolalia; quality of psychomotor function Exclusions : consciousness functions (b110); orientation functions (b114); intellectual functions (b117); energy and drive functions (b130); attention 통계청 59

68 한국표준건강분류 b1470 b1471 b1478 b1479 정신기능 (b176) 정신운동통제정신운동지연을가져오는통제의차단 ( 행동이나말이느림 ; 몸짓과자동적반응의저하 ) 이나정신운동흥분 ( 과잉행동과인지활동, 대체로비생산적이며흔히발가락을두드리고, 손을꼬고, 안절부절또는초조와같은내적긴장상태에대한반응들 ) 과같은행동및심리적요소에관계되는행동속도및반응시간을조절하는정신기능 정신운동기능의질손과눈의협응또는보행과같이적절한수순을가지고그하위요소의특징을나타내는비구어적행위를일으키는정신기능 기타명시된정신운동기능 상세불명의정신운동기능 functions (b140); mental functions of language (b167); mental functions of sequencing complex movements (b176) Psychomotor control Mental functions that regulate the speed of behaviour or response time that involves both motor and psychological components, such as in disruption of control producing psychomotor retardation (moving and speaking slowly; decrease in gesturing and spontaneity) or psychomotor excitement (excessive behavioural and cognitive activity, usually nonproductive and often in response to inner tension as in toe-tapping, hand-wringing, agitation, or restlessness.) Quality of psychomotor functions Mental functions that produce nonverbal behaviour in the proper sequence and character of its subcomponents, such as hand and eye coordination, or gait. Psychomotor functions, other specified Psychomotor functions, unspecified b152 정서기능 심리과정의느낌과감정적구성요소와관련된특정정신기능 포함 : 정서의적절성, 정서의조절과폭기능 ; 감정 ; 비애, 행복, 사랑, 공포, 분노, 증오, 긴장, 불안, 기쁨, 슬픔 ; 감정의불안정성 ; 감정둔마 제외 : 기질과인격기능 (b126), 에너지와욕동기능 (b130) b1520 b1521 정서의적절성좋은소식을접했을때기쁨을느끼는것처럼상황에대해적합하게느끼거나감정을갖게하는정신기능 정서의조절감정의경험과감정의표시를제어할수 Emotional functions Specific mental functions related to the feeling and affective components of the processes of the mind. Inclusions : functions of appropriateness of emotion, regulation and range of emotion; affect; sadness, happiness, love, fear, anger, hate, tension, anxiety, joy, sorrow; lability of emotion; flattening of affect Exclusions : temperament and personality functions (b126); energy and drive functions (b130) Appropriateness of emotion Mental functions that produce congruence of feeling or affect with the situation, such as happiness at receiving good news. Regulation of emotion Mental functions that control the 60

69 정의에의한세부분류 b1522 b1528 b1529 있는정신기능 정서의범위사랑, 증오, 불안, 슬픔, 기쁨, 공포그리고분노와같은감정이나느낌을각성하는체험의스펙트럼을생성하는정신기능 기타명시된정서기능 상세불명의정서기능 experience and display of affect. Range of emotion Mental functions that produce the spectrum of experience of arousal of affect or feelings such as love, hate, anxiousness, sorrow, joy, fear and anger. Emotional functions, other specified Emotional functions, unspecified b156 지각기능 감각자극을인식하고해석할수있는특정정신기능포함 : 청각, 시각, 후각, 미각, 촉각그리고환각이나착각과같은시공지각의기능 제외 : 의식기능 (b110); 지남력기능 (b114); 지적기능 (b117); 주의력기능 (b140); 기억기능 (b144); 언어의정신기능 (b167); 시각과관련기능 (b210-b229); 청각과전정기능 (b230-b249); 부가적감각기능 (b250-b279) b1560 청각음향, 음색, 음도와기타청각자극을식별하는데관여하는정신기능 Perceptual functions Specific mental functions of recognizing and interpreting sensory stimuli. Inclusions : functions of auditory, visual, olfactory, gustatory, tactile and visuospatial perception, such as hallucination or illusion Exclusions : consciousness functions (b110); orientation functions (b114); attention functions (b140); memory functions (b144); mental functions of language (b167); seeing and related functions (b210-b229); hearing and vestibular functions (b230-b249); additional sensory functions (b250-b279) Auditory perception Mental functions involved in discriminating sounds, tones, pitches and other acoustic stimuli. b1561 b1562 b1563 b1564 시각형태, 크기, 색상과기타시각자극을구별하는데관여하는정신기능 후각냄새의차이를구별하는데관련된정신기능 미각혀로달고, 시고, 짜고, 쓴자극과같은맛의차이를구별하는데관련된정신기능 촉각접촉에의해거칠거나부드러운자극과같은감촉의차이를구별하는데관련된 Visual perception Mental functions involved in discriminating shape, size, colour and other ocular stimuli. Olfactory perception Mental functions involved in distinguishing differences in smells. Gustatory perception Mental functions involved in distinguishing differences in tastes, such as sweet, sour, salty and bitter stimuli, detected by the tongue. Tactile perception Mental functions involved in distinguishing differences in texture, such as rough or 통계청 61

70 한국표준건강분류 b1565 정신기능 시공간지각주변환경이나자신과관련된사물의상대적위치를시각으로구별하는데관련된정신기능 제외 : 사물지남력 (b1143) b1568 b1569 기타명시된지각기능 상세불명의지각기능 smooth stimuli, detected by touch. Visuospatial perception Mental function involved in distinguishing by sight the relative position of objects in the environment or in relation to oneself. Exclusion : orientation to objects (b1143) Perceptual functions, other specified Perceptual functions, unspecified b160 사고기능 정신의관념적구성요소와관련된특정정신기능포함 : 사고의속도, 형식, 통제와내용에관한기능 ; 목표지향적사고기능, 목표비지향적사고기능 ; 사고압박, 사고비약, 사고차단, 사고산만, 사고이탈, 우원증, 망상, 강박사고및강박행위와같은논리적사고기능 제외 : 지적기능 (b117); 기억기능 (b144); 정신운동기능 (b147); 지각기능 (b156); 고위인지기능 (b164); 언어의정신기능 (b167); 계산기능 (b172) b1600 사고의속도사고과정의속도를조절하는정신기능 b1601 사고의형식사고과정을일관성과논리성에따라조직화하는정신기능포함 : 관념적보속증, 사고이탈과우원증장해 b1602 사고의내용사고과정에나타나는관념들과개념화될수있는것들로구성된정신기능 포함 : 망상, 과대평가된관념과신체화의장해 Thought functions Specific mental functions related to the ideational component of the mind. Inclusions : functions of pace, form, control and content of thought; goaldirected thought functions, non-goal directed thought functions; logical thought functions, such as pressure of thought, flight of ideas, thought block, incoherence of thought, tangentiality, circumstantiality, delusions, obsessions and compulsions Exclusions : intellectual functions (b117); memory functions (b144); psychomotor functions (b147); perceptual functions (b156); higher-level cognitive functions (b164); mental functions of language (b167); calculation functions (b172) Pace of thought Mental functions that govern speed of the thinking process. Form of thought Mental functions that organize the thinking process as to its coherence and logic. Inclusions : impairments of ideational perseveration, tangentiality and circumstantiality Content of thought Mental functions consisting of the ideas that are present in the thinking process and what is being conceptualized. Inclusions : impairments of delusions, overvalued ideas and somatization 62

71 정의에의한세부분류 b1603 사고의통제생각을의식적으로통제하고또한그럴것이라고인정하게하는정신기능 포함 : 반추사고, 강박사고, 사고전파와사고주입의장해 b1608 b1609 기타명시된사고기능 상세불명의사고기능 Control of thought Mental functions that provide volitional control of thinking and are recognized as such by the person. Inclusions : impairments of rumination, obsession, thought broadcast and thought insertion Thought functions, other specified Thought functions, unspecified b164 고위인지기능 의사결정, 추상적사고, 계획의수립과수행, 정신적유연성등과같은복잡한목표지향적행동을포함하며또한특정한상황에서어떠한행동이적절한지를결정하는등의특별히뇌의전두엽에의존하는특정정신기능 ; 흔히집행기능이라고함 포함 : 관념의추상과조직화기능 ; 시간관리, 통찰과판단 ; 개념형성, 범주화와인지의유연성 제외 : 기억기능 (b144), 사고기능 (b160), 언어의정신기능 (b167), 계산기능 (b172) b1640 b1641 b1642 추상화구체적현실, 개별적대상또는실재상황과는구별되는일반개념, 질또는특성을창출하는정신기능 조직화와계획부분으로나뉘어있는것을전체로통합하고체계화하는정신기능 ; 일을진행시키거나행동하는방법을전개시키는데관련된정신기능 시간관리연대기적순서에따라사건을정열하고, 사건과활동에일정양의시간을할당할수있는정신기능 Higher-level cognitive functions Specific mental functions especially dependent on the frontal lobes of the brain, including complex goal-directed behaviours such as decision-making, abstract thinking, planning and carrying out plans, mental flexibility, and deciding which behaviours are appropriate under what circumstances; often called executive functions. Inclusions : functions of abstraction and organization of ideas; time management, insight and judgement; concept formation, categorization and cognitive flexibility Exclusions : memory functions (b144); thought functions (b160); mental functions of language (b167); calculation functions (b172) Abstraction Mental functions of creating general ideas, qualities or characteristics out of, and distinct from, concrete realities, specific objects or actual instances. Organization and planning Mental functions of coordinating parts into a whole, of systematizing; the mental function involved in developing a method of proceeding or acting. Time management Mental functions of ordering events in chronological sequence, allocating amounts of time to events and activities. 통계청 63

72 한국표준건강분류 b1643 b1644 b1645 b1646 b1648 b1649 인지의유연성전략의변경또는특별히문제해결에관여하는정신적자세를변경시킬수있는정신기능 통찰자신과타인의행동을인식하고이해할수있는정신기능 판단의견을형성하는데관여하는기능과같이서로다른선택을분별하고평가할수있는정신기능 문제해결조화롭지못하거나모순된정보를해결하기위해확인하고분석하며통합할수있는정신기능 기타명시된고위인지기능 상세불명의고위인지기능 Cognitive flexibility Mental functions of changing strategies, or shifting mental sets, especially as involved in problem-solving. Insight Mental functions of awareness and understanding of oneself and one's behaviour. Judgement Mental functions involved in discriminating between and evaluating different options, such as those involved in forming an opinion. Problem-solving Mental functions of identifying, analysing and integrating incongruent or conflicting information into a solution. Higher-level cognitive functions, other specified Higher-level cognitive functions, unspecified b167 언어의정신기능 기호, 상징, 언어의기타구성요소를인식하고사용할수있는특정정신기능 포함 : 구어, 문어또는수화와같은기타형태의언어를수용하고해독할수있는능력 ; 구어체, 문어체또는기타형태로언어를표현하는기능 ; 수용성, 표현성, 브로카실어증, 베르니케실어증그리고전도성실어증에서침해되는것과같은구어와문어에대한통합언어기능 제외 : 주의력기능 (b140); 기억기능 (b144); 지각기능 (b156); 사고기능 (b160); 고위인지기능 (b164); 계산기능 (b172); 복잡한동작의순서를매기는정신기능 (b176); 제 2 장감각기능과통증 ; 제 3 장음성과말하기의기능 Mental functions of language Specific mental functions of recognizing and using signs, symbols and other components of a language. Inclusions : functions of reception and decryption of spoken, written or other forms of language such as sign language; functions of expression of spoken, written or other forms of language; integrative language functions, spoken and written, such as involved in receptive, expressive, Broca's, Wernicke's and conduction aphasia Exclusions : attention functions (b140); memory functions (b144); perceptual functions (b156); thought functions (b160); higher-level cognitive functions (b164); calculation functions (b172); mental functions of complex movements (b176); Chapter 2 Sensory Functions and Pain; Chapter 3 Voice and Speech Functions 64

73 정의에의한세부분류 b1670 b16700 b16701 b16702 b16703 b16708 b16709 b1671 b16710 b16711 b16712 b16713 b16718 언어의수용구어, 문어또는수화와같은기타형태의언어의뜻을알고메시지를해독할수있는특정정신기능 구어의수용구두메시지를해독하여그의미를파악할수있는정신기능 문어의수용서면메시지를해독하여그의미를파악할수있는정신기능 수화의수용손과기타의동작에의한신호를사용한언어의메시지를해독하여그의미를파악할수있는정신기능 몸짓언어의수용몸짓언어의의미를이해하기위해, 손및기타동작에의해수행되는몸짓메시지를해독하는정신기능 기타명시된언어의수용 상세불명의언어의수용 언어의표현구어, 문어, 수화또는기타형태의언어에있어서의미있는메시지를만들어내는데필요한특정한정신기능 구어의표현의미있는구두메시지를만들어낼수있는데필요한정신기능 문어의표현의미있는서면메시지를만들어낼수있는데필요한정신기능 수화의표현손과기타동작에의한신호를사용한언어에서의미있는메시지를만들어낼수있는데필요한정신기능 몸짓언어의표현손및기타동작에의해수행되는몸짓을사용하여메시지를산출하기위해필요한정신기능 기타명시된언어의표현 Reception of language Specific mental functions of decoding messages in spoken, written or other forms, such as sign language, to obtain their meaning. Reception of spoken language Mental functions of decoding spoken messages to obtain their meaning. Reception of written language Mental functions of decoding written messages to obtain their meaning. Reception of sign language Mental functions of decoding messages in languages that use signs made by hands and other movements, in order to obtain their meaning. Reception of body language Mental functions of decoding messages in body gestures made by hands and other movements, in order to obtain their meaning. Reception of language, other specified Reception of language, unspecified Expression of language Specific mental functions necessary to produce meaningful messages in spoken, written, signed or other forms of language. Expression of spoken language Mental functions necessary to produce meaningful spoken messages. Expression of written language Mental functions necessary to produce meaningful written messages. Expression of sign language Mental functions necessary to produce meaningful messages in languages that use signs made by hands and other movements. Expression of body language Mental functions necessary to produce messages using body gestures made by hands and other movements. Expression of language, other specified 통계청 65

74 한국표준건강분류 b16719 b1672 b1678 b1679 b172 상세불명의언어의표현 통합언어기능의미론적및상징적의미, 문법구조그리고구어, 문어또는기타형태의언어로메시지를만들어낼수있는관념을조직화할수있는정신기능 기타명시된언어의정신기능 상세불명의언어의정신기능 계산기능 수학부호와과정을결정, 추론과조작할수있는특정정신기능 포함 : 더하기, 빼기와기타단순한수학적계산기능 ; 복잡한수학연산기능 제외 : 주의력기능 (b140), 기억기능 (b144), 사고기능 (b160), 고위인지기능 (b164), 언어의정신기능 (b167) b1720 b1721 b1728 b1729 b176 단순계산더하기, 빼기, 곱하기및나누기와같이수를계산할수있는정신기능 복잡한계산어휘문제를산수과정으로옮기는것, 수학적형태를산수과정으로옮기는것그리고숫자와관련된기타복잡한조작을할수있는정신기능 기타명시된계산기능 상세불명의계산기능 복잡한동작의순서를매기는정신기능 복잡하고목적에의한동작의순서를정하고조정하는특정정신기능 포함 : 관념실행증, 관념운동실행증, 옷입기실행증, Expression of language, unspecified Integrative language functions Mental functions that organize semantic and symbolic meaning, grammatical structure and ideas for the production of messages in spoken, written or other forms of language. Mental functions of language, other specified Mental functions of language, unspecified Calculation functions Specific mental functions of determination, approximation and manipulation of mathematical symbols and processes. Inclusions : functions of addition, subtraction, and other simple mathematical calculations; functions of complex mathematical operations Exclusions : attention functions (b140); memory functions (b144); thought functions (b160); higher-level cognitive functions (b164); mental functions of language (b167) Simple calculation Mental functions of computing with numbers, such as addition, subtraction, multiplication and division. Complex calculation Mental functions of translating word problems into arithmetic procedures, translating mathematical formulas into arithmetic procedures, and other complex manipulations involving numbers. Calculation functions, other specified Calculation functions, unspecified Mental function of sequencing complex movements Specific mental functions of sequencing and coordinating complex, purposeful movements. Inclusions : impairments such as in 66

75 정의에의한세부분류 안구운동실행증및말실행증과같은장해 제외 : 정신운동기능 (b147); 고위인지기능 (b164); 7 장신경근골격계및운동과관련된기능 b180 자아와시간의경험기능 실제자신이처한환경과시간속에서자신의정체성, 신체, 위치등을인식하는것과관련된특정정신기능 포함 : 자아, 신체상및시간의경험에관한기능 b1800 자아의경험실제자신이처한환경속에서정체성과위치를인식할수있는특정정신기능 포함 : 탈인격화및탈현실화와같은장해 b1801 신체상신체의묘사및인식과관련된특정한정신기능 포함 : 환상지와너무비만하다거나말랐다고느끼는것과같은장해 b1802 시간의경험시간의길이나흐름과관련된주관적인식의특정정신기능 포함 : 미시감 ( 실제로는잘알고있는일을마치처음경험하는것처럼느끼는체험 ) 과기시감 ( 실제로는처음보거나경험하는것을이미경험한것으로여기는착각 ) 장해 b1808 b1809 b189 기타명시된자아와시간의경험기능 상세불명의자아와시간의경험기능 기타명시된및상세불명의특정정신기능 ideation, ideomotor, dressing, oculomotor and speech apraxia Exclusions : psychomotor functions (b147); higher-level cognitive functions (b164); Chapter 7 Neuromusculoskeletal and Movement-Related Functions Experience of self and time functions Specific mental functions related to the awareness of one's identity, one's body, one's position in the reality of one's environment and of time. Inclusions : functions of experience of self, body image and time Experience of self Specific mental functions of being aware of one's own identity and one's position in the reality of the environment around oneself. Inclusion : impairments such as depersonalization and derealization Body image Specific mental functions related to the representation and awareness of one's body. Inclusion : impairments such as phantom limb and feeling too fat or too thin Experience of time Specific mental functions of the subjective experiences related to the length and passage of time. Inclusion : impairments such as jamais vu and déjà vu Experience of self and time functions, other specified Experience of self and time functions, unspecified Specific mental functions, other specified and unspecified b198 기타명시된정신기능 Mental functions, other specified b199 상세불명의정신기능 Mental functions, unspecified 통계청 67

76 한국표준건강분류 제 2 장감각기능과통증 (Sensory functions and pain) 이장에서는시각, 청각, 미각등감각에관한기능과더불어통증에대해살펴본다. 시각과관련기능 (b210-b229) Seeing and related functions b210 시각기능 빛의존재감지와시각적자극에대한형태, 크기, 모양, 색상의감지와관련된감각기능 포함 : 시력 ; 시야 ; 시각의질 ; 빛과색을감지하는능력 ; 원거리와단거리사물을볼수있는시력, 단안과양안시력 ; 시각의질 ; 근시, 원시, 난시, 반맹, 색맹, 터널시, 중심과주변암점, 복시, 야맹증과명순응장해 제외 : 지각기능 (b156) b2100 b21000 b21001 b21002 b21003 시력양안과단안으로근거리와원거리상에대한형태와윤곽을감지할수있는시력 양안의원거리시력눈에서멀리떨어져있는사물을두눈을사용하여형태와윤곽을감지할수있는시각능력 단안의원거리시력눈에서멀리떨어져있는사물에대하여한눈을사용하여형태와윤곽을감지할수있는시각능력 양안의단거리시력눈에서가까이있는사물에대하여두눈을사용하여형태와윤곽을감지할수있는시각능력 단안의단거리시력눈에서가까이있는사물에대하여한눈을사용하여형태와윤곽을감지할수있는시각능력 Seeing functions Sensory functions relating to sensing the presence of light and sensing the form, size, shape and colour of the visual stimuli. Inclusions : visual acuity functions; visual field functions; quality of vision; functions of sensing light and colour, visual acuity of distant and near vision, monocular and binocular vision; visual picture quality; impairments such as myopia, hypermetropia, astigmatism, hemianopia, colour-blindness, tunnel vision, central and peripheral scotoma, diplopia, night blindness and impaired adaptability to light Exclusion : perceptual functions (b156) Visual acuity functions Seeing functions of sensing form and contour, both binocular and monocular, for both distant and near vision. Binocular acuity of distant vision Seeing functions of sensing size, form and contour, using both eyes, for objects distant from the eye. Monocular acuity of distant vision Seeing functions of sensing size, form and contour, using either right or left eye alone, for objects distant from the eye. Binocular acuity of near vision Seeing functions of sensing size, form and contour, using both eyes, for objects close to the eye. Monocular acuity of near vision Seeing functions of sensing size, form and contour, using either right or left eye alone, for objects close to the eye. 68

77 정의에의한세부분류 b21008 b21009 기타명시된시력 상세불명의시력 b2101 시야기능시선을고정한상태에서볼수있는전체영역과관련된시각기능포함 : 암점, 터널시, 시각소실등의장해 b2102 b21020 시각의질피사체에대한광민감도, 색각, 대비민감도그리고전체적인화상의질과관련된시각기능 광민감도최소의빛의양 ( 최소광 ) 과최소의광감도차이 ( 명암차 ) 를감지할수있는시각기능 포함 : 어두움적응의기능 ; 야맹증 ( 빛에대한민감성저하 ) 과눈부심 ( 빛에대한민감성증가 ) 등의장해 b21021 b21022 b21023 색각색깔을구별하고맞추는시각기능 대비민감도최소의조명하에서배경으로부터글자를분별하는시각기능 시상의질시상의질에관여하는시각기능 포함 : 빗나간빛, 변형된시상 ( 부유물또는물갈퀴 ), 상의왜곡그리고별과번쩍임을보는것등의장해 b21028 b21029 b2108 b2109 기타명시된시각의질 상세불명의시각의질 기타명시된시각기능 상세불명의시각기능 Visual acuity functions, other specified Visual acuity functions, unspecified Visual field functions Seeing functions related to the entire area that can be seen with fixation of gaze. Inclusions : impairments such as in scotoma, tunnel vision, anopsia Quality of vision Seeing functions involving light sensitivity, colour vision, contrast sensitivity and the overall quality of the picture. Light sensitivity Seeing functions of sensing a minimum amount of light (light minimum), and the minimum difference in intensity (light difference.) Inclusions : functions of dark adaptation; impairments such as night blindness (hyposensitivity to light) and photophobia (hypersensitivity to light) Colour vision Seeing functions of differentiating and matching colours. Contrast sensitivity Seeing functions of separating figure from ground, involving the minimum amount of luminance required. Visual picture quality Seeing functions involving the quality of the picture. Inclusions : impairments such as in seeing stray lights, affected picture quality (floaters or webbing), picture distortion, and seeing stars or flashes Quality of vision, other specified Quality of vision, unspecified Seeing functions, other specified Seeing functions, unspecified b215 안구주변구조의기능 시각기능을촉진하는안구내부와주변구조의기능포함 : 안구내근의기능, 안검의기능, 안구외근의 Functions of structures adjoining the eye Functions of structures in and around the eye that facilitate seeing functions. Inclusions : functions of internal muscles 통계청 69

78 한국표준건강분류 기능, 수의운동과안구추적운동을포함한안구고정기능, 눈물샘기능, 조절기능, 동공반사 ; 안진, 건성안구와안검하수증같은장해 제외 : 시각기능 (b210); 제 7 장신경근골격계및운동과관련된기능 b2150 안구내재근의기능동공과수정체의형태와크기를조절하는홍채와같은안구내부근육의기능 포함 : 조절기능 ; 동공반사 b2151 b2152 눈꺼풀의기능방어반사등과같은눈꺼풀의기능 안구외재근의기능 다른방향을주시하거나, 시야를 가로질러움직이는사물을쫒아가거나, 움직이는목표물을잡기위하여신속히 점프할때사용하며또한안구를고정할 때사용하는근육의기능 포함 : 안진 ; 양안의협동 b2153 b2158 b2159 눈물샘기능눈물샘과눈물관의기능 기타명시된안구주변구조의기능 상세불명의안구주변구조의기능 of the eye, eyelid, external muscles of the eye, including voluntary and tracking movements and fixation of the eye, lachrymal glands, accommodation, pupillary reflex; impairments such as in nystagmus, xerophthalmia and ptosis Exclusions : seeing functions (b210); Chapter 7 Neuromusculoskeletal and Movement-related Functions Functions of internal muscles of the eye Functions of the muscles inside the eye, such as the iris, that adjust the shape and size of the pupil and lens of the eye. Inclusions : functions of accommodation; pupillary reflex Functions of the eyelid Functions of the eyelid, such as the protective reflex. Functions of external muscles of the eye Functions of the muscles that are used to look in different directions, to follow an object as it moves across the visual field, to produce saccadic jumps to catch up with a moving target, and to fix the eye. Inclusions : nystagmus; cooperation of both eyes Functions of lachrymal glands Functions of the tear glands and ducts. Functions of structures adjoining the eye, other specified Functions of structures adjoining the eye, unspecified b220 눈및주변구조와관련된감각 피로, 건조및눈의가려움과관련된느낌의감각 포함 : 안구뒤쪽의압력감, 내부의이물감, 눈의긴장, 눈내부의작열감등의감각 ; 눈의자극제외 : 통증감각 (b280) Sensations associated with the eye and adjoining structures Sensations of tired, dry and itching eye and related feelings. Inclusions : feelings of pressure behind the eye, of something in the eye, eye strain, burning in the eye; eye irritation Exclusion : sensation of pain (b280) b229 기타명시된및상세불명의시각과관련기능 Seeing and related functions, other specified and unspecified 70

79 정의에의한세부분류 청각과전정기능 (b230-b249) b230 청각기능 소리의존재감지와소리의위치, 높낮이, 음도, 음질등을구별해내는것과관련된감각기능포함 : 청각, 소리판별, 음원위치파악, 음의편위, 말소리판별능력등의기능 ; 난청, 청각장애와청력상실등의장해 제외 : 지각기능 (b156) 과언어의정신기능 (b167) b2300 b2301 b2302 b2303 b2304 b2308 b2309 소리탐지소리의존재감지와관련된감각기능 소리판별배경음의식별과양쪽귀에들리는소리의합성, 음의분리와혼합의판별과연관된소리의존재를감지하는감각기능 음원의위치탐지음원의위치를탐지하는것과관련된감각기능 음의편위소리가들려오는방향이오른쪽인지왼쪽인지를탐지해내는것과관련된감각기능 말소리판별구어를알아듣고 ( 확인 ) 다른소리로부터구어를분별해낼수있는것과관련된감각기능 기타명시된청각기능 상세불명의청각기능 Hearing and vestibular functions Hearing functions Sensory functions relating to sensing the presence of sounds and discriminating the location, pitch, loudness and quality of sounds. Inclusions : functions of hearing, auditory discrimination, localization of sound source, lateralization of sound, speech discrimination; impairments such as deafness, hearing impairment and hearing loss Exclusions : perceptual functions (b156) and mental functions of language (b167) Sound detection Sensory functions relating to sensing the presence of sounds. Sound discrimination Sensory functions relating to sensing the presence of sound involving the differentiation of ground and binaural synthesis, separation and blending. Localisation of sound source Sensory functions relating to determining the location of the source of sound. Lateralization of sound Sensory functions relating to determining whether the sound is coming from the right or left side. Speech discrimination Sensory functions relating to determining spoken language and distinguishing it from other sounds. Hearing functions, other specified Hearing functions, unspecified b235 전정기능 위치, 균형및동작등과관련된내이의감각기능포함 : 위치와위치감각의기능 ; 신체와동작의균형기능 제외 : 청각및전정기능과관련된감각 (b240) Vestibular functions Sensory functions of the inner ear related to position, balance and movement. Inclusions : functions of position and positional sense; functions of balance of the body and movement Exclusion : sensation associated with 통계청 71

80 한국표준건강분류 b2350 b2351 b2352 b2358 b2359 위치전정기능신체의위치를결정하는것과관련된내이의감각기능 균형전정기능신체의균형을잡는것과관련된내이의감각기능 동작의결정에관한전정기능신체의방향과속도등을포함한동작과관련된내이의감각기능 기타명시된전정기능 상세불명의전정기능 hearing and vestibular functions (b240) Vestibular function of position Sensory functions of the inner ear related to determining the position of the body. Vestibular function of balance Sensory functions of the inner ear related to determining the balance of the body. Vestibular function of determination of movement Sensory functions of the inner ear related to determining movement of the body, including its direction and speed. Vestibular functions, other specified Vestibular functions, unspecified b240 청각및전정기능과관련된감각 어지럼증, 쓰러질것같은감각, 이명과현기증의감각 포함 : 이명, 귀속자극, 귀의압력, 어지럼증이나현기증과관련된구역 제외 : 전정기능 (b235), 통증감각 (b280) b2400 b2401 b2402 b2403 b2404 b2405 b2408 귀울림또는이명귀속에서낮은음의바람소리, 풀소리또는울리는소리를느낌 어지럼증자기신체자체나또는신체주변이회전이나흔들림또는기울어지는듯한감각 낙상의감각쥐고있는것을놓치고넘어질것같은감각 어지럼증이나현기증과관련된구역어지럼증이나현기증과함께토할것같은감각 귀속의자극귀속의가려움이나기타유사한느낌을가져오는감각 귀의압력감귀속에느껴지는압박감 기타명시된청력및전정기능과관련된 Sensations associated with hearing and vestibular function Sensations of dizziness, falling, tinnitus and vertigo. Inclusions : sensations of ringing in ears, irritation in ear, aural pressure, nausea associated with dizziness or vertigo Exclusions : vestibular functions (b235); sensation of pain (b280) Ringing in ears or tinnitus Sensation of low-pitched rushing, hissing or ringing in the ear. Dizziness Sensation of motion involving either oneself or one's environment; sensation of rotating, swaying or tilting. Sensation of falling Sensation of losing one's grip and falling. Nausea associated with dizziness or vertigo Sensation of wanting to vomit that arises from dizziness or vertigo. Irritation in the ear Sensation of itching or other similar sensations in the ear. Aural pressure Sensation of pressure in the ear. Sensations associated with hearing and 72

81 정의에의한세부분류 b2409 감각 상세불명의청력및전정기능과관련된감각 vestibular function, other specified Sensations associated with hearing and vestibular function, unspecified b249 기타명시된및상세불명의청력및전정기능과관련된감각 Hearing and vestibular functions, other specified and unspecified 부가적감각기능 (b250-b279) Additional sensory functions b250 미각기능 쓴맛, 단맛, 신맛과짠맛을감지하는감각기능포함 : 미각 ; 미각상실및미각감퇴등과같은장해 Taste function Sensory functions of sensing qualities of bitterness, sweetness, sourness and saltiness. Inclusions : gustatory functions; impairments such as ageusia and hypogeusia b255 후각기능 향이나냄새를감지하는감각기능 포함 : 후각 ; 후각상실및후각감퇴등과같은장해 b260 고유감각기능 신체부위의상대적위치를감지하는감각기능포함 : 위치감지와동작감지기능 제외 : 전정기능 (b235); 근육및운동기능과관련된감각 (b780) b265 촉각기능 표면과그질감및상태를감지하는감각기능포함 : 촉각기능, 촉감 ; 감각마비, 무감각, 저림, 지각이상및지각과민등과같은장해 제외 : 온도및기타자극과관련된감각기능 (b270) Smell function Sensory functions of sensing odours and smells. Inclusions : olfactory functions; impairments such as anosmia or hyposmia Proprioceptive function Sensory functions of sensing the relative position of body parts. Inclusions : functions of statesthesia and kinaesthesia Exclusions : vestibular functions (b235); sensations related to muscles and movement functions (b780) Touch function Sensory functions of sensing surfaces and their texture or quality. Inclusions : functions of touching, feeling of touch; impairments such as numbness, anaesthesia, tingling, paraesthesia and hyperaesthesia Exclusions : sensory functions related to temperature and other stimuli (b270) 통계청 73

82 한국표준건강분류 b270 온도및기타자극과관련된감각기능 온도, 진동, 압박과유해자극을감지하는감각기능포함 : 온도, 진동, 흔들림또는떨림, 표재압박, 심부압박, 작열감또는기타유해자극에민감한기능 제외 : 촉각기능 (b265); 통증감각 (b280) b2700 b2701 b2702 온도에대한민감성한랭과온열을감지하는감각기능 진동에대한민감성흔들림이나떨림을감지하는감각기능 압력에대한민감성피부에대한압력을감지하는감각기능 포함 : 접촉에대한민감성, 감각마비, 지각감퇴, 지각과민, 지각이상, 저림같은장해 b2703 유해자극에대한민감성통증이나불편한감각을감지하는감각기능포함 : 통각저하, 통각과다, 이질통증, 무통증및통증성무감각과같은장해 b2708 b2709 기타명시된온도및기타자극과관련된감각기능 상세불명의온도및기타자극과관련된감각기능 Sensory functions related to temperature and other stimuli Sensory functions of sensing temperature, vibration, pressure and noxious stimulus. Inclusions : functions of being sensitive to temperature, vibration, shaking or oscillation, superficial pressure, deep pressure, burning sensation or a noxious stimulus Exclusions : touch functions (b265); sensation of pain (b280) Sensitivity to temperature Sensory functions of sensing cold and heat. Sensitivity to vibration Sensory functions of sensing shaking or oscillation. Sensitivity to pressure Sensory functions of sensing pressure against or on the skin. Inclusions : impairments such as sensitivity to touch, numbness, hypaesthesia, hyperaesthesia, paraesthesia and tingling Sensitivity to a noxious stimulus Sensory functions of sensing painful or uncomfortable sensations. Inclusions : impairments such as hypalgesia, hyperpathia, allodynia, analgesia and anaesthesia dolorosa Sensory functions related to temperature and other stimuli, other specified Sensory functions related to temperature and other stimuli, unspecified b279 기타명시된및상세불명의부가적감각기능 Additional sensory functions, other specified and unspecified 통증 (b ) Pain b280 통증감각 일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌의감각 Sensation of pain Sensation of unpleasant feeling indicating potential or actual damage to some body 74

83 정의에의한세부분류 포함 : 피부절의통증, 찌르는것같은통증, 작열통, 둔통, 쑤시는것같은통증이한군데또는여러군데의신체부위에서의전신적또는국소적인통증감각 ; 근육통, 통각소실과통각과민등의장애 b2800 b2801 b28010 b28011 b28012 전신적통증신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이전신에서느껴지는감각 신체부위통증신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이신체의특정부위또는여러부위에서느껴지는감각 포함 : 골반부위의통증 머리와목의통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이머리와목에서느껴지는감각 가슴통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이흉부에서느껴지는감각 위통또는복통일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이위또는복부에서느껴지는감각 b28013 등통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이등에서느껴지는감각포함 : 몸통통증 ; 하부요통 b28014 b28015 팔의통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이한쪽또는양쪽의팔이나손에서느껴지는감각 하지의통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이한쪽 structure. Inclusions : sensations of generalized or localized pain, in one or more body part, pain in a dermatome, stabbing pain, burning pain, dull pain, aching pain; impairments such as myalgia, analgesia and hyperalgesia Generalized pain Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt all over, or throughout the body. Pain in body part Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in a specific part, or parts, of the body. Pain in head and neck Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in the head and neck. Pain in chest Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in the chest. Pain in stomach or abdomen Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in the stomach or abdomen. Inclusion : pain in the pelvic region Pain in back Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in the back. Inclusions : pain in the trunk; low backache Pain in upper limb Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in either one or both upper limbs, including hands. Pain in lower limb Sensation of unpleasant feeling indicating potential or actual damage to some body 통계청 75

84 한국표준건강분류 또는양쪽의하지나발에서느껴지는감각 b28016 관절의통증일부신체구조에잠재적또는실질적손상을의미하는불쾌한느낌이하나이상의크고작은관절을포함한관절에서느껴지는것포함 : 고관절의통증 ; 어깨관절의통증 b28018 b28019 b2802 b2803 b2804 b289 b298 b299 기타명시된신체부위통증 상세불명의신체부위통증 여러신체부위의통증여러신체부위의일부신체구조에잠재적또는실질적손상을의미하는불쾌한감정 동일피부절의방사통동일신경뿌리에있는피부에있는일부신체구조에잠재적또는실질적손상을의미하는불쾌한감각 분절또는부위의방사통동일신경뿌리에영향받지않는상이한피부의일부신체구조에잠재적또는실질적손상을의미하는불쾌한감각 기타명시된및상세불명의통증감각 기타명시된감각기능과통증 상세불명의감각기능과통증 structure felt in either one or both lower limbs, including feet. Pain in joints Sensation of unpleasant feeling indicating potential or actual damage to some body structure felt in one or more joints, including small and big joints. Inclusions : pain in the hip; pain in the shoulder Pain in body part, other specified Pain in body part, unspecified Pain in multiple body parts Unpleasant sensation indicating potential or actual damage to some body structure located in several body parts. Radiating pain in a dermatome Unpleasant sensation indicating potential or actual damage to some body structure located in areas of skin served by the same nerve root. Radiating pain in a segment or region Unpleasant sensation indicating potential or actual damage to some body structure located in areas of skin in different body parts not served by the same nerve root. Sensation of pain, other specified and unspecified Sensory functions and pain, other specified Sensory functions and pain, unspecified 76

85 정의에의한세부분류 제 3 장음성과말하기의기능 (Voice and speech functions) 이장은발성과말하기기능에대한내용이다. b310 음성기능 공기가후두를통해지나갈때발생되는여러가지소리를생성하는기능 포함 : 음성의생성과음질의기능 ; 발성, 음도, 크기와기타음성의질 ; 발성불능, 발성장애, 쉰목소리, 과다콧소리, 과소콧소리같은장해 제외 : 언어의정신기능 (b167); 조음기능 (b320); 대체음성기능 (b340) b3100 음성의생성 ( 발성 ) 후두와주위근육들의협응으로호흡계통과함께소리를발생시키는기능 포함 : 발성, 음량의기능 ; 발성불능장해 b3101 음성의질음도, 공명및다른특징을포함하여음성의특성을결정하는기능 포함 : 높고낮은음도의기능 ; 과다콧소리, 과소콧소리, 발성장애, 쉰목소리또는거친소리같은장해 b3108 b3109 기타명시된음성기능 상세불명의음성기능 Voice functions Functions of the production of various sounds by the passage of air through the larynx. Inclusions : functions of production and quality of voice; functions of phonation, pitch, loudness and other qualities of voice; impairments such as aphonia, dysphonia, hoarseness, hypernasality and hyponasality Exclusions : mental functions of language (b167); articulation functions (b320); alternative vocalization functions (b340) Production of voice Functions of the production of sound made through coordination of the larynx and surrounding muscles with the respiratory system. Inclusions : functions of phonation, loudness; impairment of aphonia Quality of voice Functions of the production of characteristics of voice including pitch, resonance and other features. Inclusions : functions of high or low pitch; impairments such as hypernasality, hyponasality, dysphonia, hoarseness or harshness Voice functions, other specified Voice functions, unspecified b320 조음기능 말소리를생성하는기능 포함 : 말투의기능, 음소의조음 ; 강직성운동실조성, 이완성조음장애 ; 무조음증 제외 : 언어의정신기능 (b167); 음성기능 (b310) Articulation functions Functions of the production of speech sounds. Inclusions : functions of enunciation, articulation of phonemes; spastic, ataxic, flaccid dysarthria; anarthria Exclusions : mental functions of language (b167); voice functions (b310) 통계청 77

86 한국표준건강분류 b330 말하기기능의유창성과리듬 말하기의흐름과템포를생성하는기능 포함 : 말하기의유창성, 리듬, 속도와멜로디의기능 ; 운율과억양 ; 말더듬, 눌어증, 속화증, 느리게말하기, 빠르게말하기와같은장해 제외 : 언어의정신기능 (b167); 음성기능 (b310); 조음기능 (b320) b3300 말하기의유창성말하기의흐름이부드럽고끊이지않게생성되는기능포함 : 말하기의부드러운연결기능 ; 말더듬, 눌어증, 속화증, 비유창성, 소리의반복, 음소, 단어, 단어의반복, 말하기에서불규칙한중단 b3301 말하기의리듬템포나강약으로조절되는패턴의말하기기능포함 : 상동적이거나반복적인말하기리듬같은장해 b3302 말하기의속도말하기생성속도의기능포함 : 느리게말하기와빠르게말하기와같은장해 b3303 말하기의멜로디말하기에서음도패턴조절의기능 포함 : 말하기의운율, 억양, 멜로디 ; 단음조말하기같은장해 b3308 b3309 기타명시된말하기기능의유창성과리듬 상세불명의말하기기능의유창성과리듬 Fluency and rhythm of speech functions Functions of the production of flow and tempo of speech. Inclusions : functions of fluency, rhythm, speed and melody of speech; prosody and intonation; impairments such as stuttering, stammering, cluttering, bradylalia and tachylalia Exclusions : mental functions of language (b167); voice functions (b310); articulation functions (b320) Fluency of speech Functions of the production of smooth, uninterrupted flow of speech. Inclusions : functions of smooth connection of speech; impairments such as stuttering, stammering, cluttering, dysfluency, repetition of sounds, words or parts of words and irregular breaks in speech Rhythm of speech Functions of the modulated, tempo and stress patterns in speech. Inclusions : impairments such as stereotypic or repetitive speech cadence Speed of speech Functions of the rate of speech production. Inclusions : impairments such as bradylalia and tachylalia Melody of speech Functions of modulation of pitch patterns in speech. Inclusions : prosody of speech, intonation, melody of speech; impairments such as monotone speech Fluency and rhythm of speech functions, other specified Fluency and rhythm of speech functions, unspecified b340 대체음성기능 다른방식으로의음성생성기능 포함 : 노래부르기, 환호하기, 옹알거리기및콧노래부르기와같은소리의음조와 Alternative vocalization functions Functions of the production of other manners of vocalization. Inclusions : functions of the production of tones and range of sounds, such as in 78

87 정의에의한세부분류 범위의생성기능 ; 크게울기와소리지르기 제외 : 언어의정신기능 (b167); 음성기능 (b310); 조음기능 (b320); 말하기기능의유창성과리듬 (b330) b3400 음조의생성음악적발성을생성하는기능 포함 : 노래부르기, 콧노래부르기와환호하기같은것에서음도를변화하면서단일또는연결된음성의지속과조율및중단 b3401 음역만들기다양한음성의생성기능 포함 : 울기, 옹알이, 까르륵거리기, 재잘대기기능예, 아동기 b3408 b3409 기타명시된대체음성기능 상세불명의대체음성기능 singing, chanting, babbling and humming; crying aloud and screaming Exclusions : mental functions of language (b167); voice functions (b310); articulation functions (b320); fluency and rhythm of speech functions (b330) Production of tones Functions of production of musical vocal sounds. Inclusions : sustaining, modulating and terminating production of single or connected vocalizations with variation in pitch such as in singing, humming and chanting Making a range of sounds Functions of production of a variety of vocalizations. Inclusion : functions of crying, cooing, gurgling and babbling e.g. in children Alternative vocalization functions, other specified Alternative vocalization functions, unspecified b398 기타명시된음성과말하기의기능 Voice and speech functions, other specified b399 상세불명의음성과말하기의기능 Voice and speech functions, unspecified 통계청 79

88 한국표준건강분류 제4장심혈관계통, 혈액계통, 면역계통과호흡계통기능 (Functions of the cardiovascular, haematological, immunological and respiratory systems) 이장은심혈관계통 ( 심장과혈관의기능 ), 혈액계통과면역계통 ( 혈액생성과면역기능 ), 그리고호흡계통 ( 호흡과운동허용의기능 ) 의기능에대한것이다. 심혈관계통기능 (b410-b429) Functions of the cardiovascular system b410 심장기능 전신에적당하거나필요한양과압력으로피를펌프질하는기능 포함 : 심박수, 심장리듬, 심박출량 ; 심실근수축력 ; 심판막의기능 ; 폐순환을통한혈액의펌프질 ; 심장으로순환동태 ; 빈맥, 서맥과불규칙한심박동과심부전에서와같은장해, 심근병증, 심근염과관상동맥기능부족과같은장해 제외 : 혈관기능 (b415); 혈압기능 (b420); 운동내성기능 (b455) b4100 심박수분당심박동수와관련된기능 포함 : 심박수가너무빠르거나 ( 빈맥 ) 느린 ( 서맥 ) 것과같은장해 b4101 심장리듬심장박동의규칙성과관련된기능 포함 : 부정맥과같은장해 b4102 심실근육의수축력매심장박동동안심실근육에의해펌프질된혈액의양과관련된기능 포함 : 심박출량감소와같은장해 Heart functions Functions of pumping the blood in adequate or required amounts and pressure throughout the body. Inclusions : functions of heart rate, rhythm and output; contraction force of ventricular muscles; functions of heart valves; pumping the blood through the pulmonary circuit; dynamics of circulation to the heart; impairments such as tachycardia, bradycardia and irregular heart beat and as in heart failure, cardiomyopathy, myocarditis, and coronary insufficiency Exclusions : blood vessel functions (b415); blood pressure functions (b420); exercise tolerance functions (b455) Heart rate Functions related to the number of times the heart contracts every minute. Inclusions : impairments such as rates that are too fast (tachycardia) or too slow (bradycardia) Heart rhythm Functions related to the regularity of the beating of the heart. Inclusions : impairments such as arrhythmias Contraction force of ventricular muscles Functions related to the amount of blood pumped by the ventricular muscles during every beat. Inclusions : impairments such as diminished cardiac output 80

89 정의에의한세부분류 b4103 심장으로의혈액공급심근에공급될수있는혈액양과관련된기능포함 : 관상동맥허혈과같은장해 b4108 b4109 기타명시된심장기능 상세불명의심장기능 Blood supply to the heart Functions related to the volume of blood available to the heart muscle. Inclusion : impairments such as coronary ischaemia Heart functions, other specified Heart functions, unspecified b415 혈관기능 전신으로혈액을운반하는기능 포함 : 동맥, 모세혈관, 정맥의기능 ; 혈관운동기능 ; 폐동맥, 폐모세혈관과폐정맥의기능 ; 정맥판막의기능 ; 동맥의폐쇄나협착과같은장해 ; 죽상경화증, 동맥경화증, 혈전색전증과정맥류 제외 : 심장기능 (b410); 혈압기능 (b420); 혈액계통기능 (b430); 운동내성기능 (b455) b4150 동맥의기능동맥에서혈류와관련된기능 포함 : 동맥확장과같은장해 ; 간헐성파행증같은동맥협착 b4151 모세혈관의기능모세혈관에서혈류와관련된기능 b4152 정맥의기능정맥혈류와관련된기능과정맥판막의기능포함 : 정맥확장같은장해 ; 정맥협착 ; 정맥류에서의불충분한판막의폐쇄 b4158 b4159 기타명시된혈관기능 상세불명의혈관기능 Blood vessel functions Functions of transporting blood throughout the body. Inclusions : functions of arteries, capillaries and veins; vasomotor function; functions of pulmonary arteries, capillaries and veins; functions of valves of veins; impairments such as in blockage or constriction of arteries; atherosclerosis, arteriosclerosis, thromboembolism and varicose veins Exclusions : heart functions (b410); blood pressure functions (b420); haematological system functions (b430); exercise tolerance functions (b455) Functions of arteries Functions related to blood flow in the arteries Inclusions : impairments such as arterial dilation; arterial constriction such as in intermittent claudication Functions of capillaries Functions related to blood flow in the capillaries. Functions of veins Functions related to blood flow in the veins, and the functions of valves of veins. Inclusions : impairments such as venous dilation; venous constriction; insufficient closing of valves as in varicose veins Blood vessel functions, other specified Blood vessel functions, unspecified b420 혈압기능 동맥내에서혈압을유지하는기능 Blood pressure functions Functions of maintaining the pressure of 통계청 81

90 한국표준건강분류 포함 : 혈압을유지하는기능 ; 증가되거나감소한혈압 ; 저혈압, 고혈압, 체위성저혈압같은장해 제외 : 심장기능 (b410); 혈관기능 (b415) ; 운동내성기능 (b455) b4200 b4201 b4202 b4208 b4209 증가된혈압수축기또는이완기혈압이연령별정상치보다높은것과관련된기능 감소된혈압수축기또는이완기혈압이연령별정상치보다낮은것과관련된기능 혈압의유지신체변화에반응하여적절한혈압유지와관련된기능 기타명시된혈압기능 상세불명의혈압기능 blood within the arteries. Inclusions : functions of maintenance of blood pressure; increased and decreased blood pressure; impairments such as in hypotension, hypertension and postural hypotension Exclusions : heart functions (b410); blood vessel functions (b415); exercise tolerance functions (b455) Increased blood pressure Functions related to a rise in systolic or diastolic blood pressure above normal for the age. Decreased blood pressure Functions related to a fall in systolic or diastolic blood pressure below normal for the age. Maintenance of blood pressure Functions related to maintaining an appropriate blood pressure in response to changes in the body. Blood pressure functions, other specified Blood pressure functions, unspecified b429 기타명시된및상세불명의심혈관계통기능 Functions of the cardiovascular system, other specified and unspecified 혈액계통과면역계통기능 (b430-b439) Functions of the haematological and immunological systems b430 혈액계통기능 혈액생산, 산소와대사물운반, 응고기능 포함 : 혈액의생산과골수의기능 ; 혈액의산소운반기능 ; 비장의혈액과관련된기능 ; 혈액의대사물운반기능 ; 빈혈, 혈우병과기타응고이상같은장해 제외 : 심혈관계통기능 (b410-b429); 면역계통기능 (b435); 운동내성기능 (b455) Haematological system functions Functions of blood production, oxygen and metabolite carriage, and clotting. Inclusions : functions of the production of blood and bone marrow; oxygen-carrying functions of blood; blood-related functions of spleen; metabolite-carrying functions of blood; clotting; impairments such as anaemia, haemophilia and other clotting dysfunctions Exclusions : functions of the cardiovascular system (b410-b429); immunological system functions (b435); 82

91 정의에의한세부분류 b4300 b4301 혈액의생산혈액과그모든성분의생성과관련된기능 혈액의산소운반기능전신에산소를운반하는혈액기능과관련된기능 exercise tolerance functions (b455) Production of blood Functions related to the production of blood and all its constituents. Oxygen-carrying functions of the blood Functions related to the blood's capacity to carry oxygen throughout the body. b4302 b4303 b4308 b4309 혈액의대사물운반기능전신에대사물을운반하는혈액기능과관련된기능 응고기능손상부위와같이혈액응고와관련된기능 기타명시된혈액계통기능 상세불명의혈액계통기능 Metabolite-carrying functions of the blood Functions related to the blood's capacity to carry metabolites throughout the body. Clotting functions Functions related to the coagulation of blood, such as at a site of injury. Haematological system functions, other specified Haematological system functions, unspecified b435 면역계통기능 특정그리고비특정면역반응에의한감염을포함한이물질에대한방어와관련된신체의기능 포함 : 면역반응 ( 특정비특정 ); 과민반응 ; 림프관과림프절의기능 ; 세포매개면역기능, 항체매개면역 ; 접종에대한반응 ; 자가면역, 앨러지반응, 림프절염, 림프부종같은장해 제외 : 혈액계통기능 (b430) b4350 b43500 b43501 면역반응감염을포함한이물질에대한민감한신체반응기능 특정면역반응특정이물질에대한민감한신체반응기능 비특정면역반응 Immunological system functions Functions of the body related to protection against foreign substances, including infections, by specific and non-specific immune responses. Inclusions : immune response (specific and non-specific); hypersensitivity reactions; functions of lymphatic vessels and nodes; functions of cellmediated immunity, antibody-mediated immunity; response to immunization; impairments such as in autoimmunity, allergic reactions, lymphadenitis and lymphoedema Exclusion : haematological system functions (b430) Immune response Functions of the body's response of sensitization to foreign substances, including infections. Specific immune response Functions of the body's response of sensitization to a specific foreign substance. Non-specific immune response 통계청 83

92 한국표준건강분류 b43508 b43509 b4351 감염을포함한이물질에민감한일반적인신체반응에관한기능 기타명시된면역반응 상세불명의면역반응 과민반응다른항원에대한민감도같은이물질에대한증가된민감한신체반응 포함 : 과민반응또는앨러지같은장해 제외 : 음식에대한내성 (b5153) b4352 b4353 b4358 b4359 림프관의기능림프를운반하는혈관에관련된기능 림프절의기능림프관의경로에따른샘과관련된기능 기타명시된면역계통기능 상세불명의면역계통기능 Functions of the body's general response of sensitization to foreign substances, including infections. Immune response, other specified Immune response, unspecified Hypersensitivity reactions Functions of the body's response of increased sensitization to foreign substances, such as in sensitivities to different antigens. Inclusions : impairments such as hypersensitivities or allergies Exclusion : tolerance to food (b5153) Functions of lymphatic vessels Functions related to vascular channels that transport lymph. Functions of lymph nodes Functions related to glands along the course oflymphatic vessels. Immunological system functions, other specified Immunological system functions, unspecified b439 기타명시된및상세불명의혈액계통과면역계통기능 Functions of the haematological and immunological systems, other specified and unspecified 호흡계통기능 (b440-b449) Functions of the respiratory system b440 호흡기능 공기를폐로흡입하고, 공기와혈액과가스교환과공기를내쉬는기능 포함 : 호흡수, 호흡의리듬과깊이 ; 무호흡, 과다환기, 과호흡, 불규칙한호흡, 역행성호흡, 기관지경련등의장해와폐기종에서와같은장해 ; 상기도폐색, 상기도및하기도를통과하는공기흐름감소 제외 : 호흡근육기능 (b445); 부가적인폐기능 (b450); 운동내성기능 (b455) Respiration functions Functions of inhaling air into the lungs, the exchange of gases between air and blood, and exhaling air. Inclusions : functions of respiration rate, rhythm and depth; impairments such as apnoea, hyperventilation, irregular respiration, paradoxical respiration, and bronchial spasm, and as in pulmonary emphysema; upper pulmonary obstruction, reduction in airflow through upper and lower airways Exclusions : respiratory muscle functions (b445); additional respiratory functions 84

93 정의에의한세부분류 b4400 호흡수분당호흡수와관련된기능 포함 : 너무빠른호흡수 ( 빈호흡 ) 나너무느린호흡수 ( 서호흡 ) 등의장해 b4401 호흡리듬숨쉬기의주기성및규칙성과관련된기능포함 : 불규칙한숨쉬기와같은장해 b4402 호흡깊이숨쉬는동안폐의부피팽창과관련된기능포함 : 표재또는얕은호흡등의장해 b4408 b4409 b445 기타명시된호흡기능 상세불명의호흡기능 호흡근육기능 호흡에관여하는근육의기능 포함 : 흉부호흡근육의기능 ; 횡격막의기능 ; 보조호흡근육의기능 제외 : 호흡기능 (b440); 부가적인호흡기능 (b450) ; 운동내성기능 (b455) b4450 b4451 b4452 b4458 b4459 흉부호흡근육의기능호흡에관여하는흉부근육의기능 횡격막의기능호흡에관여하는횡격막의기능 호흡보조근육의기능호흡에관여하는부가적인근육의기능 기타명시된호흡근육기능 상세불명의호흡근육기능 (b450); exercise tolerance functions (b455) Respiration rate Functions related to the number of breaths taken per minute. Inclusions : impairments such as rates that are too fast (tachypnoea) or too slow (bradypnoea) Respiratory rhythm Functions related to the periodicity and regularity of breathing. Inclusions : impairments such as irregular breathing Depth of respiration Functions related to the volume of expansion of the lungs during breathing. Inclusions : impairments such as superficial or shallow respiration Respiration functions, other specified Respiration functions, unspecified Respiratory muscle functions Functions of the muscles involved in breathing. Inclusions : functions of thoracic respiratory muscles; functions of the diaphragm; functions of accessory respiratory muscles Exclusions : respiration functions (b440); additional respiratory functions (b450); exercise tolerance functions (b455) Functions of the thoracic respiratory muscles Functions of the thoracic muscles involved in breathing. Functions of the diaphragm Functions of the diaphragm as involved in breathing. Functions of accessory respiratory muscles Functions of the additional muscles involved in breathing. Respiratory muscle functions, other specified Respiratory muscle functions, unspecified b449 기타명시된및상세불명의호흡계통기능 Functions of the respiratory system, other specified and unspecified 통계청 85

94 한국표준건강분류 심혈관계통과호흡계통의부가적인기능과감각 (b450-b469) Additional functions and sensations of the cardiovascular and respiratory systems b450 호흡계통의부가적인기능 기도분비물의생산과이동, 기침, 재채기와하품같은호흡과관련된부가적인기능 포함 : 불기, 휘파람불기, 입으로숨쉬기기능 b4500 입을통한호흡기능포함 : 불기기능과휘파람불기기능 b4501 b4502 b4503 b4504 b45040 b45041 b45048 b45049 b4508 b4509 기침기능 재채기기능 하품기능 점액관련기능 점액생산 점액이송 기타명시된점액관련기능 명시되지않은점액관련기능 기타명시된호흡계통의부가적인기능 명시되지않은호흡계통의부가적인기능 Additional functions of the respiratory system Additional functions related to breathing, such as producing and transporting airway secretions, coughing, sneezing and yawning. Inclusions : functions of blowing, whistling and mouth breathing Functions of breathing through the mouth Inclusions : functions of blowing and whistling Functions of coughing Functions of sneezing Functions of yawning Functions related to mucus Production of mucus Transportation of mucus Functions related to mucus, other specified Functions related to mucus, not specified Additional functions of the respiratory system, other specified Additional functions of the respiratory system, not specified b455 운동내성기능 신체적피로감을극복하기위한호흡기와심혈관용량과관련된기능 포함 : 신체적지구력, 유산소용량, 스태미나와피로도의기능 제외 : 심혈관계통기능 (b ); 혈액계통기능 (b430); 호흡기능 (b440); 호흡근육기능 (b445) ; 부가적인호흡기능 (b450) Exercise tolerance functions Functions related to respiratory and cardiovascular capacity as required for enduring physical exertion. Inclusions : functions of physical endurance, aerobic capacity, stamina and fatiguability Exclusions : functions of the cardiovascular system (b410-b429); haematological system functions (b430); respiration functions (b440); respiratory muscle functions (b445); additional respiratory functions (b450) 86

95 정의에의한세부분류 b4550 b4551 b4552 b4558 b4559 전반적인신체적지구력신체운동의내성이나스태미나의전반적수준과관련된기능 유산소능력숨이차지않고운동할수있는정도와관련된기능 피로도모든운동수준에서피로에대한감수성과관련된기능 기타명시된운동내성기능 상세불명의운동내성기능 General physical endurance Functions related to the general level of tolerance of physical exercise or stamina. Aerobic capacity Functions related to the extent to which a person can exercise without getting out of breath. Fatiguability Functions related to susceptibility to fatigue, at any level of exertion. Exercise tolerance functions, other specified Exercise tolerance functions, unspecified b460 심혈관및호흡기능과관련된감각 심박동결손, 두근거림, 호흡이짧아지는것과같은감각 포함 : 가슴을꽉죄는느낌, 불규칙한심장박동, 호흡곤란, 공기부족, 질식, 구역과쌕쌕거림과같은감각. 제외 : 통증감각 (b280) Sensations associated with cardiovascular and respiratory functions Sensations such as missing a heart beat, palpitation and shortness of breath. Inclusions : sensations of tightness of chest, feelings of irregular beat, dyspnoea, air hunger, choking, gagging and wheezing Exclusion : sensation of pain (b280) b469 기타명시된및상세불명의심혈관과호흡의부가적인기능과감각 Additional functions and sensations of the cardiovascular and respiratory systems, other specified and unspecified b498 기타명시된심혈관계통, 혈액계통, 면역계통과호흡계통기능 Functions of the cardiovascular, haematological, immunological and respiratory systems, other specified b499 상세불명의심혈관계통, 혈액계통, 면역계통과호흡계통기능 Functions of the cardiovascular, haematological, immunological and respiratory systems, unspecified 통계청 87

96 한국표준건강분류 제 5 장소화계통, 대사와내분비계통기능 (Functions of the digestive, metabolic and endocrine systems) 이장은섭취, 소화, 배설기능뿐아니라대사와내분비선기능에관한내용이다. 소화계통과관련된기능 (b ) Functions related to the digestive systems b510 섭취기능 고형물또는액체를입을통해체내로넣고다루는것과관련된기능 포함 : 빨기, 씹기와깨물기, 입안에서음식물다루기, 침분비, 삼키기, 트림, 역류, 침뱉기와구토 ; 삼킴곤란, 음식물흡인, 공기삼킴증, 과다한침분비, 침흘림과불충분한침분비등과같은장해 제외 : 소화계통과관련된감각 (b535) b5100 b5101 b5102 b5103 b5104 b5105 빨기볼, 입술, 혀를움직이어흡인력을발생시켜입안으로끌어들이는기능 깨물기앞니로음식물을자르고, 꿰뚫거나찢는기능 씹기어금니로음식물을으깨고, 갈고, 씹는기능 입안에서음식물다루기혀와이로음식물을입안에서움직이는기능 침분비입안에침을생성하는기능 삼킴적절한비율과속도로구강, 인두, 식도를거쳐위로음식, 음료그리고 Ingestion functions Functions related to taking in and manipulating solids or liquids through the mouth into the body. Inclusions : functions of sucking, chewing and biting, manipulating food in the mouth, salivation, swallowing, burping, regurgitation, spitting and vomiting; impairments such as dysphagia, aspiration of food, aerophagia, excessive salivation, drooling and insufficient salivation Exclusion : sensations associated with digestive system (b535) Sucking Functions of drawing into the mouth by a suction force produced by movements of the cheeks, lips and tongue. Biting Functions of cutting into, piercing or tearing off food with the front teeth. Chewing Functions of crushing, grinding and masticating food with the back teeth (e.g. molars). Manipulation of food in the mouth Functions of moving food around the mouth with the teeth and tongue. Salivation Function of the production of saliva within the mouth. Swallowing Functions of clearing substances, such as food, drink and saliva through the oral 88

97 정의에의한세부분류 타액과같은물질을보내는기능 포함 : 입안, 인두또는식도에서의삼킴곤란 ; 물질의식도통과장해 b51050 포함 : 침삼키기 b51051 b51052 b51058 b51059 b5106 b51060 b51061 b5108 b5109 입안삼키기구강에서적절한비율과속도로물질을비우는기능 인두삼킴인두에서적절한비율과속도로물질을비우는기능 식도삼킴식도에서적절한비율과속도로물질을비우는기능 기타명시된삼킴 상세불명의삼킴 위, 식도또는인두내용물의배출기능 음식, 액체, 약물, 의도적또는비의도적으로삼킨물질과같은것들을역류와구토처럼섭취반대방향으로이동하는기능 구토 역류 기타명시된섭취기능 상세불명의섭취기능 cavity, pharynx and oesophagus into the stomach at an appropriate rate and speed. Inclusions : oral, pharyngeal or oesophageal dysphagia; impairments in oesophageal passage of substances Oral swallowing Function of clearing substances through the oral cavity at an appropriate rate and speed. Inclusion : drooling Pharyngeal swallowing Function of clearing substances through the pharynx at an appropriate rate and speed. Oesophageal swallowing Function of clearing substances through the oesophagus at an appropriate rate and speed. Swallowing, other specified Swallowing, unspecified Functions of expelling the contents of the stomach, oesophagus or pharynx Functions of moving substance such as food, liquid, medications, objects intentionally or unintentionally swallowed in the reverse direction to ingestion, such as in regurgitation and vomiting. Vomiting Regurgitation Ingestion functions, other specified Ingestion functions, unspecified b515 소화기능 음식물을위장관으로운반하고분해하고, 영양분을흡수하는기능 포함 : 위를통해음식물을운반하는기능, 연동운동 ; 음식물분해, 위와장에서소화효소생산과작용 ; 영양분흡수와음식물에대한내성 ; 위산과다, 흡수장애, 음식물에대한불내성, 장운동항진, 장운동마비, 장폐색과담즙생성감소등의장해 Digestive functions Functions of transporting food through the gastrointestinal tract, breakdown of food and absorption of nutrients. Inclusions : functions of transport of food through the stomach, peristalsis; breakdown of food, enzyme production and action in stomach and intestines; absorption of nutrients and tolerance to food; impairments such as in hyperacidity of stomach, malabsorption, 통계청 89

98 한국표준건강분류 제외 : 섭취기능 (b510); 동화기능 (b520); 배변기능 (b525); 소화계통과관련된감각 (b535) b5150 b5151 b5152 위와장을통한음식물의운반기계적으로음식물을위와장을통하여이동시키는연동운동및관련기능 음식물의분해위장관에서음식물을기계적으로작은조각으로만드는기능 영양분의흡수장관전체로부터음식과음료의영양분을혈액으로보내는기능 b5153 음식에대한내성소화에적합한음식과음료를받아들이고, 부적합한것은거부하는기능포함 : 과민성, 글루텐불내성등의장해 b5158 b5159 기타명시된소화기능 상세불명의소화기능 intolerance to food, hypermotility of intestines, intestinal paralysis, intestinal obstruction and decreased bile production Exclusions : ingestion functions (b510); assimilation functions (b520); defecation functions (b525); sensations associated with the digestive system (b535) Transport of food through stomach and intestines Peristalsis and related functions that mechanically move food through stomach and intestines. Breakdown of food Functions of mechanically reducing food to smaller particles in the gastrointestinal tract. Absorption of nutrients Functions of passing food and drink nutrients into the blood stream from along the intestines. Tolerance to food Functions of accepting suitable food and drink for digestion and rejecting what is unsuitable. Inclusion : impairments such as hypersensitivities, gluten intolerance Digestive functions, other specified Digestive functions, unspecified b520 동화기능영양분을살아있는신체의구성요소로전환시키는기능포함 : 신체내영양분을저장하는기능제외 : 소화기능 (b515); 배변기능 (b525); 체중유지기능 (b530); 전반적대사기능 (b540) Assimilation functions Functions by which nutrients are converted into components of the living body. Inclusion : functions of storage of nutrients in the body Exclusions : digestive functions (b515); defecation functions (b525); weight maintenance functions (b530); general metabolic functions (b540) b525 배변기능 소화되지않는음식물과찌꺼기를배출하는것및관련기능 Defecation functions Functions of elimination of wastes and undigested food as faeces and related 90

99 정의에의한세부분류 포함 : 배출기능, 대변경도, 배변횟수 ; 대변자제, 고창 ; 변비, 설사, 물대변, 항문괄약근부전또는대변실금등과같은장해 제외 : 소화기능 (b515); 동화기능 (b520); 소화계통과관련된감각 (b535) b5250 b5251 b5252 b5253 b5254 b5258 b5259 대변배출복부근육의수축을포함하여직장에서찌꺼기를배출하는기능 대변경도딱딱함, 단단함, 연함또는물기등의대변의굳기 배변빈도배변의빈도에관여하는기능 대변자제분변의배출기능을자의적으로조절할수있는기능 고창장관내에과다한공기또는가스의배출에관여하는기능 기타명시된배변기능 상세불명의배변기능 functions. Inclusions : functions of elimination, faecal consistency, frequency of defecation; faecal continence, flatulence; impairments such as constipation, diarrhoea, watery stool and anal sphincter incompetence or incontinence Exclusions : digestive functions (b515); assimilation functions (b520); sensations associated with the digestive system (b535) Elimination of faeces Functions of the elimination of waste from the rectum, including the functions of contraction of the abdominal muscles in doing so. Faecal consistency Consistency of faeces such as hard, firm, soft or watery. Frequency of defecation Functions involved in the frequency of defecation. Faecal continence Functions involved in voluntary control over the elimination function. Flatulence Functions involved in the expulsion of excessive amounts of air or gases from the intestines. Defecation functions, other specified Defecation functions, unspecified b530 체중유지기능 신체발달기간동안에체중증가등을포함하여적절한체중을유지하는기능 포함 : 만족할만한체질량지수를유지하는기능 ; 그리고저체중, 카켁시아, 수척, 과체중, 쇠약등과같은장해그리고일차성과이차성비만등에서볼수있는장해 제외 : 동화기능 (b520); 전반적대사기능 (b540); 내분비선기능 (b555) Weight maintenance functions Functions of maintaining appropriate body weight, including weight gain during the developmental period. Inclusions : functions of maintenance of acceptable Body Mass Index (BMI); and impairments such as underweight, cachexia, wasting, overweight, emaciation and such as in primary and secondary obesity Exclusions : assimilation functions (b520); general metabolic functions (b540); 통계청 91

100 한국표준건강분류 b535 소화계통과관련된감각 먹기, 마시기그리고관련된소화기능으로부터발생하는감각 포함 : 구역, 팽만감, 복부경련감 ; 위포만감, 종류감, 위경련, 위내가스와가슴쓰림 제외 : 통증감각 (b280); 섭취기능 (b510); 소화기능 (b515); 배변기능 (b525) b5350 b5351 b5352 b5358 b5359 구역감토하고싶은감각 팽만감위또는복부의팽창감각 복부경련감각위장관평활근의경련성또는통증성수축의감각 기타명시된소화계통과관련된감각 상세불명의소화계통과관련된감각 endocrine gland functions (b555) Sensations associated with the digestive system Sensations arising from eating, drinking and related digestive functions. Inclusions : sensations of nausea, feeling bloated, and the feeling of abdominal cramps; fullness of stomach, globus feeling, spasm of stomach, gas in stomach and heartburn Exclusions : sensation of pain (b280); ingestion functions (b510); digestive functions (b515); defecation functions (b525) Sensation of nausea Sensation of needing to vomit. Feeling bloated Sensation of distension of the stomach or abdomen. Sensation of abdominal cramp Sensation of spasmodic or painful muscular contractions of the smooth muscles of the gastrointestinal tract. Sensations associated with the digestive system, other specified Sensations associated with the digestive system, unspecified b539 기타명시된및상세불명의소화계통과관련된기능 Functions related to the digestive system, other specified and unspecified 대사및내분비계통과관련된기능 (b540-b559) Functions related to metabolism and the endocrine system b540 전반적대사기능 탄수화물, 단백질, 지방등과같은신체의필수구성요소들이한요소에서다른물질로전환되고이들이분해되어에너지가되는과정을조절하는기능 포함 : 대사, 기초대사율, 탄수화물, 지방과단백질의대사, 분해대사, 합성대사, 신체내에너지생산의기능 ; 대사율의증가 General metabolic functions Functions of regulation of essential components of the body such as carbohydrates, proteins and fats, the conversion of one to another, and their breakdown into energy. Inclusions : functions of metabolism, basal metabolic rate, metabolism of carbohydrate, protein and fat, 92

101 정의에의한세부분류 또는감소 제외 : 동화기능 (b520); 체중유지기능 (b530); 수분, 무기질과전해질의균형기능 (b545); 체온조절기능 (b550); 내분비선기능 (b555) b5400 기초대사율안정상태와온도등의명시된조건하에서신체의산소소비에관련된기능 포함 : 기초대사율증가또는감소 ; 갑상선기능항진증과갑상선기능저하증에서나타나는장해 b5401 b5402 b5403 b5408 b5409 탄수화물대사음식내탄수화물이저장되고, 포도당으로분해되고최종적으로이산화탄소와수분으로되는과정에관련된기능 단백질대사음식내단백질이신체내에서아미노산으로전환되고그다음단계로분해되는과정에관련된기능 지방대사음식내지방이신체내에저장되고분해되는과정에관련된기능 기타명시된전반적대사기능 상세불명의전반적대사기능 catabolism, anabolism, energy production in the body; increase or decrease in metabolic rate Exclusions : assimilation functions (b520); weight maintenance functions (b530); water, mineral and electrolyte balance functions (b545); thermoregulatory functions (b550); endocrine glands functions (b555) Basal metabolic rate Functions involved in oxygen consumption of the body at specified conditions of rest and temperature. Inclusions : increase or decrease in basic metabolic rate; impairments such as in hyperthyroidism and hypothyroidism Carbohydrate metabolism Functions involved in the process by which carbohydrates in the diet are stored and broken down into glucose and subsequently into carbon dioxide and water. Protein metabolism Functions involved in the process by which proteins in the diet are converted to amino acids and broken down further in the body. Fat metabolism Functions involved in the process by which fat in the diet is stored and broken down in the body. General metabolic functions, other specified General metabolic functions, unspecified b545 수분, 무기질과전해질의균형기능 신체내의수분, 무기질그리고전해질조절기능포함 : 수분균형, 칼슘, 아연, 철분등과같은무기질균형의기능, 소듐, 포타슘등과같은전해질균형의기능 ; 수분정체, 탈수, 고칼슘혈증, 저칼슘혈증, 철분결핍, 고나트륨혈증, 저나트륨혈증, 고칼륨혈증, 그리고저칼륨혈증등과같은장해 Water, mineral and electrolyte balance functions Functions of the regulation of water, mineral and electrolytes in the body. Inclusions : functions of water balance, balance of minerals such as calcium, zinc and iron, and balance of electrolytes such as sodium and potassium; impairments such as in water retention, dehydration, hypercalcaemia, 통계청 93

102 한국표준건강분류 제외 : 혈액계통기능 (b430); 전반적대사기능 (b540); 내분비선기능 (b555) b5450 수분균형신체내의수분의수준이나총량의유지에관련된기능포함 : 탈수와재수화등의장해 b54500 b54501 b54508 b54509 b5451 b5452 b5458 b5459 수분정체신체내에수분을붙잡아두는데관련된기능 수분균형의유지신체내에적절한양의수분을유지하는데관련된기능 기타명시된수분균형기능 상세불명의수분균형기능 무기질균형신체내무기질의섭취, 저장, 이용, 그리고배설사이의균형을유지하는데관련된기능 전해질균형신체내전해질의섭취, 저장, 이용, 그리고배설사이의균형을유지하는데관련된기능 기타명시된수분, 무기질과전해질의균형기능 상세불명의수분, 무기질과전해질의균형기능 hypocalcaemia, iron deficiency, hypernatraemia, hyponatraemia, hyperkalaemia and hypokalaemia Exclusions : haematological system functions (b430); general metabolic functions (b540); endocrine gland functions (b555) Water balance Functions involved in maintaining the level or amount of water in the body. Inclusions : impairments such as in dehydration and rehydration Water retention Functions involved in keeping water in the body. Maintenance of water balance Functions involved in maintaining the optimal amount of water in the body. Water balance functions, other specified Water balance functions, unspecified Mineral balance Functions involved in maintaining an equilibrium between intake, storage, utilization and excretion of minerals in the body. Electrolyte balance Functions involved in maintaining an equilibrium between intake, storage, utilization and excretion of electrolytes in the body. Water, mineral and electrolyte balance functions, other specified Water, mineral and electrolyte balance functions, unspecified b550 체온조절기능 체온을조절하는기능 포함 : 체온유지의기능 ; 저체온과고체온같은장해 제외 : 전반적대사기능 (b540); 내분비선기능 (b555) b5500 체온 Thermoregulatory functions Functions of the regulation of body temperature. Inclusions : functions of maintenance of body temperature; impairments such as hypothermia, hyperthermia Exclusions : general metabolic functions (b540); endocrine gland functions (b555) Body temperature 94

103 정의에의한세부분류 신체중심부체온을조절하는데관련된기능포함 : 고체온또는저체온등과같은장해 b5501 체온유지주위환경의기온이변할때에적절한체온을유지하는데관련된기능 포함 : 더위또는추위에대한내성 b5508 b5509 기타명시된체온조절기능 상세불명의체온조절기능 Functions involved in regulating the core temperature of the body. Inclusions : impairments such as hyperthermia or hypothermia Maintenance of body temperature Functions involved in maintaining optimal body temperature as environmental temperature changes. Inclusion : tolerance to heat or cold Thermoregulatory functions, other specified Thermoregulatory functions, unspecified b555 내분비선기능 주기적인변화를포함하여신체내호르몬수준을생성하고조절하는기능 포함 : 호르몬균형의기능 ; 뇌하수체기능항진증, 뇌하수체기능저하증, 갑상선기능항진증, 갑상선기능저하증, 부신기능항진증, 부신기능저하증, 부갑상선기능항진증, 부갑상선기능저하증, 생식선항진증, 생식선저하증 제외 : 전반적대사기능 (b540); 수분, 무기질과전해질의균형기능 (b545); 체온조절기능 (b550); 성기능 (b640); 월경기능 (b650) b5550 b55500 b55501 b55502 b55508 b55509 사춘기기능사춘기시작및제 1 차, 제 2 차성징의발현과관련된기능 체모및음모의발달체모및음모의발달과관련된기능 유방및유두의발달유방및유두의발달과관련된기능 음경, 고환및음낭의발달음경, 고환및음낭의발달과관련된기능 기타명시된사춘기기능 상세불명의사춘기기능 Endocrine gland functions Functions of production and regulation of hormonal levels in the body, including cyclical changes. Inclusions : functions of hormonal balance; hyperpituitarism, hypopituitarism, hyperthyroidism, hypothyroidism, hyperadrenalism, hypoadrenalism, hyperparathyroidism, hypoparathyroidism, hypergonadism, hypogonadism Exclusions : general metabolic functions (b540); water, mineral and electrolyte balance functions (b545); thermoregulatory functions (b550); sexual functions (b640); menstruation functions (b650) Pubertal functions Functions associated with the onset of puberty and manifestations of primary and secondary sexual characteristics. Body and pubic hair development Functions associated with development of body and pubic hair. Breast and nipple development Functions associated with breast and nipple development. Penis, testes and scrotum development Functions associated with development of penis, testes and scrotum. Pubertal functions, other specified Pubertal functions, unspecified 통계청 95

104 한국표준건강분류 b559 기타명시된및상세불명의대사및내분비계통과관련된기능 Functions related to metabolism and the endocrine system, other specified and unspecified b598 기타명시된소화계통, 대사와내분비계통기능 Functions of the digestive, metabolic and endocrine systems, other specified b599 상세불명의소화계통, 대사와내분비계통기능 Functions of the digestive, metabolic and endocrine systems, unspecified 96

105 정의에의한세부분류 제 6 장비뇨생식계통기능 (Genitourinary and reproductive function) 이장은성기능과출산기능을포함하여배뇨와생식기능에대한것이다. 비뇨기능 (b610-b639) Urinary function b610 소변배설기능 소변의여과와집적기능 포함 : 소변을여과하고집적하는기능 ; 신부전, 무뇨, 핍뇨, 수신증, 저긴장성방광과요관폐색등과같은장해 제외 : 배뇨기능 (b620) b6100 b6101 b6108 b6109 소변의여과신장에의한소변의여과기능 소변의집적요관과방광에의한소변집적과저장기능 기타명시된소변배설기능 상세불명의소변배설기능 Urinary excretory functions Functions of filtration and collection of the urine. Inclusions : functions of urinary filtration, collection of urine; impairments such as in renal insufficiency, anuria, oliguria, hydronephrosis, hypotonic urinary bladder and ureteric obstruction Exclusion : urination functions (b620) Filtration of urine Functions of filtration of urine by the kidneys. Collection of urine Functions of collection and storage of urine by the ureters and bladder. Urinary excretory functions, other specified Urinary excretory functions, unspecified b620 배뇨기능 방광으로부터소변을배출하는기능 포함 : 배뇨기능, 배뇨빈도, 배뇨자제 ; 긴장성, 절박성, 반사성, 범람, 지속성요실금, 방울방울뇨, 자동방광, 다뇨, 요정체및요의절박등과같은장해 제외 : 소변배설기능 (b610) ; 비뇨기능과관련된감각 (b630) b6200 배뇨방광의소변배출기능포함 : 소변정체와같은장해 Urination functions Functions of discharge of urine from the urinary bladder. Inclusions : functions of urination, frequency of urination, urinary continence; impairments such as in stress, urge, reflex, overflow, continuous incontinence, dribbling, automatic bladder, polyuria, urinary retention and urinary urgency Exclusions : urinary excretory functions (b610); sensations associated with urinary functions (b630) Urination Functions of voiding the urinary bladder. Inclusions : impairments such as in urine retention 통계청 97

106 한국표준건강분류 b6201 배뇨빈도배뇨의횟수에관련된기능 b6202 배뇨자제배뇨를조절하는기능포함 : 긴장성, 절박성, 반사성, 지속성및혼합성요실금등과같은장해 b6028 b6209 기타명시된배뇨기능 상세불명의배뇨기능 Frequency of urination Functions involved in the number of times urination occurs. Urinary continence Functions of control over urination. Inclusions : impairments such as in stress, urge, reflex, continuous and mixed incontinence Urination functions, other specified Urination functions, unspecified b630 비뇨기능과관련된감각 배뇨와관련된배뇨기능으로부터유발되는감각포함 : 불완전한배뇨감각, 방광의충만감 제외 : 통증감각 (b280); 배뇨기능 (b620) Sensations associated with urinary functions Sensations arising from voiding and related urinary functions Inclusions : sensations of incomplete voiding of urine, feeling of fullness of bladder Exclusions : sensations of pain (b280); urination functions (b620) b639 기타명시된및상세불명의비뇨기능 Urinary functions, other specified and unspecified 생식기능 (b640-b679) Genital and reproductive functions b640 성기능 성의각성기, 준비기, 절정기, 해소기등을포함하여성행위와관련된정신적및육체적기능 포함 : 성의각성기, 준비기, 절정기와해소기의기능 ; 성적감흥, 성교, 음경발기, 음핵발기, 질윤활, 사정, 성극치감과관련된기능 ; 발기불능, 불감증, 질경련, 조루, 지속발기증과사정지연같은장해 제외 : 출산기능 (b660), 생식기능과관련된감각 (b670) Sexual functions Mental and physical functions related to the sexual act, including the arousal, preparatory, orgasmic and resolution stages. Inclusions : functions of the sexual arousal, preparatory, orgasmic and resolution phase: functions related to sexual interest, performance, penile erection, clitoral erection, vaginal lubrication, ejaculation, orgasm; impairments such as impotence, frigidity, vaginismus, premature ejaculation, priapism and delayed ejaculation Exclusions : procreation functions (b660); sensations associated with genital and 98

107 정의에의한세부분류 b6400 b6401 b6402 성의각성기기능성적감흥과흥분기능 성의준비기기능성교를할수있게하는기능 절정기기능성극치감에도달하게하는기능 reproductive functions (b670) Functions of sexual arousal phase Functions of sexual interest and excitement. Functions of sexual preparatory phase Functions of engaging in sexual intercourse. Functions of orgasmic phase Functions of reaching orgasm. b6403 성해소기의기능성극치감이후의만족감과수반되는이완의기능포함 : 성극치감의불만족감같은장해 b6408 b6409 기타명시된성기능 상세불명의성기능 Functions of sexual resolution phase Functions of satisfaction after orgasm and accompanying relaxation. Inclusions : impairments such as dissatisfaction with orgasm Sexual functions, other specified Sexual functions, unspecified b650 월경기능 월경의규칙성과월경액의배출을포함하는월경주기와관련된기능 포함 : 월경의규칙성과간격, 월경혈의양 ; 초경, 폐경 ; 일차성과이차성무월경, 월경과다, 빈발월경과역행성월경, 월경전긴장등과같은장해 제외 : 성기능 (b640), 출산기능 (b660), 생식기능과관련된감각 (b670), 통증감각 (b280) b6500 월경주기의규칙성월경주기의규칙성에관련된기능 포함 : 너무잦거나드문월경 b6501 b6502 월경간격월경주기사이의기간에관련된기능 월경의양 Menstruation functions Functions associated with the menstrual cycle, including regularity of menstruation and discharge of menstrual fluids. Inclusions : functions of regularity and interval of menstruation, extent of menstrual bleeding, menarche, menopause; impairments such as primary and secondary amenorrhoea, menorrhagia, polymenorrhoea and retrograde menstruation, premenstrual tension Exclusions : sexual functions (b640); procreation functions (b660); sensations associated with genital and reproductive functions (b670); sensation of pain (b280) Regularity of menstrual cycle Functions involved in the regularity of the menstrual cycle. Inclusions : too frequent or too few occurrences of menstruation Interval between menstruation Functions relating to the length of time between two menstrual cycles. Extent of menstrual bleeding 통계청 99

108 한국표준건강분류 월경분비량에관련된기능 포함 : 극소량의월경 ( 과소월경 ), 아주대량의월경 ( 월경과다 ) b6503 월경의시작초경의시작에관련된기능 b6504 월경의중단월경의일시적또는영구적중단과관련된기능포함 : 무월경, 폐경, 조기폐경 Functions involved in the quantity of menstrual flow. Inclusions : too little menstrual flow (hypomenorrhoea); too much menstrual flow (menorrhagia, hypermenorrhoea) Onset of menstruation Functions related to the onset of the first menstruation (menarche). Cessation of menstruation Functions related to the temporary or permanent cessation of menstruation. Inclusions : amenorrhea, menopause, praecoxial menopause b6508 b6509 기타명시된월경기능 상세불명의월경기능 Menstruation functions, other specified Menstruation functions, unspecified b660 출산기능 생식능력, 임신, 출산및수유와관련된기능포함 : 남성의생식능력과여성의생식능력, 임신과출산, 그리고수유의기능 ; 무정자증, 정자감소증, 무유즙분비, 유루증, 무수유 ; 생식능력저하, 불임, 자연유산, 자궁외임신, 유산, 미숙태아, 양수과다증과조기분만, 그리고지연분만등과같은장해 제외 : 성기능 (b640), 월경기능 (b650) b6600 생식능력과관련된기능출산을위한생식세포생산능력과관련된기능포함 : 생식능력저하와불임등과같은장해 제외 : 성기능 (b640) b6601 b6602 b6603 임신과관련된기능임신이되는것과임신이된것에관련된기능 분만과관련된기능분만과정에관련된기능 수유모유를생산하고아이에게먹이는일에관련된기능 Procreation functions Functions associated with fertility, pregnancy, childbirth and lactation. Inclusions : functions of male fertility and female fertility, pregnancy and childbirth, and lactation; impairments such as azoospermia, oligozoospermia, agalactorrhoea, galactorrhoea, alactation and such as in subfertility, sterility, spontaneous abortions, ectopic pregnancy, miscarriage, small fetus, hydramnios and premature childbirth, and delayed childbirth Exclusions : sexual functions (b640); menstruation functions (b650) Functions related to fertility Functions related to the ability to produce gametes for procreation. Inclusion : impairments such as in subfertility and sterility Exclusion : sexual functions (b640) Functions related to pregnancy Functions involved in becoming pregnant and being pregnant. Functions related to childbirth Functions involved during childbirth. Lactation Functions involved in producing milk and making it available to the child

109 정의에의한세부분류 b6608 b6609 기타명시된출산기능 상세불명의출산기능 Procreation functions, other specified Procreation functions, unspecified b670 생식기능과관련된감각 성적각성, 성교, 월경그리고이와관련된성기능또는생식기능으로부터유발되는감각 포함 : 성교통, 월경통, 폐경기동안의홍조와폐경기의야간발한등과같은감각 제외 : 통증감각 (b280); 비뇨기능과관련된감각 (b630); 성기능 (b640); 월경기능 (b650); 출산기능 (b660) b6700 b6701 b6702 성교와관련된불쾌감각성기, 준비기, 성교, 성극치감및해소기와관련된감각 월경주기와관련된불쾌감월경전후를포함하는월경에관련된감각 폐경과관련된불쾌감월경주기의정지와관련된감각 포함 : 폐경기동안의홍조와야간발한 b6708 b6709 기타명시된생식기능과관련된감각 상세불명의생식기능과관련된감각 Sensations associated with genital and reproductive functions Sensations arising from sexual arousal, intercourse, menstruation, and related genital or reproductive functions. Inclusions : sensations of dyspareunia, dysmenorrhoea, hot flushes during menopause and night sweats during menopause Exclusions : sensation of pain (b280); sensations associated with urinary functions (b630); sexual functions (b640); menstruation functions (b650); procreation functions (b660) Discomfort associated with sexual intercourse Sensations associated with sexual arousal, preparation, intercourse, orgasm and resolution. Discomfort associated with the menstrual cycle Sensations involved with menstruation, including pre- and post-menstrual phases. Discomfort associated with menopause Sensations associated with cessation of the menstrual cycle. Inclusions : hot flushes and night sweats during menopause Sensations associated with genital and reproductive functions, other specified Sensations associated with genital and reproductive functions, unspecified b679 b698 b699 기타명시된및상세불명의생식기능 기타명시된비뇨생식기능 상세불명의비뇨생식기능 Genital and reproductive functions, other specified and unspecified Genitourinary and reproductive functions, other specified Genitourinary and reproductive functions, unspecified 통계청 101

110 한국표준건강분류 제 7 장신경근골격계및운동과관련된기능 (Neuromusculoskeletal and movement related functions) 이장은관절, 뼈, 반사그리고근육의기능을포함하여운동과가동기능에대한장이다. 관절과뼈의기능 (b710-b729) Functions of the joints and bones b710 관절의가동기능 한관절의가동범위와원활한동작에관여하는관절포함 : 척추관절, 어깨관절, 팔꿈치관절, 손목관절, 고관절, 무릎관절, 발목관절, 손과발의작은관절등의하나또는여러관절의가동성기능 ; 전반적인관절의가동성 ; 관절의과다가동, 동결관절, 동결어깨관절, 관절염등과같은장해 제외 : 관절의안정기능 (b715); 수의운동의조절기능 (b760) b7100 b7101 b7102 b7108 b7109 한관절의가동성한관절의가동범위와원활한동작에관여하는기능 여러관절의가동성하나이상의관절의가동범위와원활한동작에관여하는기능 전반적인관절의가동성전신관절의가동범위와원활한동작에관여하는기능 기타명시된관절의가동기능 상세불명의관절의가동기능 Mobility of joint functions Functions of the range and ease of movement of a joint. Inclusions : functions of mobility of single or several joints, vertebral, shoulder, elbow, wrist, hip, knee, ankle, small joints of hands and feet; mobility of joints generalized; impairments such as in hypermobility of joints, frozen joints, frozen shoulder, arthritis Exclusions : stability of joint functions (b715); control of voluntary movement functions (b760) Mobility of a single joint Functions of the range and ease of movement of one joint. Mobility of several joints Functions of the range and ease of movement of more than one joint. Mobility of joints generalized Functions of the range and ease of movement of joints throughout the body. Mobility of joint functions, other specified Mobility of joint functions, unspecified b715 관절의안정기능 관절의구조적완전성을유지하는기능 포함 : 하나, 여러개그리고전반적인관절의안정성의기능 ; 불안정한어깨관절, 관절의탈구, 어깨관절및고관절탈구등과같은장해 제외 : 관절의가동기능 (b710) Stability of joint functions Functions of the maintenance of structural integrity of the joints. Inclusions : functions of the stability of a single joint, several joints, and joints generalized; impairments such as in unstable shoulder joint, dislocation of a joint, dislocation of shoulder and hip Exclusion : mobility of joint functions (b710) 102

111 정의에의한세부분류 b7150 b7151 b7152 b7158 b7159 한관절의안정성한관절의구조적완전성을유지하는기능 여러관절의안정성여러관절의구조적완전성을유지하는기능 전반적인관절의안정성전신을통한관절의구조적완전성을유지하는기능 기타명시된관절의안정기능 상세불명의관절의안정기능 Stability of a single joint Functions of the maintenance of structural integrity of one joint. Stability of several joints Functions of the maintenance of structural integrity of more than one joint. Stability of joints generalized Functions of the maintenance of structural integrity of joints throughout the body. Stability of joint functions, other specified Stability of joint functions, unspecified b720 뼈의가동기능 견갑골, 골반골, 수근골및족근골의가동범위와원활한동작에관여하는기능 포함 : 동결견갑골및동결골반골등과같은장해제외 : 관절의가동기능 (b710) b7200 견갑골의가동성견갑골의가동범위와원활한동작에관여하는기능포함 : 견갑골의전방움직임, 후방움직임, 외회전과내회전등의장해 b7201 골반골의가동성골반골의가동범위와원활한동작에관여하는기능포함 : 골반골의회전 b7202 b7203 b7208 b7209 수근골의가동성수근골의가동범위와원활한동작에관여하는기능 족근골의가동성족근골의가동범위와원활한동작에관여하는기능 기타명시된뼈의가동기능 상세불명의뼈의가동기능 Mobility of bone functions Functions of the range and ease of movement of the scapula, pelvis, carpal and tarsal bones. Inclusions : impairments such as frozen scapula and frozen pelvis Exclusion : mobility of joints functions (b710) Mobility of scapula Functions of the range and ease of movement of the scapula. Inclusions : impairments such as protraction, retraction, laterorotation and medial rotation of the scapula Mobility of pelvis Functions of the range and ease of movement of the pelvis. Inclusion : rotation of the pelvis Mobility of carpal bones Functions of the range and ease of movement of the carpal bones. Mobility of tarsal bones Functions of the range and ease of movement of the tarsal bones. Mobility of bone functions, other specified Mobility of bone functions, specified b729 기타명시된및상세불명의관절과뼈의기능 Functions of the joints and bones, other specified and unspecified 통계청 103

112 한국표준건강분류 근육기능 (b730-b749) Muscle functions b730 근력기능 하나의근육또는근육군의수축에의해생성된힘과관련된기능 포함 : 특정한근육과근육군, 한팔 ( 또는다리 ), 신체의편측, 하반신, 사지, 체간및전신의근육들의힘과관련된기능 ; 발과손의작은근육들의약화, 근육부전마비, 근육마비, 단일마비, 편마비, 하반신마비, 사지마비, 무동성함구증등의장해 제외 : 안구주변구조의기능 (b215); 근긴장도기능 (b735); 근지구력기능 (b740) b7300 고립된근육과근육군의근력특정한그리고고립된근육과근육군의수축에의해생성된힘과관련된기능 포함 : 발또는손의작은근육의약화와같은장해 b7301 단일사지의근력한쪽팔 ( 또는다리 ) 의근육과근육군의수축에의해생성된힘과관련된기능 포함 : 단일부전마비및단일마비와같은장해 b7302 신체의편측근력 신체의좌측또는우측편의근육과 근육군의수축에의해생성된힘과 관련된기능 포함 : 편부전마비및편마비와같은장해 b7303 하반신의근력하반신의근육과근육군의수축에의해생성된힘과관련된기능 Muscle power functions Functions related to the force generated by the contraction of a muscle or muscle groups. Inclusions : functions associated with the power of specific muscles and muscle groups, muscles of one limb, one side of the body, the lower half of the body, all limbs, the trunk and the body as a whole; impairments such as weakness of small muscles in feet and hands, muscle paresis, muscle paralysis, monoplegia, hemiplegia, paraplegia, quadriplegia and akinetic mutism Exclusions : functions of structures adjoining the eye (b215); muscle tone functions (b735); muscle endurance functions (b740) Power of isolated muscles and muscle groups Functions related to the force generated by the contraction of specific and isolated muscles and muscle groups. Inclusions : impairments such as weakness of small muscles of feet or hands Power of muscles of one limb Functions related to the force generated by the contraction of the muscles and muscle groups of one arm or leg. Inclusions : impairments such as monoparesis and monoplegia Power of muscles of one side of the body Functions related to the force generated by the contraction of the muscles and muscle groups found on the left or right side of the body. Inclusions : impairments such as hemiparesis and hemiplegia Power of muscles in lower half of the body Functions related to the force generated by the contraction of the muscles and muscle groups found in the lower half 104

113 정의에의한세부분류 포함 : 하반신부전마비및하반신마비와같은장해 b7304 사지근력사지전체의근육과근육군의수축에의해생성된힘과관련된기능 포함 : 사지부전마비및사지마비와같은장해 b7305 b7306 몸통근력몸통의근육과근육군의수축에의해생성된힘과관련된기능 신체의모든근력신체의모든근육과근육군의수축에의해생성된힘과관련된기능 포함 : 무동성함구증과같은장해 b7308 b7309 기타명시된근력기능 상세불명의근력기능 of the body. Inclusions : impairments such as paraparesis and paraplegia Power of muscles of all limbs Functions related to the force generated by the contraction of muscles and muscle groups of all four limbs. Inclusions : impairments such as tetraparesis and tetraplegia Power of muscles of the trunk Functions related to the force generated by the contraction of muscles and muscle groups in the trunk. Power of all muscles of the body Functions related to the force generated by the contraction of all muscles and muscle groups of the body. Inclusions : impairments such as akinetic mutism Muscle power functions, other specified Muscle power functions, unspecified b735 근긴장도기능 휴식기근육의긴장도와수동적으로근육을움직일때발생하는저항과관련된기능 포함 : 고립된근육과근육군, 한팔 ( 또는다리 ), 신체의편측과하반신, 사지, 체간의근육그리고전신의근육의긴장과관련된기능 ; 긴장과소, 긴장과도그리고근강직, 근긴장및이상근긴장등과같은장해 제외 : 근력기능 (b730); 근지구력기능 (b740) b7350 고립된근육과근육군의긴장도고립된근육과근육군의휴지기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 포함 : 국소적근긴장이상등과같은장해, 예 : Muscle tone functions Functions related to the tension present in the resting muscles and the resistance offered when trying to move the muscles passively. Inclusions : functions associated with the tension of isolated muscles and muscle groups, muscles of one limb, one side of the body and the lower half of the body, muscles of all limbs, muscles of the trunk, and all muscles of the body; impairments such as hypotonia, hypertonia and muscle spasticity, myotonia and paramyotonia. Exclusions : muscle power functions (b730); muscle endurance functions (b740) Tone of isolated muscles and muscle groups Functions related to the tension present in the resting isolated muscles and muscle groups and the resistance offered when trying to move those muscles passively. Inclusions : impairments such as in focal 통계청 105

114 한국표준건강분류 b7351 기운목 단일사지근육의긴장도한쪽팔 ( 또는다리 ) 의근육과근육군의휴지기긴장도와수동적으로근육을움직일때발생하는근긴장도와관련된기능 포함 : 단일부전마비와단일마비와관련된장해 dystonias, e.g. torticollis Tone of muscles of one limb Functions related to the tension present in the resting muscles and muscle groups in one arm or leg and the resistance offered when trying to move those muscles passively. Inclusions : impairments associated with monoparesis and monoplegia b7352 신체편측근육의긴장도신체의좌측또는우측편의근육들과근육군의휴식기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 포함 : 편부전마비및편마비와관련된장해 b7353 하반신근육의긴장도하반신근육과근육군의휴식기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 포함 : 하반신부전마비및하반신마비와관련된장해 b7354 사지근육의긴장도사지의근육과근육군의휴식기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 포함 : 사지부전마비및사지마비와관련된장해 b7355 b7356 몸통근육의긴장도몸통근육과근육군의휴지기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 신체모든근육의긴장도전신의근육과근육군의휴지기긴장도와수동적으로근육을움직일때발생하는긴장도와관련된기능 Tone of muscles of one side of body Functions related to the tension present in the resting muscles and muscle groups of the right or left side of the body and the resistance offered when trying to move those muscles passively. Inclusions : impairments associated with hemiparesis and hemiplegia Tone of muscles of lower half of body Functions related to the tension present in the resting muscles and muscle groups in the lower half of the body and the resistance offered when trying to move those muscles passively. Inclusions : impairments associated with paraparesis and paraplegia Tone of muscles of all limbs Functions related to the tension present in the resting muscles and muscle groups in all four limbs and the resistance offered when trying to move those muscles passively. Inclusions : impairments associated with tetraparesis and tetraplegia Tone of muscles of trunk Functions related to the tension present in the resting muscles and muscle groups of the trunk and the resistance offered when trying to move those muscles passively. Tone of all muscles of the body Functions related to the tension present in the resting muscles and muscle groups of the whole body and the resistance offered when trying to move those 106

115 정의에의한세부분류 포함 : 전반적인근긴장이상과파킨슨병, 또는전반적인부전마비및마비등과같은장해 b7358 b7359 기타명시된근긴장도기능 상세불명의근긴장도기능 muscles passively. Inclusions : impairments such as in generalized dystonias and Parkinson's disease, or general paresis and paralysis Muscle tone functions, other specified Muscle tone functions, unspecified b740 근지구력기능 필요한시간동안근수축유지와관련된기능 포함 : 단일근육과근육군, 그리고신체의모든근육의지속적인근수축과관련된기능 ; 중증근무력증과같은장해 제외 : 운동내성기능 (b455); 근력기능 (b730); 근긴장도기능 (b735) b7400 b7401 단일근육의지구력단일근육이필요한시간동안근수축을유지할수있는기능 근육군의지구력단일근육군이필요한시간동안근수축을유지할수있는기능 포함 : 단일부전마비, 단일마비, 편부전마비와편마비, 하반신부전마비및하반신마비와관련된장해 b7402 전신근육의지구력신체의모든근육이필요한시간동안지속적인근수축을유지할수있는기능 포함 : 사지부전마비, 사지마비, 전신부전마비및마비와관련된장해 b7408 b7409 기타명시된근지구력기능 상세불명의근지구력기능 Muscle endurance functions Functions related to sustaining muscle contraction for the required period of time. Inclusions : functions associated with sustaining muscle contraction for isolated muscles and muscle groups, and all muscles of the body; impairments such as in myasthenia gravis Exclusions : exercise tolerance functions (b455); muscle power functions (b730); muscle tone functions (b735) Endurance of isolated muscles Functions related to sustaining muscle contraction of isolated muscles for the required period of time. Endurance of muscle groups Functions related to sustaining muscle contraction of isolated muscle groups for the required period of time. Inclusions : impairments associated with monoparesis, monoplegia, hemiparesis and hemiplegia, paraparesis and paraplegia Endurance of all muscles of the body Functions related to sustaining muscle contraction of all muscles of the body for the required period of time. Inclusions : impairments associated with tetraparesis, tetraplegia, general paresis and paralysis Muscle endurance functions, other specified Muscle endurance functions, unspecified b749 기타명시된및상세불명의근육기능 Muscle functions, other specified and unspecified 통계청 107

116 한국표준건강분류 운동기능 (b750-b789) Movement functions b750 반사운동기능 특별한자극에의해자동적으로유발되는근육의불수의적수축기능들 포함 : 근신장반사, 자동적국소관절반사및유해자극과기타외수용성자극에의해발생되는반사기능 ; 회피반사, 이두근반사, 요골반사, 사두근반사, 슬개건반사, 발목반사, 반사의발생과지속 b7500 근신장반사근육의스트레칭에의해자동적으로유발되는불수의적근수축기능 b7501 유해자극에의해발생되는반사통증또는다른유해자극에의해자동적으로유발되는불수의적근수축기능포함 : 회피반사 b7502 외수용성자극에의해발생되는반사 유해성자극이외의외부자극에의해자동적으로유발되는불수의적근수축기능포함 : 포유반사, 잡기, 빨기및기타원시반사 b7508 b7509 기타명시된반사운동기능 상세불명의반사운동기능 Motor reflex functions Functions of involuntary contraction of muscles automatically induced by specific stimuli. Inclusions : functions of stretch motor reflex, automatic local joint reflex, reflexes generated by noxious stimuli and other exteroceptive stimuli; withdrawal reflex, biceps reflex, radius reflex, quadriceps reflex, patellar reflex, ankle reflex, emergence and persistence of reflexes. Stretch motor reflex Functions of involuntary contractions of muscles automatically induced by stretching. Reflexes generated by noxious stimuli Functions of involuntary contractions of muscles automatically induced by painful or other noxious stimuli. Inclusion : withdrawal reflex Reflexes generated by other exteroceptive stimuli Functions of involuntary contractions of muscles automatically induced by external stimuli other than noxious stimuli. Inclusions : rooting, grasping, sucking and other primitive reflexes Motor reflex functions, other specified Motor reflex functions, unspecified b755 불수의운동반응기능 신체의위치, 균형또는위해한자극에의해유발되는대근육또는전신의의불수의적수축기능 포함 : 체위성반응, 바로잡기반응, 신체조정반응, 균형반응, 지지반응, 방어반응 제외 : 반사운동기능 (b750) Involuntary movement reaction functions Functions of involuntary contractions of large muscles or the whole body induced by body position, balance and threatening stimuli. Inclusions : functions of postural reactions, righting reactions, body adjustment reactions, balance reactions, supporting reactions, defensive reactions Exclusion : motor reflex functions (b750) 108

117 정의에의한세부분류 b760 수의운동의조절기능 수의운동의조절및협응과관련된기능 포함 : 단순수의운동과복잡수의운동의조절기능, 수의운동의협응, 팔또는하지의지지기능, 좌우운동의협응, 눈손협응, 눈발협응등의기능 : 조절과협응문제등과같은장해, 예 : 연속반복운동불능 제외 : 근력기능 (b730); 불수의운동기능 (b765); 보행형태기능 (b770) b7600 b7601 b7602 단순한수의운동의조절단순한또는개별적수의운동의조절및협응과관련된기능 복잡한수의운동의조절복잡한수의운동의조절및협응과관련된기능 수의운동의협응단순및복잡한수의운동의협응, 순서대로운동수행과관련된기능 포함 : 좌우협응, 눈손협응및눈발협응과같이시각적으로유도되는운동의협응 ; 연속반복운동불능같은장해 b7603 b7608 b7609 팔또는다리의지지기능팔 ( 팔꿈치또는손 ) 이나다리 ( 무릎또는발 ) 에체중을실음으로발생되는수의운동의조절과협응에관련된기능 기타명시된수의운동의조절기능 상세불명의수의운동의조절기능 Control of voluntary movement functions Functions associated with control over and coordination of voluntary movements. Inclusions : functions of control of simple voluntary movements and of complex voluntary movements, coordination of voluntary movements, supportive functions of arm or leg, right left motor coordination, eye hand coordination, eye foot coordination; impairments such as control and coordination problems, e.g. dysdiadochokinesia Exclusions : muscle power functions (b730); involuntary movement functions (b765); gait pattern functions (b770) Control of simple voluntary movements Functions associated with control over and coordination of simple or isolated voluntary movements. Control of complex voluntary movements Functions associated with control over and coordination of complex voluntary movements. Coordination of voluntary movements Functions associated with coordination of simple and complex voluntary movements, performing movements in an orderly combination. Inclusions : right left coordination, coordination of visually directed movements, such as eye hand coordination and eye foot coordination; impairments such as dysdiadochokinesia Supportive functions of arm or leg Functions associated with control over and coordination of voluntary movements by placing weight either on the arms (elbows or hands) or on the legs (knees or feet). Control of voluntary movement functions, other specified Control of voluntary movement functions, unspecified 통계청 109

118 한국표준건강분류 b761 자발적동작 유아의자발적동작과동작의패턴과같이전신및신체일부동작의빈도, 능숙함및복잡성과관련된기능주 : 이코드는 8 개월미만의유아에게만적용해야한다. 제외 : 반사운동기능 (b750); 불수의운동반응기능 (b755); 불수의운동기능 (b765) Spontaneous movements Functions associated with frequency, fluency and complexity of total and individual body-part movements such as infant spontaneous movements and patterns of movement. Note: this code should be applied only to infants aged less than corrected age 6 months. Exclusions : motor reflex functions (b750); involuntary movement reaction functions (b755); involuntary movement functions (b765) b7610 일반적동작생애초기의 몸부림 과 꼼지락거림 과같은연령별일반적인자발적동작의수준과레퍼토리 General movements Repertoire and quality of age-specific general spontaneous movements such as "writhing" movements and "fidgety" movements in early life. b7611 특정자발적동작신체의정중선을향하는팔과다리움직임, 손가락움직임및발차기와같이출생후첫달에일반적으로나타나는다른자발적동작의수준과레퍼토리 Specific spontaneous movements Repertoire and quality of other spontaneous movements normally present in the first postnatal months, such as arm and leg movements toward midline, finger movements and kicking. b7618 b7619 기타명시된자발적동작 상세불명의자발적동작 Spontaneous movements, other specified Spontaneous movements, unspecified b765 불수의운동기능 하나의근육또는근육군의비의도적, 무목적또는반의도적인불수의수축기능 포함 : 근육의불수의수축 ; 떨림, 틱, 매너리즘, 상동증, 운동보속증, 무도병, 무정위운동, 음성틱, 근긴장이상운동과이상운동증등과같은장해 제외 : 수의운동의조절기능 (b760); 보행형태기능 (770) b7650 근육의불수의수축정신적인기능이상의일부로나타나는것과같은근육또는근육군의비의도적, Involuntary movement functions Functions of unintentional, non- or semi-purposive involuntary contractions of a muscle or group of muscles. Inclusions : involuntary contractions of muscles; impairments such as tremors, tics, mannerisms, stereotypies, motor perseveration, chorea, athetosis, vocal tics, dystonic movements and dyskinesia Exclusions : control of voluntary movement functions (b760); gait pattern functions (b770) Involuntary contractions of muscles Functions of unintentional, non- or semi-purposive involuntary contractions 110

119 정의에의한세부분류 무목적또는반의도적인불수의수축기능 포함 : 무도병적운동및무정위성운동등과같은장해 ; 수면과관련된운동장애 b7651 b7652 떨림관절주위근육군의수축과이완이교대로일어나흔들림이일어나게하는기능 틱과매너리즘하나의근육군의반복적이고, 목적을지닌것같은불수의수축기능 포함 : 음성틱, 욕설증, 이갈이와등과같은장해 b7653 b7658 b7659 상동성과운동보속증반복적으로앞뒤로움직거리고머리를끄덕거리나흔드는것같은자연발생적이고무목적적인운동기능 기타명시된불수의운동기능 상세불명의불수의운동기능 of a muscle or group of muscles, such as those involved as part of a psychological dysfunction. Inclusions : impairments such as choreatic and athetotic movements; sleep-related movement disorders Tremor Functions of alternating contraction and relaxation of a group of muscles around a joint, resulting in shakiness. Tics and mannerisms Functions of repetitive, quasi-purposive, involuntary contractions of a group of muscles. Inclusion : impairments such as vocal tics, coprolalia and bruxism Stereotypies and motor perseveration Functions of spontaneous, non-purposive movements such as repetitively rocking back and forth and nodding the head or wiggling. Involuntary movement functions, other specified Involuntary movement functions, unspecified b770 보행형태기능 걷기, 달리기또는다른전신운동들과관련된운동형태의기능 포함 : 걷기와달리기형태 ; 강직성보행, 편마비보행, 하반신마비보행, 비대칭보행, 절름발이및강직보행형태등과같은장해 제외 : 근력기능 (b730); 근긴장기능 (b735); 수의운동의조절기능 (b760); 불수의운동기능 (b765) Gait pattern functions Functions of movement patterns associated with walking, running or other whole body movements. Inclusions : walking patterns and running patterns; impairments such as spastic gait, hemiplegic gait, paraplegic gait, asymmetric gait, limping and stiff gait pattern Exclusions : muscle power functions (b730); muscle tone functions (b735); control of voluntary movement functions (b760); involuntary movement functions (b765) b780 근육및운동기능과관련된감각 신체의근육이나근육군과그들의운동과관련된감각 Sensations related to muscles and movement functions Sensations associated with the muscles or muscle groups of the body and their 통계청 111

120 한국표준건강분류 포함 : 근육강직, 근육의팽팽함, 근육경련또는수축, 근육의중압감등의감각 제외 : 통증감각 (b280) b7800 b7801 b7808 b7809 근육강직의감각근육의팽팽함또는강직감각 근육경련의감각근육이나근육군의불수의수축의감각 기타명시된근육및운동기능과관련된감각 상세불명의근육및운동기능과관련된감각 movement. Inclusions : sensations of muscle stiffness and tightness of muscles, muscle spasm or constriction, and heaviness of muscles Exclusion : sensation of pain (b280) Sensation of muscle stiffness Sensation of tightness or stiffness of muscles. Sensation of muscle spasm Sensation of involuntary contraction of a muscle or a group of muscles. Sensations related to muscles and movement functions, other specified Sensations related to muscles and movement functions, unspecified b789 기타명시된및상세불명의운동기능 Movement functions, other specified and unspecified b798 기타명시된신경근골격계및운동과관련된기능 Neuromusculoskeletal and movement-related functions, other specified b799 상세불명의신경근골격계및운동과관련된기능 Neuromusculoskeletal and movement-related functions, unspecified 112

121 정의에의한세부분류 제 8 장피부와관련구조의기능 (Functions of the skin and related structures) 이장은피부, 손발톱그리고모발의기능에관한것이다. 피부의기능 (b810-b849) Functions of the skin b810 피부의보호기능 물리적, 화학적, 그리고생물학적위협으로부터신체를보호하기위한피부의기능포함 : 태양과기타방사선에대해보호하는기능, 광민감성, 색소침착, 피부성상의변화 ; 피부의차단기능, 굳은살형성, 피부경화 ; 손상된피부, 궤양, 욕창과얇아진피부등과같은장해 제외 : 피부의수복기능 (b820); 피부의기타기능 (b830) Protective functions of the skin Functions of the skin for protecting the body from physical, chemical and biological threats. Inclusions : functions of protecting against the sun and other radiation, photosensitivity, pigmentation, quality of skin; insulating function of skin, callus formation, hardening; impairments such as broken skin, ulcers, bedsores and thinning of skin Exclusions : repair functions of the skin (b820); other functions of the skin (b830) b820 피부의수복기능 피부의찢김과기타피부손상을복구하기위한피부의기능포함 : 딱지형성기능, 치유, 흉터형성 ; 타박상과켈로이드형성 제외 : 피부의보호기능 (b810); 피부의기타기능 (b830) Repair functions of the skin Functions of the skin for repairing breaks and other damage to the skin. Inclusions : functions of scab formation, healing, scarring; bruising and keloid formation Exclusions : protective functions of the skin (b810); other functions of the skin (b830) b830 피부의기타기능 보호와수복외의피부의기능, 예컨대몸식히기와땀분비 포함 : 발한기능, 피부의샘의기능과그로인한냄새 제외 : 피부의보호기능 (b810); 피부의수복기능 (b820) Other functions of the skin Functions of the skin other than protection and repair, such as cooling and sweat secretion. Inclusions : functions of sweating, glandular functions of the skin and resulting body odour Exclusions : protective functions of the skin (b810); repair functions of the skin (b820) b840 피부와관련된감각 가려움, 작열감과저림같은피부관련 Sensation related to the skin Sensations related to the skin such as 통계청 113

122 한국표준건강분류 감각포함 : 따끔거리는감각및벌레가기는듯한감각같은장해제외 : 통증감각 (b280) itching, burning sensation and tingling. Inclusions : impairments such as pins and needles sensation and crawling sensation Exclusion : sensation of pain (b280) b849 기타명시된및상세불명의피부의기능 Functions of the skin, other specified and unspecified 모발과손발톱의기능 (b850-b869) b850 모발의기능 보호, 착색그리고모양같은모발의기능 포함 : 모발의성장, 모발의색소침착, 모발의위치기능 ; 모발의소실또는탈모증같은장해 b860 손발톱의기능 보호, 할큄과모양같은손발톱의기능 포함 : 손발톱의성장과색소침착, 손발톱의질 Functions of the hair and nails Functions of hair Functions of the hair, such as protection, coloration and appearance. Inclusions : functions of growth of hair, pigmentation of hair, location of hair; impairments such as loss of hair or alopecia Functions of nails Functions of the nails, such as protection, scratching and appearance. Inclusions : growth and pigmentation of nails, quality of nails b869 기타명시된및상세불명의모발과손발톱의기능 Functions of the hair and nails, other specified and unspecified b898 기타명시된피부와관련구조의기능 Functions of the skin and related structures, other specified b899 상세불명의피부와관련구조의기능 Functions of the skin and related structures, unspecified 114

123 정의에의한세부분류 신체구조 (Body structures) 정의 : 신체구조 (Body Structures) 란기관, 사지와그구성부분등신체기관의해부조직을말한다. 장해 (Impairments) 란의미있는변형이나손실과같은신체기능또는구조의이상이다. 제 1 평가값 장해의정도또는규모를나타내는, 음 (-) 의척도를가지는일반평가값 xxx.0 장해없음 없는, 부재의, 사소한 0-4% (No impairment) (none, absent, negligible) xxx.1 경도장해 약간의, 낮은 5-24% (Mild impairment) (slight, low) xxx.2 중등도장해 중간의, 보통의 25-49% (Moderate impairment) (medium, fair) xxx.3 중증장해 높은, 심각한 50-95% (Severe impairment) (high, extreme) xxx.4 완전장해 전체 % (Complete impairment) (total) xxx.8 명시되지않음 (Not specified) xxx.9 해당없음 (Not applicable) 몇단계로나눈백분율을제시함으로써보정된평가도구나기타표준을사용하여신체기능의장해를수량화한다. 예를들면, 장해없음 이나 완전장해 는최대 5% 의오차범위를가진다. 일반적으로 중등도장해 는완전장해의절반수준미만을의미한다. 이백분율은표준인구백분위수를참조하여다른영역에서조정할수있다. 이러한측정법을일관된방식으로사용하기위해서는, 향후연구를통하여평가절차개발이필요하다. 통계청 115

124 한국표준건강분류 제 2 평가값 각신체구조의변화의성질을나타낸다. 0 구조상의변화없음 (no change in structure) 1 완전결여 (total absence) 2 부분결여 (partial absence) 3 부가부분 (additional part) 4 크기이상 (aberrant dimensions) 5 불연속성 (discontinuity) 6 위치를벗어남 (deviating position) 7 체액축적을포함한구조상질적변화 (qualitative changes in structure, including accumulation of fluid) 8 명시되지않음 (not specified) 9 해당없음 (not applicable) 제 3 평가값 ( 제안사항 ) 부위별분류를위해개발중 0 2개부위이상 (more than region) 1 오른쪽 (right) 2 왼쪽 (left) 3 양쪽 (both sides) 4 전면 (front) 5 후면 (back) 6 근위 (proximal) 7 원위 (distal) 8 명시되지않음 (not specified) 9 해당없음 (not applicable) KCF 분류규정에관한상세설명은 [ 부록 2] 를참조한다

125 정의에의한세부분류 제 1 장신경계통구조 (Structure of the nervous system) s110 뇌구조 s1100 대뇌피질구조 s11000 전두엽 s11001 측두엽 s11002 두정엽 s11003 후두엽 s11008 기타명시된대뇌피질구조 s11009 상세불명의대뇌피질구조 s1101 중뇌구조 s1102 간뇌구조 s1103 기저핵과관련구조 s1104 소뇌구조 s1105 뇌간구조 s11050 연수 s11051 교뇌 s11058 기타명시된뇌간구조 s11059 상세불명의뇌간구조 s1106 뇌신경구조 s1108 기타명시된뇌구조 s1109 상세불명의뇌구조 Structure of brain Structure of cortical lobes Frontal lobe Temporal lobe Parietal lobe Occipital lobe Structure of cortical lobes, other specified Structure of cortical lobes, unspecified Structure of midbrain Structure of diencephalon Basal ganglia and related structures Structure of cerebellum Structure of brain stem Medulla oblongata Pons Structure of brain stem, other specified Structure of brain stem, unspecified Structure of cranial nerves Structure of brain, other specified Structure of brain, unspecified s120 척수와관련구조 s1200 척수구조 s12000 경수 s12001 흉수 s12002 요천수 s12003 말총 s12008 기타명시된척수구조 s12009 상세불명의척수구조 s1201 척추신경 s1208 기타명시된척수와관련구조 s1209 상세불명의척수와관련구조 Spinal cord and related structures Structure of spinal cord Cervical spinal cord Thoracic spinal cord Lumbosacral spinal cord Cauda equina Structure of spinal cord, other specified Structure of spinal cord, unspecified Spinal nerves Spinal cord and related structures, other specified Spinal cord and related structures, unspecified s130 수막구조 Structure of meninges 통계청 117

126 한국표준건강분류 s140 교감신경계통구조 Structure of sympathetic nervous system s150 부교감신경계통구조 Structure of parasympathetic nervous system s198 기타명시된신경계통구조 Structure of the nervous system, other specified s199 상세불명의신경계통구조 Structure of the nervous system, unspecified 118

127 정의에의한세부분류 제 2 장눈, 귀와관련구조 (The eye, ear and related structures) s210 안와구조 Structure of eye socket s220 s2200 s2201 s2202 s2203 s2204 s2205 s2208 s2209 안구구조결막, 공막, 맥락막각막홍채망막안구수정체유리체기타명시된안구구조상세불명의안구구조 Structure of eyeball Conjunctiva, sclera, choroid Cornea Iris Retina Lens of eyeball Vitreous body Structure of eyeball, other specified Structure of eyeball, unspecified s230 s2300 s2301 s2302 s2303 s2308 s2309 눈주위구조눈물샘과관련구조눈꺼풀눈썹외안근기타명시된눈주위구조상세불명의눈주위구조 Structures around eye Lachrymal gland and related structures Eyelid Eyebrow External ocular muscles Structures around eye, other specified Structures around eye, unspecified s240 외이구조 Structure of external ear s250 s2500 s2501 s2502 s2508 s2509 중이구조고막귀인두관이소골기타명시된중이구조상세불명의중이구조 Structure of middle ear Tympanic membrane Eustachian canal Ossicles Structure of middle ear, other specified Structure of middle ear, unspecified s260 s2600 s2601 s2602 s2603 s2608 s2609 s298 내이구조달팽이관전정미로반고리관내이도기타명시된내이구조상세불명의내이구조기타명시된눈, 귀와관련구조 Structure of inner ear Cochlea Vestibular labyrinth Semicircular canals Internal auditory meatus Structure of inner ear, other specified Structure of inner ear, unspecified Eye, ear and related structures, other specified s299 상세불명의눈, 귀와관련구조 Eye, ear and related structures, unspecified 통계청 119

128 한국표준건강분류 제 3 장음성및말하기와관련된구조 (Structures involved in voice and speech) s310 s3100 s3101 s3102 s3108 s3109 코구조바깥코비중격비강기타명시된코구조상세불명의코구조 Structure of nose External nose Nasal septum Nasal fossae Structure of nose, other specified Structure of nose, unspecified s320 입구조 Structure of mouth s3200 치아 s32000 유치 s32001 s32008 s32009 영구치 s3201 잇몸 s3202 구개구조 s32020 경구개 s32021 기타명시된치아 상세불명의치아 연구개 s3203 혀 s3204 입술구조 s32040 윗입술 s32041 아랫입술 s3205 인중 s3208 기타명시된입구조 s3209 상세불명의입구조 Teeth Primary dentition Permanent dentition Teeth, other specified Teeth, unspecified Gums Structure of palate Hard palate Soft palate Tongue Structure of lips Upper lip Lower lip Philtrum Structure of mouth, other specified Structure of mouth, unspecified s330 s3300 s3301 s3308 s3309 s340 s3400 s3408 s3409 s398 s399 인두구조 비강인두구강인두기타명시된인두구조상세불명의인두구조 후두구조 성대주름기타명시된후두구조상세불명의후두구조 기타명시된음성및말하기와관련된구조 상세불명의음성및말하기와관련된구조 Structure of pharynx Nasal pharynx Oral pharynx Structure of pharynx, other specified Structure of pharynx, unspecified Structure of larynx Vocal folds Structure of larynx, other specified Structure of larynx, unspecified Structures involved in voice and speech, other specified Structures involved in voice and speech, unspecified 120

129 정의에의한세부분류 제 4 장심혈관계통, 면역계통과호흡계통구조 (Structures of the cardiovascular, immunological and respiratory systems) s410 심혈관계통구조 s4100 심장 s41000 심방 s41001 심실 s41008 기타명시된심장구조 s41009 상세불명심장구조 s4101 동맥 s4102 정맥 s4103 모세혈관 s4108 기타명시된심혈관계통구조 s4109 상세불명의심혈관계통구조 Structure of cardiovascular system Heart Atria Ventricles Structure of heart, other specified Structure of heart, unspecified Arteries Veins Capillaries Structure of cardiovascular system, other specified Structure of cardiovascular system, unspecified s420 s4200 s4201 s4202 s4203 s4204 s4208 s4209 면역계통구조림프관림프절흉선비장골수기타명시된면역계통구조상세불명의면역계통구조 Structure of immune system Lymphatic vessels Lymphatic nodes Thymus Spleen Bone marrow Structure of immune system, other specified Structure of immune system, unspecified s430 호흡계통구조 s4300 기관 s4301 폐 s43010 기관지 s43011 폐포 s43018 기타명시된폐구조 s43019 상세불명의폐구조 s4302 흉곽 s4303 호흡근육 s43030 늑간근 s43031 횡격막 s43038 기타명시된호흡근육 s43039 상세불명의호흡근육 Structure of respiratory system Trachea Lungs Bronchial tree Alveoli Structure of lungs, other specified Structure of lungs, unspecified Thoracic cage Muscles of respiration Intercostal muscles Diaphragm Muscles of respiration, other specified Muscles of respiration, unspecified 통계청 121

130 한국표준건강분류 s4308 s4309 기타명시된호흡계통구조 상세불명의호흡계통구조 Structure of respiratory system, other specified Structure of respiratory system, unspecified s498 s499 기타명시된심혈관계통, 면역계통과호흡계통구조 상세불명의심혈관계통, 면역계통과호흡계통구조 Structures of the cardiovascular, immunological and respiratory systems, other specified Structures of the cardiovascular, immunological and respiratory systems, unspecified 122

131 정의에의한세부분류 제 5 장소화계통, 대사계통및내분비계통과관련된구조 (Structures related to the digestive, metabolic and endocrine systems) s510 침샘구조 Structure of salivary glands s520 식도구조 Structure of oesophagus s530 위구조 Structure of stomach s540 s5400 s5401 s5408 s5409 장구조소장대장기타명시된장구조상세불명의장구조 Structure of intestine Small intestine Large intestine Structure of intestine, other specified Structure of intestine, unspecified s550 췌장구조 Structure of pancreas s560 간구조 Structure of liver s570 담낭과담관구조 Structure of gall bladder and ducts s580 s5800 s5801 s5802 s5803 s5808 s5809 내분비선구조뇌하수체갑상선부갑상선부신기타명시된내분비선구조상세불명의내분비선구조 Structure of endocrine glands Pituitary gland Thyroid gland Parathyroid gland Adrenal gland Structure of endocrine glands, other specified Structure of endocrine glands, unspecified s598 기타명시된소화계통, 대사계통및내분비계통과관련된구조 Structures related to the digestive, metabolic and endocrine systems, other specified s599 상세불명의소화계통, 대사계통및내분비계통과관련된구조 Structures related to the digestive, metabolic and endocrine systems, unspecified 통계청 123

132 한국표준건강분류 제 6 장비뇨생식계통과관련된구조 (Structure related to the genitourinary and reproductive systems) s610 s6100 s6101 s6102 s6103 s6108 s6109 비뇨계통구조신장요관방광요도기타명시된비뇨계통구조상세불명의비뇨계통구조 Structure of urinary system Kidneys Ureters Urinary bladder Urethra Structure of urinary system, other specified Structure of urinary system, unspecified s620 골반바닥구조 Structure of pelvic floor s630 생식계통구조 s6300 난소 s6301 자궁구조 자궁체부 s63011 자궁경부 s63012 난관 s63018 기타명시된자궁구조 s63019 상세불명의자궁구조 s6302 유방과유두 s6303 질과외부생식기구조 s63030 음핵 s63031 대음순 s63032 소음순 s63033 질관 s6304 고환과음낭 s6305 음경구조 s63050 음경귀두 s63051 음경몸통 s63058 기타명시된음경구조 s63059 상세불명의음경구조 s6306 전립선 s6308 기타명시된생식계통구조 s6309 상세불명의생식계통구조 Structure of reproductive system Ovaries Structure of uterus Body of uterus Cervix Fallopian tubes Structure of uterus, other specified Structure of uterus, unspecified Breast and nipple Structure of vagina and external genitalia Clitoris Labia majora Labia minora Vaginal canal Testes and scrotum Structure of the penis Glans penis Shaft of penis Structure of penis, other specified Structure of penis, unspecified Prostate Structures of reproductive system, other specified Structures of reproductive system, unspecified 124

133 정의에의한세부분류 s698 기타명시된비뇨생식계통과관련된구조 Structures related to the genitourinary and reproductive systems, other specified s699 상세불명의비뇨생식계통과관련된구조 Structures related to the genitourinary and reproductive systems, unspecified 통계청 125

134 한국표준건강분류 제 7 장움직임과관련된구조 (Structures related to movement) s710 s7100 s7101 s7102 s7103 s7104 s7105 s7108 s7109 s720 s7200 s7201 s7202 s7203 s7208 s7209 머리와목부위의구조두개골안면골목부위의뼈머리와목부위의관절머리와목부위의근육머리와목부위의인대와근막기타명시된머리와목부위의구조상세불명의머리와목부위의구조어깨부위의구조어깨부위의뼈어깨부위의관절어깨부위의근육어깨부위의인대와근막기타명시된어깨부위의구조상세불명의어깨부위의구조 Structure of head and neck region Bones of cranium Bones of face Bones of neck region Joints of head and neck region Muscles of head and neck region Ligaments and fasciae of head and neck region Structure of head and neck region, other specified Structure of head and neck region, unspecified Structure of shoulder region Bones of shoulder region Joints of shoulder region Muscles of shoulder region Ligaments and fasciae of shoulder region Structure of shoulder region, other specified Structure of shoulder region, unspecified s730 상지구조 s7300 위팔구조 s73000 위팔뼈 s73001 팔꿈치관절 s73002 위팔근육 s73003 위팔인대와근막 s73008 기타명시된위팔구조 s73009 상세불명의위팔구조 s7301 아래팔구조 s73010 아래팔뼈 s73011 손목관절 s73012 아래팔근육 s73013 아래팔인대와근막 s73018 기타명시된아래팔구조 s73019 상세불명의아래팔구조 s7302 손의구조 s73020 손뼈 s73021 손과손가락관절 Structure of upper extremity Structure of upper arm Bones of upper arm Elbow joint Muscles of upper arm Ligaments and fasciae of upper arm Structure of upper arm, other specified Structure of upper arm, unspecified Structure of forearm Bones of forearm Wrist joint Muscles of forearm Ligaments and fasciae of forearm Structure of forearm, other specified Structure of forearm, unspecified Structure of hand Bones of hand Joints of hand and fingers 126

135 정의에의한세부분류 s73022 손의근육 s73023 손의인대와근막 s73028 기타명시된손의구조 s73029 상세불명의손의구조 s7308 기타명시된상지의구조 s7309 상세불명의상지의구조 Muscles of hand Ligaments and fasciae of hand Structure of hand, other specified Structure of hand, unspecified Structure of upper extremity, other specified Structure of upper extremity, unspecified s740 s7400 s7401 s7402 s7403 s7408 s7409 골반부위의구조골반부위의뼈골반부위의관절골반부위의근육골반부위의인대와근막기타명시된골반부위의구조상세불명의골반부위의구조 Structure of pelvic region Bones of pelvic region Joints of pelvic region Muscles of pelvic region Ligaments and fasciae of pelvic region Structure of pelvic region, other specified Structure of pelvic region, unspecified s750 하지구조 s7500 대퇴구조 s75000 대퇴골 s75001 고관절 s75002 대퇴근육 s75003 대퇴인대와근막 s75008 기타명시된대퇴구조 s75009 상세불명의대퇴구조 s7501 아래다리구조 s75010 아래다리의뼈 s75011 무릎관절 s75012 아래다리의근육 s75013 아래다리의인대와근막 s75018 기타명시된아래다리구조 s75019 상세불명의아래다리구조 s7502 발목과발의구조 s75020 발목과발의뼈 s75021 발목관절과발및발가락관절 s75022 발목과발의근육 s75023 발목과발의인대와근막 s75028 기타명시된발목과발의구조 s75029 상세불명의발목과발의구조 s7508 기타명시된하지구조 s7509 상세불명의하지구조 Structure of lower extremity Structure of thigh Bones of thigh Hip joint Muscles of thigh Ligaments and fasciae of thigh Structure of thigh, other specified Structure of thigh, unspecified Structure of lower leg Bones of lower leg Knee joint Muscles of lower leg Ligaments and fasciae of lower leg Structure of lower leg, other specified Structure of lower leg, unspecified Structure of ankle and foot Bones of ankle and foot Ankle joint and joints of foot and toes Muscles of ankle and foot Ligaments and fasciae of ankle and foot Structure of ankle and foot, other specified Structure of ankle and foot, unspecified Structure of lower extremity, other specified Structure of lower extremity, unspecified 통계청 127

136 한국표준건강분류 s760 s7600 s76000 s76001 s76002 s76003 s76004 s76008 s76009 s7601 s7602 s7608 s7609 s770 s7700 s7701 s7702 몸통구조 척주구조 경부척주 흉부척주 요부척주 천부척주 미추 기타명시된척주구조 상세불명의척주구조 몸통의근육 몸통의인대와근막 기타명시된몸통의구조 상세불명의몸통의구조 움직임과관련된부가적인근골격계통구조 뼈 관절 근육 s7703 상세불명의관절외인대, 근막, 근육외건막, 소지대, 격막, 낭 s7708 s7709 기타명시된움직임과관련된부가적인근골격계통구조 상세불명의움직임과관련된부가적인근골격계통구조 Structure of trunk Structure of vertebral column Cervical vertebral column Thoracic vertebral column Lumbar vertebral column Sacral vertebral column Coccyx Structure of vertebral column, other specified Structure of vertebral column, specified Muscles of trunk Ligaments and fasciae of trunk Structure of trunk, other specified Structure of trunk, unspecified Additional musculoskeletal structures related to movement Bones Joints Muscles Extra-articular ligaments, fasciae, extramuscular aponeuroses, retinacula, septa, bursae, unspecified Additional musculoskeletal structures related to movement, other specified Additional musculoskeletal structures related to movement, unspecified s798 기타명시된움직임과관련된구조 Structures related to movement, other specified s799 상세불명의움직임과관련된구조 Structures related to movement, unspecified 128

137 정의에의한세부분류 제 8 장피부와관련구조 (Skin and related structures) s810 s8100 s8101 s8102 s8103 s8104 s8105 s8108 s8109 피부부위의구조머리와목부위의피부어깨부위의피부상지의피부골반부위의피부하지의피부몸통과등의피부기타명시된피부부위의구조상세불명의피부부위의구조 Structure of areas of skin Skin of head and neck region Skin of the shoulder region Skin of upper extremity Skin of pelvic region Skin of lower extremity Skin of trunk and back Structure of areas of skin, other specified Structure of areas of skin, unspecified s820 s8200 s8201 s8208 s8209 피부샘구조땀샘피지선기타명시된피부샘구조상세불명의피부샘구조 Structure of skin glands Sweat glands Sebaceous glands Structure of skin glands, other specified Structure of skin glands, unspecified s830 s8300 s8301 s8308 s8309 손발톱구조손톱발톱기타명시된손발톱구조상세불명의손발톱구조 Structure of nails Finger nails Toe nails Structure of nails, other specified Structure of nails, unspecified s840 모발구조 Structure of hair s898 기타명시된피부와관련구조 Skin and related structures, other specified s899 상세불명의피부와관련구조 Skin and related structures, unspecified 통계청 129

138 한국표준건강분류 활동과참여 (Activities and participation) 정의 : 활동 (Activity) 은개인이과제나행위를수행하는것이다. 참여 (Participation) 는일상생활상황에관여하는것이다. 활동제한 (Activity limitation) 은활동수행에서개인이겪을수있는어려움이다. 참여제약 (Participation limitation) 은일상생활상황에관여할때개인이경험할수있는문제를의미한다. 평가값 활동과참여 구성요소의영역은삶의영역전범위 ( 기본적인학습과보기에서부터사회적역할 같은복잡한영역에이르는 ) 를다루는단일목록으로제시된다. 그구성요소는활동 (a) 이나참여 (p) 를 또는두가지모두를표현하기위해사용할수있다. 활동과참여구성요소의평가값은 수행 평가값과 능력 평가값으로두가지이다. 수행 평가값은개인이자신의현재환경에서무엇을하는지를나타낸다. 현재환경은사회적배경을만들기때문에평가값으로분류되는수행은 삶의상황에관여하는것 또는실제상황속에서사람들이겪는 삶의경험 으로이해될수있다. 이배경에는환경요인, 즉 환경요인 구성요소를이용해분류될수있는, 신체적 사회적 태도적부분의모든측면이포함된다. 능력 평가값은개인의일상행위또는과제수행능력을나타낸다. 이평가값은정해진시간에주어진영역에서한사람이도달할수있는기능수행의최대능력을확인시켜준다. 능력 (capacity) 은동일하거나표준화된환경속에서측정되므로환경적으로보정된개인의능력을반영한다. 환경요인 구성요소는이동일환경또는표준환경의특징을설명하는데사용될수있다. 능력 평가값과 수행 평가값은보조도구나인적지원유무와상관없이사용가능하며, 다음의분류를따른다

139 정의에의한세부분류 xxx.0 어려움없음 없는, 부재의, 하찮은 0-4% (No difficulty) (none, absent, negligible) xxx.1 경도어려움 약간의, 낮은 5-24% (Mild difficulty) (slight, low) xxx.2 중등도어려움 중간의, 보통의 25-49% (Moderate difficulty) (medium, fair) xxx.3 중증어려움 높은, 심각한 50-95% (Severe difficulty) (high, extreme) xxx.4 완전어려움 전체 % (Complete difficulty) (total) xxx.8 명시되지않음 (Not specified) xxx.9 해당없음 (Not applicable) 몇단계로나눈백분율이제시함으로써보정된평가도구나기타표준들을사용하여수행문제또는능력제한을수량화한다. 예를들면 수행문제없음 이나 완전수행문제 는최대 5% 의오차범위를가진다. 일반적으로 중등도수행문제 는완전수행문제의절반수준미만을의미한다. 이백분율은표준인구백분위수를참조하여다른영역에서조정할수있다. 이러한측정법을일관된방식으로사용하기위해서는, 향후연구를통하여평가절차개발이필요하다. KCF 분류규정에관한상세설명은 [ 부록 2] 를참조한다. 통계청 131

140 한국표준건강분류 제 1 장학습과지식의적용 (Learning and applying knowledge) 이장은학습, 학습한지식의적용, 사고, 문제해결그리고판단등에대한것이다. 의도적감각경험 (d110-d129) Purposeful sensory experiences d110 보기 시각적으로사물을추적하기, 사람을보기, 스포츠경기, 사람또는아이들노는것을보는것처럼시각적자극을경험하기위해의도적으로시각이용 Watching Using the sense of seeing intentionally to experience visual stimuli, such as visually tracking an object, watching persons, looking at a sporting event, people or children playing. d115 듣기 라디오, 사람목소리, 음악, 또는강연또는구연이야기를듣는것처럼청각적자극을경험하기위해의도적으로청각이용 Listening Using the sense of hearing intentionally to experience auditory stimuli, such as listening to a radio, to the human voice, to music, to a lecture or to a story told. d120 d1200 기타의도적인지각 직물을만지고느끼기, 사탕맛보기또는꽃냄새맡기처럼자극을경험하기위해의도적으로신체의기타기본적인감각이용 입을이용한지각입또는입술을통해사물탐색 d1201 만지기손, 손가락또는팔등신체의부분을사용하여사물탐색제외 : 입을이용한지각 (d1200) d1202 d1203 d129 냄새맡기코에사물을들이대거나사물에코를들이대거나해서사물을느낌 맛보기물기, 씹기, 빨기를통해음식물이나음료의맛을탐색 기타명시된및상세불명의의도적감각경험 Other purposeful sensing Using the body's other basic senses intentionally to experience stimuli, such as touching and feeling textures, tasting sweets or smelling flowers. Mouthing Exploring objects using mouth or lips. Touching Exploring objects using hands, fingers or other limbs or body parts. Exclusion : mouthing (d1200) Smelling Sensing objects by bringing them to the nose or the nose to objects. Tasting Exploring the taste of food or liquid by biting, chewing, sucking. Purposeful sensory experiences, other specified and unspecified 132

141 정의에의한세부분류 기본적학습 (d130-d159) Basic learning d130 d132 모방 얼굴표정, 몸짓, 소리또는철자를따라하는것처럼기본적인학습의구성요소를모방하거나흉내 언어습득 단어, 상징, 어구및문장을통해서사람, 물건, 사건, 느낌을표현하는역량개발 Copying Imitating or mimicking as a basic component of learning, such as copying a facial expression, a gesture, a sound or the letters of an alphabet. Acquiring language Developing the competence to represent persons, objects, events, feelings through words, symbols, phrases and sentences. 포함 : 언어의재습득제외 : 부가적인언어습득 (d133); 의사소통 (d310-d399) Inclusion : re-acquisition of language Exclusions : acquiring an additional language(d133); communication(d310-d399) d1320 d1321 d1322 d1328 d1329 하나의단어또는의미있는부호습득그래프나수화또는상징과같은의미있는단어또는상징학습 단어로어구생성단어를조합하여어구생성의학습 구문습득적절하게구성된문장또는문장의집합을만들어내는학습 기타명시된언어습득 상세불명의언어습득 Acquiring single words or meaningful symbols Learning words or meaningful symbols such as graphic or manual signs or symbols. Combining words into phrases Learning to combine words into phrases. Acquiring syntax Learning to produce appropriately constructed sentences or set of sentences. Acquiring language, other specified Acquiring language, unspecified d133 부가적인언어습득 외국어나수화같은부가적인언어에서단어, 부호, 어구, 문장을통하여사람, 물건, 사건, 느낌을표현하는역량개발 제외 : 언어습득 (d132); 의사소통 (d310-d399) Acquiring an additional language Developing the competence to represent persons, objects, events, feelings through words, symbols, phrases and sentences, in an additional language such as a foreign language or signing. Exclusions : acquiring language(d132); communication(d310-d399) d135 반복 10 단위의수를센다든지, 시낭송연습을하는것처럼학습의기본적 Rehearsing Repeating a sequence of events or symbols as a basic component of learning, such 통계청 133

142 한국표준건강분류 구성요소의일련의사건또는상징을반복 as counting by tens or practising the recitation of a poem. d137 d1370 d1371 d1378 d1379 개념습득 사물, 사람또는사건의특징과관련된기초적이거나복잡한개념을이해하고사용하는능력개발 기초적개념습득크기, 모양, 양, 길이, 동일성, 대립성과같은개념을사용하는것을학습 복잡한개념습득분류, 집단편성, 가역성, 순차배열과같은개념을사용하는것을학습 기타명시된개념습득 상세불명의개념습득 Acquiring concepts Developing competence to understand and use basic and complex concepts related to characteristics, of things, persons or events. Acquiring basic concepts Learning to use such concepts as size, form, quantity, length, same, opposite. Acquiring complex concepts Learning to use such concepts as classification, grouping, reversibility, seriation. Acquiring concepts, other specified Acquiring concepts, unspecified d138 정보습득 왜, 무엇을, 어디서, 어떻게, 질문하는것과이름을묻는질문과같이사람, 사물그리고사건에관한사실획득제외 : 개념습득 (d137); 기술습득 (d155) Acquiring information Obtaining facts about persons, things and events, such as asking why, what, where and how, asking for names. Exclusions : acquiring concepts(d137); acquiring skills(d155) d140 d1400 d1401 d1402 읽기학습 문자와철자를알아보고기록된단어를정확히발음하고, 기록된단어와어구를이해하는것처럼유창하고정확하게문자도구 ( 점자및기타부호포함 ) 를읽는능력개발 그림, 아이콘, 문자, 철자와단어를포함한부호를인식하는기술습득 암호화된부호, 철자와단어의기본적인행동학습 기록된단어의소리를내는기술습득정확한발음으로문자와글자, 부호와단어를소리내는기본적인행동학습 기록된단어와어구이해기술습득 Learning to read Developing the competence to read written material (including Braille and other symbols) with fluency and accuracy, such as recognizing characters and alphabet letters, sounding out written words with correct pronunciation, and understanding written words and phrases. Acquiring skills to recognize symbols including figures, icons, characters, alphabet letters and word Learning basic actions of deciphering symbols, alphabet letters and words. Acquiring skills to sound out written words Learning basic actions of sounding out characters, alphabet letters, symbols and words with correct pronunciation. Acquiring skills to understanding written 134

143 정의에의한세부분류 기록된단어와문장의의미를파악하기위한기본적인행동학습 words and phrases Learning basic actions to grasp the meaning of written words and texts. d1408 d1409 기타명시된읽기학습 상세불명의읽기학습 Learning to read, other specified Learning to read, unspecified d145 d1450 d1451 d1452 d1458 d1459 d150 d1500 쓰기학습 철자를정확하고문법에맞게사용하는것처럼의미를전달 ( 점자및기타상징을포함 ) 하기위해특정소리, 단어, 어구를나타내는부호를활용능력개발 필기도구를사용하기위한기술습득연필, 분필또는붓을잡고, 종이위에문자또는부호를쓰고, 점자를사용하고, 키보드나주변의장치 ( 마우스 ) 를사용하는것과같은기본적인행동학습 부호, 문자그리고철자를쓰기위한기술습득소리 ( 뜻을갖는최소언어단위 ) 를부호나문자 ( 의미를나타내는최소문자단위 ) 로바꾸는기본적인행동학습 단어와어구를쓰기위한기술습득소리낸단어나생각을단어나어구로바꾸는기본적인행동학습 기타명시된쓰기학습 상세불명의쓰기학습 계산학습 덧셈과뺄셈에대한수학적기호를사용하여올바른수학적연산을문제에적용하는것처럼숫자를조작하여간단하고복잡한수학적연산을수행할수있는능력개발 계산의기본기술습득수세기, 정렬, 그리고묶음과같은산술능력의기본적인기술에대한학습 Learning to write Developing the competence to produce symbols that represent sounds, words or phrases in order to convey meaning (including Braille writing and other symbols) such as spelling effectively and using correct grammar. Acquiring skills to use writing implements Learning basic actions of writing down symbols or alphabet letters, such as holding a pencil, chalk or brush, writing a character or a symbol on a piece of paper, using a brailler, keyboard or peripheral device(mouse). Acquiring skills to write symbols, characters and alphabet letters Learning basic actions to transpose a sound(morpheme) into a symbol or a character(grapheme) Acquiring skills to write words and phrases Learning basic actions to transpose spoken words or ideas into written words or phrases. Learning to write, other specified Learning to write, unspecified specified Learning to calculate Developing the competence to manipulate numbers and perform simple and complex mathematical operations, such as using mathematical signs for addition and subtraction and applying the correct mathematical operation to a problem. Acquiring basic skills of numeracy Learning elementary skills of numeracy such as counting, ordering and grouping. 통계청 135

144 한국표준건강분류 d1501 d1502 d1508 d1509 숫자, 연산표시와부호인식기술습득 숫자인식과사용에대한학습 기본계산을이용한기술습득더하기, 빼기, 곱셈과나누기의연산을이용하고, 이와관련된부호인식에대한학습 기타명시된계산기술습득 상세불명의계산기술습득 Acquiring skills to recognize numerals, arithmetic signs and symbols Learning to recognize and use numbers. Acquiring skills in using basic operations Learning to recognize symbols related to and to use operations of addition, subtraction, multiplication and division. Acquiring skills in calculating, other specified Acquiring skills in calculating, unspecified d155 기술습득 도구또는장난감을조작하거나게임을하는것처럼기술을습득하기위해일련의행동과업무를통합할수있는기본적이고복잡한능력개발 포함 : 기본적이면서복잡한기술의습득 d1550 d1551 기본적기술습득연필, 식기와같은간단한도구를사용하는방법을배우는것처럼기본적이고의도적인동작학습 복잡한기술습득축구또는체스같은게임을하는방법을배우거나건축도구를사용하는방법을배우는것처럼순서대로규칙을이행하고각움직임이상호협응을이룰수있도록통합된행위학습 Acquiring skills Developing basic and complex competencies in integrated sets of actions or tasks so as to initiate and follow through with the acquisition of a skill, such as manipulating tools or toys or playing games. Inclusions : acquiring basic and complex skills Acquiring basic skills Learning elementary, purposeful actions, such as learning to use simple tools, such as pencils and eating utensils. Acquiring complex skills Learning integrated sets of actions so as to follow rules, and to sequence and coordinate one's movements, such as learning to play games (e.g. football or chess)and to use a building tool. d1558 d1559 기타명시된기술습득 상세불명의기술습득 Acquiring skills, other specified Acquiring skills, unspecified d159 기타명시된및상세불명의기본적학습 Basic learning, other specified and unspecified 지식의적용 (d160-d179) Applying knowledge d160 주의집중 정신을산란하게하는소음은듣지않는것처럼특정자극에의도적으로주의집중 Focusing attention Intentionally focusing on specific stimuli, such as by filtering out distracting noises

145 정의에의한세부분류 d1600 d1601 d1608 d1609 사람에대한주의집중얼굴, 촉각, 목소리와같은다른사람들의특징에대한의도적집중 환경에대한주의집중질적, 양적또는강도높은신체적또는사회적자극의변화와같은환경의일부요소에대한의도적주의집중 기타명시된주의집중 상세불명의주의집중 Focusing attention on the person Intentionally attending to features of other persons such as their face, touch or voice. Focusing attention on the environment Intentionally attending to some element of the environment, such as changes in the quality, quantity or intensity of physical or social stimuli. Focusing attention, other specified Focusing attention, unspecified d163 사고 이야기를꾸며내고, 이론을증명하고, 아이디어를제시하고, 영감을불어넣고, 명상하고, 고민하고, 사색하고, 반성하는행위처럼아이디어, 개념, 그리고이미지를형성및활용 제외 : 문제해결 (d175), 의사결정 (d177) Thinking Formulating and manipulating ideas, concepts, and images, whether goal-oriented or not, either alone or with others, such as creating fiction, proving a theorem, playing with ideas, brainstorming, meditating, pondering, speculating, or reflecting. Exclusions : solving problems (d175); making decisions (d177) d166 읽기 일반적인지식또는특정한정보를얻기위해문어 ( 문자또는점자로표기된책, 지침서, 신문등 ) 를이해하고해석하는것과관련된활동수행 제외 : 읽기학습 (d140) Reading Performing activities involved in the comprehension and interpretation of written language (e.g. books, instructions or newspapers in text or Braille), for the purpose of obtaining general knowledge or specific information. Exclusion : learning to read (d140) d170 쓰기 사건이나생각을글로기록하거나편지를작성하는것과같이정보를전달하기위해부호나언어생산또는사용 Writing Using or producing symbols or language to convey information, such as producing a written record of events or ideas or drafting a letter. 제외 : 쓰기학습 (d145) d1700 글쓰기과정의일반적기술과전략사용적절한의미를전달하는단어적용, 관례적인문장구조채택 Exclusion : learning to write (d145) Using general skills and strategies of the writing process Applying words which convey appropriate 통계청 137

146 한국표준건강분류 d1701 d1702 d1708 d1709 작문시문법적규칙사용 표준철자구두점 ( 맞춤법 ) 및적절한사례양식등적용 작문을위한일반적기술과전략사용 복잡한의미와추상적인생각을전달하기위하여단어와문장적용 기타명시된쓰기 상세불명의쓰기 meaning, employing conventional sentence structure Using grammatical conventions in writing compositions Applying standards spelling punctuation and proper case forms etc. Using general skills and strategies to write compositions Applying words and sentences to convey complex meaning and abstract ideas Writing, other specified Writing, unspecified d172 계산 한숫자로다른숫자를나눈값을알아내는것또는세숫자를더한합을계산하는것처럼수학적원리를적용하여문제를풀어그결과를제시함으로써계산수행 제외 : 계산학습 (d150) d1720 d1721 d1728 d1729 d175 단순한수계산의실행을위한기술과전략의사용수세기, 묶음과산수계산과같은단순한숫자연산의실행 복잡한숫자연산과계산을실행하기위한기술과전략의사용대수학, 미적분그리고방정식과같은문제해결을위한수학적절차의적용 기타명시된계산 상세불명의계산 문제해결 두사람간의분쟁을해결하는것처럼현안을파악 분석하고, 대안과해결책을개발하고, 해결책이미칠잠재적결과를평가하고, 선택한해결책을실행함으로써고민또는상황에대한해결책찾기 포함 : 간단한그리고복잡한문제해결 Calculating Performing computations by applying mathematical principles to solve problems that are described in words and producing or displaying the results, such as computing the sum of three numbers or finding the result of dividing one number by another. Exclusion : learning to calculate (d150) Using skills and strategies to perform simple numeric calculations Performing simple numeric operations such as counting, grouping and arithmetic calculations. Using skills and strategies to perform complex numeric operations and calculations Applying mathematical procedures and methods such as algebra, calculus and geometry to solve problems. Calculating, other specified Calculating, unspecified Solving problems Finding solutions to questions or situations by identifying and analysing issues, developing options and solutions, evaluating potential effects of solutions, and executing a chosen solution, such as in resolving a dispute between two people. Inclusions : solving simple and complex 138

147 정의에의한세부분류 제외 : 사고 (d163), 의사결정 (d177) d1750 d1751 d1758 d1759 d177 간단한문제해결현안을파악 분석하고, 대안과해결책을개발하고, 해결책이미칠잠재적결과를평가하고, 선택한해결책을실행함으로써한가지문제또는현안만을포함하고있는간단한문제의해결책찾기 복잡한문제해결현안을파악 분석하고, 대안과해결책을개발하고, 해결책이미칠잠재적결과를평가하고, 선택한해결책을실행함으로써상호관련을맺고있는여러가지현안을포함하고있는복잡한문제의해결책찾기 기타명시된문제해결 상세불명의문제해결 의사결정 특정아이템을선별구매하거나책임을맡을것인지결정하고, 몇가지과제가운데한가지역할을선별하여맡는것처럼여러가지선택권중에서한가지를선택 실행하고, 그선택이미칠영향을평가 제외 : 사고 (d163), 문제해결 (d175) problems Exclusions : thinking (d163); making decisions (d177) Solving simple problems Finding solutions to a simple problem involving a single issue or question, by identifying and analysing the issue, developing solutions, evaluating the potential effects of the solutions and executing a chosen solution. Solving complex problems Finding solutions to a complex problem involving multiple and interrelated issues, or several related problems, by identifying and analysing the issue, developing solutions, evaluating the potential effects of the solutions and executing a chosen solution. Solving problems, other specified Solving problems, unspecified Making decisions Making a choice among options, implementing the choice, and evaluating the effects of the choice, such as selecting and purchasing a specific item, or deciding to undertake and undertaking one task from among several tasks that need to be done. Exclusions : thinking (d163); solving problems (d175) d179 기타명시된및상세불명의지식의적용 Applying knowledge, other specified and unspecified d198 기타명시된학습과지식의적용 Learning and applying knowledge, other specified d199 상세불명의학습과지식의적용 Learning and applying knowledge, unspecified 통계청 139

148 한국표준건강분류 제 2 장일반적과제와요구 (General tasks and demands) 이장은하나또는여러가지과제를수행하고, 일과를계획하고스트레스에대응하는일등의일반적인 측면을다루고있다. 그리고이러한항목들은상이한상황에서과제수행의기본적인특징을파악 하기위해보다특정한과제또는행위와관련지어사용될수있다 d210 단일과제수행 과제에착수하고, 과제이행을위해시간, 공간, 그리고자원을조직화하고, 과제수행속도를조절하고, 과제를이행및관리하는것처럼단일과제의정신적및신체적구성요소와관련하여간단하거나복잡한통합된행위수행 포함 : 간단한또는복잡한과제수행, 집단으로또는단독으로단일과제수행 제외 : 기술습득 (d155), 문제해결 (d175), 의사결정 (d177), 다중과제수행 (d220) d2100 d2101 d2102 d2103 간단한과제수행간단한과제를수행하는데필요한시간과공간을준비하고착수하고계획 ; 책을읽거나편지를쓰거나침대를정리하는것처럼하나의주가되는요소를이용해간단한과제를수행 복잡한과제수행한가지의복잡한과제를수행하기위해시간과공간을준비하고착수하고조정 ; 집안의가구를재배치하거나학교숙제를하는것처럼한가지이상의구성요소를이용해, 동시에또는연속하여수행될수있는복잡한과제를수행 단독으로단일과제수행간단한또는복잡한과제수행을위해시간과공간을준비하고착수하고조정 ; 다른사람의도움없이혼자힘으로과제를수행및관리 집단으로단일과제수행간단한과제든복잡한과제든한가지 Undertaking a single task Carrying out simple or complex and coordinated actions related to the mental and physical components of a single task, such as initiating a task, organizing time, space and materials for a task, pacing task performance, and carrying out, completing, and sustaining a task. Inclusions : undertaking a simple or complex task; undertaking a single task independently or in a group Exclusions : acquiring skills (d155); solving problems (d175); making decisions (d177); undertaking multiple tasks (d220) Undertaking a simple task Preparing, initiating and arranging the time and space required for a simple task; executing a simple task with a single major component, such as reading a book, writing a letter, or making one's bed. Undertaking a complex task Preparing, initiating and arranging the time and space for a single complex task; executing a complex task with more than one component, which may be carried out in sequence or simultaneously, such as arranging the furniture in one's home or completing an assignment for school. Undertaking a single task independently Preparing, initiating and arranging the time and space for a simple or complex task; managing and executing a task on one's own and without the assistance of others. Undertaking a single task in a group Preparing, initiating and arranging the 140

149 정의에의한세부분류 d2108 d2109 과제를위해시간과공간을준비, 착수, 조정 ; 과제를수행하는특정단계에서또는과제수행전단계에서다른사람들과협력하여과제를수행및관리 기타명시된단일과제수행 상세불명의단일과제수행 time and space for a single task, simple or complex; managing and executing a task with people who are involved in some or all steps of the task. Undertaking single tasks, other specified Undertaking single tasks, unspecified d220 다중과제수행 연속적또는동시에다양하고복잡한종합적인과제의구성요소를간단하거나복잡한그리고융합된행동을이행 포함 : 다중과제이행, 다중과제완수, 단독으로또는집단으로다중과제수행 제외 : 기술습득 (d155), 문제해결 (d175), 의사결정 (d177), 단일과제수행 (d210) d2200 d2201 d2202 d2203 다중과제이행다중과제를수행하는데필요한시간과공간을준비, 착수하고조정하며, 다양한과제를동시에또는연달아수행및관리 다중과제완수다양한과제를동시에또는연달아완수 단독으로다중과제수행다중과제를수행하기위해시간과공간을준비, 착수하고조정하며동시에또는연달아다양한과제를다른사람의도움없이혼자힘으로수행및관리 집단으로다중과제수행다중과제를수행하기위해시간과공간을준비, 착수하고조정하며다양한과제를수행하는특정단계에서또는전단계에서다른사람과협력하여다양한과제를동시에또는연달아수행및관리 Undertaking multiple tasks Carrying out simple or complex and coordinated actions as components of multiple, integrated and complex tasks in sequence or simultaneously. Inclusions : undertaking multiple tasks; completing multiple tasks; undertaking multiple tasks independently and in a group Exclusions : acquiring skills (d155); solving problems (d175); making decisions (d177); undertaking a single task (d210) Carrying out multiple tasks Preparing, initiating and arranging the time and space needed for several tasks, and managing and executing several tasks, together or sequentially. Completing multiple tasks Completing several tasks, together or sequentially. Undertaking multiple tasks independently Preparing, initiating and arranging the time and space for multiple tasks, and managing and executing several tasks together or sequentially, on one's own and without the assistance of others. Undertaking multiple tasks in a group Preparing, initiating and arranging the time and space for multiple tasks, and managing and executing several tasks together or sequentially with others who are involved in some or all steps of the multiple tasks. d2208 d2209 기타명시된다중과제수행 상세불명의다중과제수행 Undertaking multiple tasks, other specified Undertaking multiple tasks, unspecified 통계청 141

150 한국표준건강분류 d230 일상생활이행 시간계획을짜고하루동안행할개별적인행동을계획하는것처럼일상적인절차또는의무의요구사항을관리하고완성하기위한계획을수행하기위해간단하거나복잡한행동을이행함 Carrying out daily routine Carrying out simple or complex and coordinated actions in order to plan, manage and complete the requirements of day-to-day procedures or duties, such as budgeting time and making plans for separate activities throughout the day. 포함 : 일상생활관리와완수, 자기자신의활동수준관리 제외 : 다중과제수행 (d220) d2301 d2302 d2303 d2304 d2308 d2309 일상생활관리일상적인절차나의무를수행하는데필요한것들을계획하고관리하기위해간단한또는복잡하고조정된행동의이행 일상생활완수옷입기, 아침식사하기, 학교또는직장가기, 저녁에귀가하기와같이일상적인절차나의무를수행하는데필요한것들을완수하기위해간단한또는복잡하고조정된행동의이행 자기자신의활동수준관리일상적인절차나의무를수행하는데필요한노력과시간을조절하기위해어떤행동과행동양식의이행 일상생활변화에적응일상적과제의성취수단으로써평상시의활동형태로부터새로운활동환경으로전환되거나새로운요구사항에대응하는과제와행동에대한중단과넘김 기타명시된일상생활이행 상세불명의일상생활이행 Inclusions : managing and completing the daily routine; managing one's own activity level Exclusion : undertaking multiple tasks (d220) Managing daily routine Carrying out simple or complex and coordinated actions in order to plan and manage the requirements of day-to-day procedures or duties. Completing the daily routine Carrying out simple or complex and coordinated actions in order to complete the requirements of usual day-to-day procedures or duties, such as getting dressed, eating breakfast, leaving for school or work and returning home at the end of the day. Managing one's own activity level Carrying out actions and behaviours to arrange the requirements in energy and time day-to-day procedures or duties. Adapting to changes in daily routines Interrupting and shifting tasks and actions in response to new requirements or making a transition from a usual pattern of activities to a new set of activities as a means of fulfilling daily tasks. Carrying out daily routine, other specified Carrying out daily routine, unspecified d240 스트레스와기타심리적요구에대한대응 혼잡한도로에서운전을한다든지, 여러아이들을돌보는일처럼스트레스, 혼란또는위기감을안겨주는, 많은책임을 Handling stress and other psychological demands Carrying out simple or complex and coordinated actions to manage and control the psychological demands 142

151 정의에의한세부분류 요하는과제수행에요구되는심리적요구를억제 관리하기위해간단한또는복잡한통합행동의이행 포함 : 책임수행, 스트레스와위기대응 d2400 d2401 d2402 d2408 d2409 책임에대한대응의무를다하고의무수행에필요한요소를평가하기위해간단한또는복잡한통합행동의이행 스트레스대응과제수행과정에서발행하는긴장감, 긴급상황, 또는스트레스에대처하기위해간단한또는복잡한행동의이행 위기대응중대한위기나난관에닥친상황또는시기에결정적인전환점을맞아간단하거나복잡한행동의이행 기타명시된스트레스와기타심리적요구에대한대응 상세불명의스트레스와기타심리적요구에대한대응 required to carry out tasks demanding significant responsibilities and involving stress, distraction, or crises, such as driving a vehicle during heavy traffic or taking care of many children. Inclusions : handling responsibilities; handling stress and crisis Handling responsibilities Carrying out simple or complex and coordinated actions to manage the duties of task performance and to assess the requirements of these duties. Handling stress Carrying out simple or complex and coordinated actions to cope with pressure, emergencies or stress associated with task performance. Handling crisis Carrying out simple or complex and coordinated actions to cope with decisive turning points in a situation or times of acute danger or difficulty. Handling stress and other psychological demands, other specified Handling stress and other psychological demands, unspecified d298 기타명시된일반적과제와요구 General tasks and demands, other specified d299 상세불명의일반적과제와요구 General tasks and demands, unspecified 통계청 143

152 한국표준건강분류 제 3 장의사소통 (Communication) 이장은메시지수신및발신, 대화, 의사소통장비와기술이용등이포함된언어, 기호, 신호를이 용한의사소통의일반적및개별적특징을다룬다. 의사소통 - 수용 (d310-d329) Communicating - receiving d310 의사소통 구두메시지수용 사실또는관용적표현이담긴진술을이해하는것처럼구두메시지의글자그대로및함축된의미이해포함 : 의사소통 단순한구두, 복잡한구두메시지수용 d3101 d3102 d3108 d3109 d315 의사소통 단순한구두메시지의수용단순한구두메시지에의해전달된글자그대로의의미이해 의사소통 복잡한구두메시지의수용 복잡한구두메세지에의해전달된글자그대로의의미와함축된의미이해 의사소통 기타명시된구두메시지의수용 의사소통 상세불명구두메시지의수용 의사소통 비구어적메시지수용 어린이가눈을비비는것은피곤함의표시라는사실을, 또는경종이울리면화재가발생했다는의미라는사실을깨닫는것처럼몸짓, 상징, 그림으로전달된메시지의글자그대로및함축된의미이해 포함 : 몸짓으로, 일반적인신호및상징으로, 그림과사진으로전달받은메시지로의사소통 d3150 의사소통 몸짓수용 Communicating with - receiving - spoken messages Comprehending literal and implied meanings of messages in spoken language, such as understanding that a statement asserts a fact or is an idiomatic expression. Inclusions : communicating with receiving simple spoken, complex spoken messages Communicating with receiving simple spoken messages Comprehending the literal meaning conveyed by simple spoken messages. Communicating with receiving complex spoken messages Comprehending the literal and implied meaning conveyed by complex spoken messages. Communicating with receiving spoken messages, other specified Communicating with receiving spoken messages, unspecified Communicating with - receiving - nonverbal messages Comprehending the literal and implied meanings of messages conveyed by gestures, symbols and drawings, such as realizing that a child is tired when she rubs her eyes or that a warning bell means that there is a fire. Inclusions : communicating with - receiving - body gestures, general signs and symbols, drawings and photographs Communicating with - receiving - body 144

153 정의에의한세부분류 d3151 d3152 d3158 d3159 표정, 손짓, 자세, 그리고기타유형의몸짓언어로전달된메시지의의미이해 의사소통 일반적인신호와상징수용교통신호, 주의표지, 음악적또는과학적표기, 그리고아이콘처럼대중적으로이용되고있는신호와상징으로전달된메시지의의미이해 의사소통 그림과사진수용신장도표에서상향곡선을보고, 아이의키가크고있다는사실을이해하는것처럼그림 ( 예를들면선그림, 그래픽디자인, 그림, 삼차원그래픽, 그림문자 ), 그래프, 차트, 사진으로전달된의미이해 의사소통 기타명시된비구어적메시지수용 의사소통 상세불명의비구어적메시지수용 gestures Comprehending the meaning conveyed by facial expressions, hand movements or signs, body postures, and other forms of body language. Communicating with - receiving - general signs and symbols Comprehending the meaning represented by public signs and symbols, such as traffic signs, warning symbols, musical or scientific notations, and icons. Communicating with - receiving - drawings and photographs Comprehending the meaning represented by drawings (e.g. line drawings, graphic designs, paintings, three-dimensional representations, pictograms), graphs, charts and photographs, such as understanding that an upward line on a height chart indicates that a child is growing. Communicating with - receiving - nonverbal messages, other specified Communicating with - receiving - nonverbal messages, unspecified d320 d325 d329 의사소통 표준수화수용 글자그대로및함축적인의미를가진표준수화로메시지를전달받고, 그것을이해 의사소통 문자메시지수용 일간지를통해정치적사건을파악하거나종교적경전에담긴뜻을이해하는것처럼문어 ( 점자를포함해 ) 로전달된메시지의글자그대로및함축적인의미이해 의사소통 - 기타명시된및상세불명의수용 Communicating with - receiving - formal sign language messages Receiving and comprehending messages in formal sign language with literal and implied meaning. Communicating with - receiving - written messages Comprehending the literal and implied meanings of messages that are conveyed through written language (including Braille), such as following political events in the daily newspaper or understanding the intent of religious scripture. Communicating - receiving, other specified and unspecified 통계청 145

154 한국표준건강분류 의사소통 - 표현 (d330-d349) Communicating - producing d330 말하기 구두로사실을표현하거나이야기를하는것처럼글자그대로및함축적인의미를가진구두메시지로단어, 어구, 및긴구절표현 Speaking Producing words, phrases and longer passages in spoken messages with literal and implied meaning, such as expressing a fact or telling a story in oral language. d332 노래부르기 메시지를전달하기위하여일련의음조를사용하여멜로디생성포함 : 콧노래부르기, 찬송하기 d335 비구어적메시지표현 반대한다는의미로머리를좌우로흔들거나사실이나복잡한생각을전달하기위해그림이나도표를그리는것처럼메시지를표현하기위해몸짓, 상징, 그림을이용포함 : 몸짓, 기호, 상징, 그림과사진으로메시지표현 d3350 d3351 d3352 d3358 d3359 몸짓으로메시지표현얼굴표정 ( 예를들면미소짓기, 인상쓰기, 움찔하기 ), 손짓, 그리고자세 ( 예를들면포옹으로애정을표현 ) 등몸짓으로의미전달 기호와상징으로메시지표현멜로디를전달하기위해음표를이용하는것처럼기호와상징 ( 예를들면아이콘, 불리스기호판, 과학부호 ) 그리고상징적표기법을이용해의미전달 그림과사진으로메시지표현위치를알려주기위해지도를그리는것처럼그림, 스케치, 도표, 사진등으로의미전달 기타명시된비구어적메시지표현 상세불명의비구어적메시지표현 Singing Using tones in a sequence resulting in a melody to convey messages. Inclusions : humming, chanting Producing nonverbal messages Using gestures, symbols and drawings to convey messages, such as shaking one's head to indicate disagreement or drawing a picture or diagram to convey a fact or complex idea. Inclusions : producing body gestures, signs, symbols, drawings and photographs Producing body language Conveying meaning by movements of the body, such as facial gestures (e.g. smiling, frowning, wincing), arm and hand movements, and postures (e.g. such as embracing to indicate affection). Producing signs and symbols Conveying meaning by using signs and symbols (e.g. icons, Bliss board, scientific symbols) and symbolic notation systems, such as using musical notation to convey a melody. Producing drawings and photographs Conveying meaning by drawing, painting, sketching, and making diagrams, pictures or photographs, such as drawing a map to give someone directions to a location. Producing nonverbal messages, other specified Producing nonverbal messages, unspecified 146

155 정의에의한세부분류 d340 d345 d349 표준수화로메시지표현 글자그대로및함축적인의미를가진표준수화로의미전달 메시지쓰기 친구에게편지를쓰는것처럼문어를이용해글자그대로및함축적인의미가담긴메시지작성 의사소통 - 기타명시된및상세불명의표현 Producing messages in formal sign language Conveying, with formal sign language, literal and implied meaning. Writing messages Producing the literal and implied meanings of messages that are conveyed through written language, such as writing a letter to a friend. Communication - producing, other specified and unspecified 대화와의사소통기기및기술의이용 (d350-d369) d350 대화 공식적인또는비공식적인자리에서 ( 아는또는낯선 ) 사람과단독으로또는집단으로구어, 문어, 기호또는기타유형의언어를이용해생각과의견교환시작, 유지, 종료 포함 : 대화시작 유지 종료, 일대일대화, 다자간대화 d3500 d3501 d3502 대화시작자신을소개하거나통상적인인사하기또는특정한주제를제시하거나질문하는것처럼의사소통또는대화를이끌어내기위해서눈을마주치거나다른수단으로소통을시도하는것과같은의견교환시작 대화유지계속해서대화를형성하기또는노래나말하기로전환하여교대로말하기, 아이디어를추가하기, 새로운주제를소개하거나이전에언급한주제를다시꺼냄 대화종료토론내용과관련해결론을도출해내고, 통상적인마무리표현을이용해대화또는의견교환종료 Conversation and use of communication devices and techniques Conversation Starting, sustaining and ending an interchange of thoughts and ideas, carried out by means of spoken, written, sign or other forms of language, with one or more people one knows or who are strangers, in formal or casual settings. Inclusions : starting, sustaining and ending a conversation; conversing with one or many people Starting a conversation Beginning an interchange, such as initiating turn-taking activity through eye-contact or other means, that leads to communication or dialogue, such as by introducing oneself, expressing customary greetings, or by introducing a topic or asking questions. Sustaining a conversation Continuing and shaping a dialogue or interchange by taking turns in vocalising speaking or signing, by adding ideas, introducing a new topic or retrieving a topic that has been previously mentioned. Ending a conversation Finishing a dialogue or interchange with customary termination statements or expressions and by bringing closure to 통계청 147

156 한국표준건강분류 d3503 d3504 d3508 d3509 일대일대화친구와날씨에대해이야기하는것처럼한사람과의대화또는의견교환을시작 유지 정리또는종료 다자간대화집단토론에참여하는것처럼두사람이상과대화또는의견교환을시작 유지 정리또는종료 기타명시된대화 상세불명의대화 the topic under discussion. Conversing with one person Initiating, maintaining, shaping and terminating a dialogue or interchange with one person, such as in discussing the weather with a friend. Conversing with many people Initiating, maintaining, shaping and terminating a dialogue or interchange with more than one individual, such as in starting and participating in a group interchange. Conversation, other specified Conversation, unspecified d355 토론 구어, 문어, 기호, 또는기타유형의언어를이용한찬반토론또는논쟁을통해 ( 아는또는낯선 ) 사람과단독으로또는집단으로, 공식적인또는비공식적인자리에서어떤문제에대한검토를시작 유지 정리또는종료 포함 : 일대일토론, 다자간토론 d3550 d3551 d3558 d3559 일대일토론한사람과논쟁또는토론을시작 유지 정리또는종료 다자간토론두사람이상과논쟁또는토론을시작 유지 정리또는종료 기타명시된토론 상세불명의토론 Discussion Starting, sustaining and ending an examination of a matter, with arguments for or against, or debate carried out by means of spoken, written, sign or other forms of language, with one or more people one knows or who are strangers, in formal or casual settings. Inclusion : discussion with one person or many people Discussion with one person Initiating, maintaining, shaping or terminating an argument or debate with one person. Discussion with many people Initiating, maintaining, shaping or terminating an argument or debate with more than one individual. Discussion, other specified Discussion, unspecified d360 의사소통기기와기술의이용 친구에게전화를거는것처럼의사소통을위해장비, 기술및기타수단이용 포함 : 원거리통신장비이용, 기록장비이용, 의사소통기술이용 Using communication devices and techniques Using devices, techniques and other means for the purposes of communicating, such as calling a friend on the telephone. Inclusions : using telecommunication devices, using writing machines and 148

157 정의에의한세부분류 d3600 d3601 d3602 d3608 d3609 원거리통신기기이용통신의수단으로써전화, 컴퓨터및다른전자장치의이용 문자기록기기이용의사소통수단으로타자기, 컴퓨터, 점자기록기같은기록장비의이용 의사소통기술이용구화처럼의사소통기술이포함된행위와과제를수행 기타명시된의사소통기기와기술의이용 상세불명의의사소통기기와기술의이용 communication techniques Using telecommunication devices Using telephones and computer, and other electronic devices as means of telecommunication Using writing machines Using machines for writing, such as typewriters, computers and Braille writers, as a means of communication. Using communication techniques Performing actions and tasks involved in techniques for communicating, such as reading lips. Using communication devices and techniques, other specified Using communication devices and techniques, unspecified d369 기타명시된및상세불명의대화와의사소통기기및기술의이용 Conversation and use of communication devices and techniques, other specified and unspecified d398 기타명시된의사소통 Communication, other specified d399 상세불명의의사소통 Communication, unspecified 통계청 149

158 한국표준건강분류 제 4 장움직임 (Mobility) 이장은다양한운송수단을이용하고, 걷기, 달리기, 등반하기, 물건나르고옮기고조작하 기, 장소이동, 신체의위치조정등, 움직이는것 에대해다룬다. 자세변경과유지 (d410-d429) Changing and maintaining body position d410 기본적자세변경 의자에서일어나침대에눕거나앉는자세, 서있는자세, 무릎꿇은자세, 혹은쪼그리고앉은자세에서다른자세로바꾸는것처럼어떤한자세를취했다가다른자세를취하며한장소에서다른장소로이동포함 : 눕기, 쪼그리고앉기, 무릎꿇기, 앉기, 서기, 뒹굴기, 구부리기의자세에서다른자세로변경, 그리고신체중력의중심이동 제외 : 자리이동 (d420) d4100 눕기일어서거나앉는것처럼누운자세를취했다가다른자세를취하거나, 수평적인자세에서어떤다른위치로자세변경포함 : 구부린자세취함 d4101 d4102 d4103 쪼그리고앉기바닥에앉아용변을볼때취하는자세처럼무릎을곧추세우고발뒷꿈치를엉덩이에붙인채웅크리고앉는자세나일어서기처럼쪼그리고앉은자세를취하거나그자세에서다른자세취함 무릎꿇기기도할때취하는자세처럼다리를구부려무릎으로신체를지탱하는자세를취하거나일어서기처럼그자세에서다른자세취함 앉기 Changing basic body position Getting into and out of a body position and moving from one location to another, such as getting up out of a chair to lie down on a bed, and getting into and out of positions of sitting, standing, kneeling or squatting. Inclusion : changing body position from lying down, from squatting or kneeling, from sitting or standing, rolling over, bending and shifting the body's centre of gravity Exclusion : transferring oneself (d420) Lying down Getting into and out of a lying down position or changing body position from horizonal to any other position, such as standing up or sitting down. Inclusion : getting into a prostrate position Squatting Getting into and out of the seated or crouched posture on one's haunches with knees closely drawn up or sitting on one's heels, such as may be necessary in toilets that are at floor level, or changing body position from squatting to any other position, such as standing up. Kneeling Getting into and out of a position where the body is supported by the knees with legs bent, such as during prayers, or changing body position from kneeling to any other position, such as standing up. Sitting Getting into and out of a seated position 150

159 정의에의한세부분류 앉은자세를취하거나, 앉은자세에서일어서기나눕기같은다른자세취함 포함 : 다리구부리거나책상다리를하고앉는자세, 발로신체를지탱하거나또는발로신체를지탱하지않고앉는자세 d4104 d4105 일어서기눕거나앉은자세처럼서기자세를취하거나일어선자세에서다른자세취함 구부리기물건을잡으려아래로손을뻗거나인사를하는것처럼허리를아래로또는옆으로기울임 d4106 신체의무게중심이동서서오른발에서왼발로무게중심을옮기는것처럼앉거나서서또는누워서무게중심을한쪽에서다른쪽으로조정또는이동제외 : 자리이동 (d420); 보행 (d450) d4107 뒹굴기신체의한면에서다른면으로또는배에서등으로전환하는것과같이한자세에서다른자세로신체를움직임 d4108 d4109 기타명시된기본적자세변경 상세불명의기본적자세변경 and changing body position from sitting down to any other position, such as standing up or lying down. Inclusions : getting into a sitting position with bent legs or crosslegged; getting into a sitting position with feet supported or unsupported Standing Getting into and out of a standing position or changing body position from standing to any other position, such as lying down or sitting down. Bending Tilting the back downwards or to the side, at the torso, such as in bowing or reaching down for an object. Shifting the body's centre of gravity Adjusting or moving the weight of the body from one position to another while sitting, standing or lying, such as moving from one foot to another while standing. Exclusions : transferring oneself (d420); walking (d450) Rolling over Moving the body from one position to another while lying such as turning from side to side or from stomach to back. Changing basic body position, other specified Changing basic body position, unspecified d415 신체의자세유지 일하는동안또는수업하는동안계속앉아있거나서있는것처럼필요에따라동일한자세유지포함 : 눕기, 쪼그리고앉기, 무릎꿇기, 앉기및서기자세유지 d4150 눕는자세유지침대에엎드려있는것처럼필요에따라한동안눕는자세유지 포함 : 얼굴을바닥에대고또는엎드려눕기자세유지, 위를쳐다보고반듯하게눕기자세유지, 또는옆으로눕기자세유지 d4151 쪼그리고앉는자세유지 Maintaining a body position Staying in the same body position as required, such as remaining seated or remaining standing for work or school. Inclusions : maintaining a lying, squatting, kneeling, sitting and standing position Maintaining a lying position Staying in a lying position for some time as required, such as remaining in a prone position in a bed. Inclusions : staying in a prone (face down or prostrate), supine (face upwards) or side-lying position Maintaining a squatting position 통계청 151

160 한국표준건강분류 d4152 의자가없는바닥에앉을때처럼필요에따라한동안쪼그리고앉는자세유지 무릎꿇는자세유지성당에서기도할때처럼필요에따라한동안다리를구부려무릎으로신체를지탱하는, 무릎꿇는자세유지 d4153 앉는자세유지책상에또는식탁에앉아있는것처럼필요에따라한동안의자위에또는바닥에앉는자세유지포함 : 발을잡거나잡지않은상태에서, 다리를쭉펴고또는책상다리를하고앉는자세유지 d4154 서는자세유지줄서있는것처럼필요에따라한동안선자세유지 포함 : 비탈길이나미끄러운바닥또는딱딱한바닥에서서기자세유지 d4155 d4158 d4159 머리자세유지머리의자세를조절하기또는일정시간동안머리의무게지탱 기타명시된신체의자세유지 상세불명의신체의자세유지 Staying in a squatting position for some time as required, such as when sitting on the floor without a seat. Maintaining a kneeling position Staying in a kneeling position where the body is supported by the knees with legs bent for some time as required, such as during prayers in church. Maintaining a sitting position Staying in a seated position, on a seat or the floor, for some time as required, such as when sitting at a desk or table. Inclusions : staying in a sitting position with straight legs or crosslegged, with feet supported or unsupported Maintaining a standing position Staying in a standing position for some time as required, such as when standing in a queue. Inclusions : staying in a standing position on a slope, on slippery or hard surfaces Maintaining head position Controlling the position of the head and supporting its weight for a determined period of time. Maintaining a body position, other specified Maintaining a body position, unspecified d420 자리이동 자세는변하지않고, 긴의자의한끝에서다른끝으로또는침대에서의자로자리를옮기는것처럼한장소에서다른장소로자리이동포함 : 앉아서또는누워서자리이동 제외 : 기본적자세변경 (d410) d4200 앉아서자리이동의자에서침대로자리를이동하는것처럼한의자에서같은높이또는다른높이의의자로앉은자세그대로자리이동포함 : 의자에서다른의자 ( 예를들면화장실좌식변기 ) 로자리이동, 휠체어에서자동차 Transferring oneself Moving from one surface to another, such as sliding along a bench or moving from a bed to a chair, without changing body position. Inclusions : transferring oneself while sitting or lying Exclusion : changing basic body position (d410) Transferring oneself while sitting Moving from a sitting position on one seat to another seat on the same or a different level, such as moving from a chair to a bed. Inclusions : moving from a chair to another seat, such as a toilet seat; 152

161 정의에의한세부분류 좌석으로자리이동제외 : 기본적자세변경 (d410) d4201 누워서자리이동한침대에서다른침대로이동하는것처럼누운자세그대로한자리에서같은높이의또는다른높이의다른자리로이동제외 : 기본적자세변경 (d410) d4208 d4209 기타명시된자리이동 상세불명의자리이동 moving from a wheelchair to a car seat Exclusion : changing basic body position (d410) Transferring oneself while lying Moving from one lying position to another on the same or a different level, such as moving from one bed to another. Exclusion : changing basic body position (d410) Transferring oneself, other specified Transferring oneself, unspecified d429 기타명시된및상세불명의자세변경과유지 Changing and maintaining body position, other specified and unspecified 물건나르기, 옮기기, 다루기 (d430-d449) Carrying, moving and handling objects d430 물건들어올리기와나르기 컵또는장난감을들어올리거나상자또는아동을한방에서다른방으로옮기는것처럼물건을들어올리거나물건을한장소에서다른장소로옮기기 Lifting and carrying objects Raising up an object or taking something from one place to another, such as when lifting a cup or toy or carrying a box, or a child from one room to another. 포함 : 들어올리기, 손으로또는팔로나르기, 어깨 엉덩이 등 머리로나르기, 내려놓기 d4300 d4301 d4302 d4303 들어올리기식탁위에놓인컵을들어올리는것처럼낮은데서높은데로옮기기위해물건을들어올림 손으로나르기물잔을또는여행가방을나를때처럼손을이용해물건을한장소에서다른장소로옮김 안아서나르기애완동물이나아동또는다른큰사물을옮길때처럼팔과손을이용해한장소에서다른장소로물건을옮김 어깨 엉덩이 등에짊어지고나르기커다란짐또는책가방을옮길때처럼 Inclusions : lifting, carrying in the hands or arms, or on shoulders, hip, back or head; putting down Lifting Raising up an object in order to move it from a lower to a higher level, such as when lifting a glass from the table. Carrying in the hands Taking or transporting an object from one place to another using the hands, such as when carrying a drinking glass or a suitcase. Carrying in the arms Taking or transporting an object from one place to another using the arms and hands, such as when carrying a pet or a child or other large object. Carrying on shoulders, hip and back Taking or transporting an object from one place to another using the shoulders, hip 통계청 153

162 한국표준건강분류 어깨, 엉덩이또는이두가지이상을함께이용해한장소에서다른장소로물건을옮김 or back, or some combination of these, such as when carrying a large parcel or school-bag. d4304 d4305 d4308 d4309 머리로나르기물통등을머리에얹어옮기는것처럼머리를이용해한장소에서다른장소로물건을옮기기 물건내려놓기물잔을바닥에내려놓을때처럼물건을바닥에또는특정장소에내려놓기위해팔, 손, 또는신체의기타부위를이용 기타명시된들어올려나르기 상세불명의들어올려나르기 Carrying on the head Taking or transporting an object from one place to another using the head, such when as carrying a container of water on the head. Putting down objects Using hands, arms or other parts of the body to place an object down on a surface or place, such as when lowering a container of water to the ground. Lifting and carrying, other specified Lifting and carrying, unspecified d435 다리로물건옮기기 공을차거나자전거의페달을밟는것처럼물건을옮길목적으로발과다리를이용해일련의행동수행 포함 : 다리로밀기, 차기 d4350 d4351 d4358 d4359 다리로밀기발로의자를미는것처럼물건을옮기기위해발과다리를이용하여물건에힘을가함 차기발로공을차는것처럼무엇인가를멀리보내기위해다리와발을이용 기타명시된다리로물건옮기기 상세불명의다리로물건옮기기 Moving objects with lower extremities Performing coordinated actions aimed at moving an object by using the legs and feet, such as kicking a ball or pushing pedals on a bicycle. Inclusions : pushing with lower extremities; kicking Pushing with lower extremities Using the legs and feet to exert a force on an object to move it away, such as pushing a chair away with a foot. Kicking Using the legs and feet to propel something away, such as kicking a ball. Moving objects with lower extremities, other specified Moving objects with lower extremities, unspecified d440 미세한손동작 식탁위의동전을집어올리거나다이얼이나손잡이를돌리는것처럼손가락을이용해물건을다루고, 집고, 조작하고, 풀어놓는일련의행동을취함 포함 : 집어올리기, 잡기, 다루기, 풀어놓기 Fine hand use Performing the coordinated actions of handling objects, picking up, manipulating and releasing them using one's hand, fingers and thumb, such as required to lift coins off a table or turn a dial or knob. Inclusions : picking up, grasping, 154

163 정의에의한세부분류 제외 : 물건들어올려나르기 (d430) d4400 d4401 d4402 d4403 d4408 d4409 집어올리기연필을집을때처럼작은물건을손으로또는손가락으로집어올림 잡기도구나문손잡이를잡을때처럼무엇인가를잡기위해한손또는양손이용 다루기가위, 신발끈묶기, 연필, 젓가락또는칼과포크와같은작은물건또는동전을다룰때와같이무엇인가를다루기위해손과손가락이용 풀어놓기옷의장식을빼거나애완동물을위한음식조각을떨어뜨리는것처럼무엇인가를풀어주어그것이떨어지도록또는위치가변하도록손과손가락이용 기타명시된미세한손동작 상세불명의미세한손동작 manipulating and releasing Exclusion : lifting and carrying objects (d430) Picking up Lifting or taking up a small object with hands and fingers, such as when picking up a pencil. Grasping Using one or both hands to seize and hold something, such as when grasping a tool or a door knob. Manipulating Using fingers and hands to exert control over, direct or guide something, such as when handling coins or other small objects, such as scissors, shoelace, pencils, chop sticks or knives and forks. Releasing Using fingers and hands to let go or set free something so that it falls or changes position, such as when dropping an item of clothing or a piece of food for a pet. Fine hand use, other specified Fine hand use, unspecified d445 손과팔의이용 문고리를돌릴때또는물건을던지거나붙잡을때처럼손과팔을이용하여물건을옮기거나물건을사용하는데요구되는일련의행동 포함 : 물건당기기또는밀기 ; 뻗기 ; 팔이나손으로돌리거나뒤틀기 ; 던지기 ; 붙잡기 제외 : 미세한손동작 (d440) d4450 d4451 당기기끈을당기거나문을닫을때처럼물건을자신에게가까이끌기위해또는물건을한장소에서다른장소로옮기기위해손가락, 손, 팔이용 밀기장난감이나동물을밀칠때당기는것과같이무엇인가를자신으로부터멀리 Hand and arm use Performing the coordinated actions required to move objects or to manipulate them by using hands and arms, such as when turning door handles or throwing or catching an object. Inclusions : pulling or pushing objects; reaching; turning or twisting the hands or arms; throwing; catching Exclusion : fine hand use (d440) Pulling Using fingers, hands and arms to bring an object towards oneself, or to move it from place to place, such as when pulling on a string or pulling a door closed. Pushing Using fingers, hands and arms to move something from oneself, or to move it 통계청 155

164 한국표준건강분류 d4452 d4453 떨어뜨리기위해또는무엇인가를한장소에서다른장소로옮기기위해손가락, 손, 및팔이용 뻗기식탁또는책상저편에놓인책을잡을때처럼무엇인가에닿기위해또는잡기위해팔과손을밖으로뻗음 손이나팔로돌리거나뒤틀기이를닦거나설거지를하기위해요구되는것처럼물건을돌리거나구부리기위해손, 손가락, 팔이용 from place to place, such as when pushing a toy or an animal away. Reaching Using the hands and arms to extend outwards and touch and grasp something, such as when reaching across a table or desk for a book. Turning or twisting the hands or arms Using fingers, hands or arms to rotate, turn or bend an object as is required to open a jar or use tools such as a toothbrushor, screwdriver. d4454 d4455 d4458 d4459 던지기공을던질때처럼무엇인가를집어힘껏공중으로던지기위해손가락, 손, 및팔이용 붙잡기공을붙잡는것처럼움직이는사물을더이상움직이지못하도록붙잡기위해손가락, 손, 및팔이용 기타명시된손과팔의이용 상세불명의손과팔의이용 Throwing Using fingers, hands and arms to lift something and propel it with some force through the air, such as when tossing a ball. Catching Using fingers, hands and arms to grasp a moving object in order to bring it to a stop and hold it, such as when catching a ball. Hand and arm use, other specified Hand and arm use, unspecified d446 미세한발동작 발과발가락을이용해물건을집고, 조작하고, 풀어놓는일련의행동수행 제외 : 다리로물건옮기기 (d435) d449 기타명시된및상세불명의물건나르기, 옮기기, 다루기 보행과이동 (d450-d469) Fine foot use Performing the coordinated actions of pick up, manipulating and releasing objects using one s foot and toes. Exclusions : moving objects with lower extremities(d435) Carrying, moving and handling objects, other specified and unspecified Walking and moving d450 보행 산책하거나거닐거나앞, 뒤로또는옆으로걸을때처럼발로한걸음씩지면위를움직이는것으로이때한발은항상지면을딛고있는상태 Walking Moving along a surface on foot, step by step, so that one foot is always on the ground, such as when strolling, sauntering, walking forwards, backwards, 156

165 정의에의한세부분류 포함 : 단거리보행, 장거리보행, 상이한지면보행, 장애물을피하여보행 제외 : 자리이동 (d420), 이동 (d455) d4500 d4501 d4502 d4503 d4508 d4509 단거리보행건물내방이나복도를걸어다니는것처럼, 또는건물밖으로나와단거리를걷는것처럼 1 킬로미터미만의거리를보행 장거리보행동네또는도시전체를걸어다니거나, 이동네에서저동네로돌아다니거나어떤개방된공간을돌아다니는것처럼 1 킬로미터이상을보행 상이한지면보행잔디밭, 자갈, 얼음또는눈위를걷거나배, 기차또는기타탈것에승선하여걸어다니는것처럼경사면, 평평한지면또는움직이는지표면위를보행 장애물선회보행시장이나상점앞에서돌아가거나교통이나기타이유로복잡한지역을돌아가는것처럼사람, 동물, 차량, 그리고이동가능한또는이동불가능한대상과부딪히는것을피하기위해우회하여보행 기타명시된보행 상세불명의보행 or sideways. Inclusions : walking short or long distances; walking on different surfaces; walking around obstacles Exclusions : transferring oneself (d420); moving around (d455) Walking short distances Walking for less than a kilometre, such as walking around rooms or hallways, within a building or for short distances outside. Walking long distances Walking for more than a kilometre, such as across a village or town, between villages or across open areas. Walking on different surfaces Walking on sloping, uneven, or moving surfaces, such as on grass, gravel or ice and snow, or walking aboard a ship, train or other vehicle. Walking around obstacles Walking in ways required to avoid moving and immobile objects, people, animals, and vehicles, such as walking around a marketplace or shop, around or through traffic or other crowded areas. Walking, other specified Walking, unspecified d455 이동 절벽을기어오르거나, 거리를달려내려가거나, 깡충깡충뛰거나, 질주하거나, 점프하거나, 재주넘기를하거나장애물을뛰어넘는것처럼 보행 을제외한기타다른방법으로한장소에서다른장소로전신을움직임포함 : 기어가기, 오르기, 달리기, 조깅, 점프, 수영제외 : 자리이동 (d420), 보행 (d450) d4550 기어가기팔로, 팔과손으로또는무릎으로엎드린 Moving around Moving the whole body from one place to another by means other than walking, such as climbing over a rock or running down a street, skipping, scampering, jumping, somersaulting or running around obstacles. Inclusions : crawling, climbing, running, jogging, jumping, and swimming Exclusions : transferring oneself (d420); walking (d450) Crawling Moving the whole body in a prone 통계청 157

166 한국표준건강분류 d4551 d4552 d4553 d4554 d4558 d4559 자세로전신을한장소에서다른장소로움직임 오르기계단, 바위, 사다리또는층계, 턱또는기타대상위를올라가는것처럼지면또는어떤대상위로또는아래로전신을움직임 달리기양발이동시에지면에서떨어질정도로빠른걸음으로움직임 점프하기한발로딛고점프하거나, 깡총뛰기, 건너뛰기등을하거나, 물속으로다이빙또는점프하는것처럼다리를구부렸다가펴면서바닥에서발을떼며뛰어오름 수영하기지면에딛지않은채사지및신체를움직여물속에서전신을움직임 기타명시된이동 상세불명의이동 position from one place to another on hands, or hands and arms, and knees. Climbing Moving the whole body upwards or downwards, over surfaces or objects, such as climbing steps, rocks, ladders or stairs, curbs or other objects. Running Moving with quick steps so that both feet may be simultaneously off the ground. Jumping Moving up off the ground by bending and extending the legs, such as jumping on one foot, hopping, skipping and jumping or diving into water. Swimming Propelling the whole body through water by means of limb and body movements without taking support from the ground underneath. Moving around, other specified Moving around, unspecified d460 다른장소로의이동 건물내에서또는집안에서방과방을넘나드는것또는도시내거리여기저기를돌아다니는것처럼걸으며여러장소를돌아다니는것포함 : 집안내이동, 집안에서기기, 집안에서오르기, 집을제외한기타건물내에서보행또는이동, 집밖에서또는집을제외한기타건물밖에서보행또는이동 d4600 집안내이동집안에서또는방안에서, 방과방사이를, 거주지전체를, 생활공간전체를걸어다니고돌아다님 포함 : 한층에서다른층으로또는발코니로, 안마당으로, 현관으로, 정원으로이동 d4601 집을제외한건물내이동남의집, 남의건물, 공공건물, 공용건물, 사유건물또는기타밀폐된공간과같이 Moving around in different locations Walking and moving around in various places and situations, such as walking between rooms in a house, within a building, or down the street of a town. Inclusions : moving around within the home, crawling or climbing within the home; walking or moving within buildings other than the home, and outside the home and other buildings Moving around within the home Walking and moving around in one's home, within a room, between rooms, and around the whole residence or living area. Inclusions : moving from floor to floor, on an attached balcony, courtyard, porch or garden Moving around within buildings other than home Walking and moving around within 158

167 정의에의한세부분류 자신의거주지를제외한다른건물내부를걸어돌아다님 포함 : 건물및밀폐된공간의어느지역을, 층과층사이, 건물안팎, 공유또는사유건물주변을이동 d4602 집그리고기타건물외부에서의이동동네나도시에서멀리떨어진곳또는동네나도시근처를걸어다니는것처럼집과기타건물에서멀리떨어진곳또는집과다른건물주변을교통수단 ( 공공교통수단이든개인교통수단이든 ) 을이용하지않고걸어서돌아다님 포함 : 동네, 도시, 마을, 또는시내거리보행또는이동. 교통수단을이용하지않고근거리도시와원거리도시사이이동 d4608 d4609 d465 기타명시된다른장소로의이동 상세불명의다른장소로의이동 장비를이용한이동 스케이트, 스키, 스쿠버장비를이용해돌아다니거나휠체어또는보행기를타고거리를돌아다니는것처럼이동의편의를위해또는돌아다닐기타방법을마련하기위해고안된특정한장비를이용해어떤지면또는공간위, 한장소에서다른장소로전신을옮기는것제외 : 자리이동 (d420), 보행 (d450), 이동 (d455), 운송수단이용 (d470), 운전 (d475) buildings other than one's residence, such as other people's homes, other private buildings, community and public buildings and enclosed areas. Inclusions : moving throughout all parts of buildings and enclosed areas, between floors, inside, outside and around buildings, both public and private Moving around outside the home and other buildings Walking and moving around close to or far from one's home and other buildings, without the use of transportation, public or private, such as walking for short or long distances around a town or village. Inclusions : walking or moving down streets in the neighbourhood, town, village or city; moving between cities and further distances, without using transportation Moving around in different locations, other specified Moving around in different locations, unspecified Moving around using equipment Moving the whole body from place to place, on any surface or space, by using specific devices designed to facilitate moving or create other ways of moving around, such as with skates, skis, or scuba equipment, or moving down the street in a wheelchair or a walker. Exclusions : transferring oneself (d420); walking (d450); moving around (d455); using transportation (d470); driving (d475) d469 기타명시된및상세불명의보행과이동 Walking and moving, other specified and unspecified 통계청 159

168 한국표준건강분류 운송수단을이용한이동 (d ) Moving around using transportation d470 운송수단이용 승용차, 버스, 인력거, 소형버스, 마차, 개인또는일반택시, 버스, 기차, 전차, 전철, 배또는항공기에탑승하는등승객으로서운송수단을이용하여이동하거나사람을운송수단으로사용 포함 : 인력운송수단이용, 개인동력운송수단이용, 대중운송수단이용, 인간의운송수단이용 제외 : 장비를이용한이동 (d465), 운전 (d475) d4700 d4701 d4702 d4703 d4708 d4709 인력운송수단이용인력거또는노젓는보트처럼한사람또는여러사람의힘에의해움직이는운송수단을탑승객으로서이용 동력화된개인운송수단이용승용차, 택시또는개인항공기, 개인선박을이용하는것처럼육 해 공에서개인소유의동력화된운송수단을탑승객으로서이용 동력화된대중운송수단이용버스, 기차, 지하철, 항공기를이용하는것처럼대중운송수단으로고안된, 동력운송수단을육 해 공에서탑승객으로서이용 사람을운송수단으로이용팔로안거나이불, 가방또는운송장비로나르는것과같이다른사람에의해옮겨지는것 기타명시된운송수단이용 상세불명의운송수단이용 Using transportation Using transportation to move around as a passenger, such as being driven in a car or on a bus, rickshaw, jitney, animal-powered vehicle, or private or public taxi, bus, train, tram, subway, boat or aircraft and using humans for transportation. Inclusions : using human-powered transportation; using private motorized or public transportation; using humans for transportation Exclusions : moving around using equipment (d465); driving (d475) Using human-powered vehicles Being transported as a passenger by a mode of transportation powered by one or more people, such as riding in a rickshaw or rowboat. Using private motorized transportation Being transported as a passenger by private motorized vehicle over land, sea or air, such as by car, taxi or privately owned aircraft or boat. Using public motorized transportation Being transported as a passenger by a motorized vehicle over land, sea or air designed for public transportation, such as being a passenger on a bus, train, subway or aircraft. Using humans for transportation Being transported by another person, such as being carried in the arms, in a sheet, in a backpack or a transportation device. Using transportation, other specified Using transportation, unspecified d475 운전 운송수단이나운송수단을끄는동물을통제하에움직이거나운전자가원하는 Driving Being in control of and moving a vehicle or the animal that draws it, travelling 160

169 정의에의한세부분류 방향으로이동하거나자동차, 자전거, 보트, 또는동물이끄는운송수단같은특정유형의운송수단운전 포함 : 인력운송수단운전, 동력화운송수단운전, 동물이끄는운송수단운전 제외 : 장비를이용한이동 (d465), 운송수단이용 (d470) d4750 d4751 d4752 d4758 d4759 인력운송수단운전두발자전거, 세발자전거, 또는노젓는보트같은인력을이용하는운송수단운전 동력화운송수단운전자동차, 모터사이클, 모터보트또는항공기처럼모터달린운송수단운전 동물이끄는운송수단운전마차처럼동물이끄는운송수단운전 기타명시된운전 상세불명의운전 under one's own direction or having at one's disposal any form of transportation, such as a car, bicycle, boat or animal-powered vehicle. Inclusions : driving human-powered transportation, motorized vehicles, animal-powered vehicles Exclusions : moving around using equipment (d465); using transportation (d470) Driving human-powered transportation Driving a human-powered vehicle, such as a bicycle, tricycle, or rowboat. Driving motorized vehicles Driving a vehicle with a motor, such as an automobile, motorcycle, motorboat or aircraft. Driving animal-powered vehicles Driving a vehicle powered by an animal, such as a horse-drawn cart or carriage. Driving, other specified Driving, unspecified d480 운송수단으로서동물등에타기 말, 소, 낙타또는코끼리같은동물의등에타서이동제외 : 운전 (d475), 레크리에이션과여가 (d920) Riding animals for transportation Travelling on the back of an animal, such as a horse, ox, camel or elephant Exclusions : driving (d475); recreation and leisure (d920) d489 기타명시된및상세불명의운송수단을이용한이동 Moving around using transportation, other specified and unspecified d498 기타명시된이동 Mobility, other specified d499 상세불명의이동 Mobility, unspecified 통계청 161

170 한국표준건강분류 제 5 장자기관리 (Self-care) 이장은씻기, 말리기, 신체전체또는일부관리, 몸단장, 먹기, 마시기, 건강관리등의자기관리에 대해서술하고있다. d510 씻기 씻기, 목욕, 손발씻기, 머리감기, 수건사용하기처럼자신의신체전체를또는일부를씻고닦고, 물과적절한욕실용품이용하기 포함 : 신체일부씻기, 전신씻기, 말리기 제외 : 신체부위관리 (d520), 대소변처리 (d530) d5100 d5101 d5102 d5108 d5109 d520 신체일부씻기손, 발, 얼굴, 머리, 손발톱같은신체일부를물, 비누, 그리고기타물질로씻기 전신씻기목욕이나샤워처럼혼자힘으로전신을물, 비누, 그리고기타물질로씻기 말리기씻은다음신체일부나전신을타월이나기타방법을이용해건조시키기 기타명시된씻기 상세불명의씻기 신체부위관리 씻기및말리기그이상을필요로하는피부, 얼굴, 치아, 머리, 손발톱생식기같은신체일부관리 포함 : 피부관리, 치아관리, 모발관리, 손발톱, 코관리제외 : 씻기 (d510), 대소변처리 (d530) d5200 피부관리굳은살또는티눈을제거하고로션이나 Washing oneself Washing and drying one's whole body, or body parts, using water and appropriate cleaning and drying materials or methods, such as bathing, showering, washing hands and feet, face and hair, and drying with a towel. Inclusions : washing body parts, the whole body; and drying oneself Exclusions : caring for body parts (d520); toileting (d530) Washing body parts Applying water, soap and other substances to body parts, such as hands, face, feet, hair or nails, in order to clean them. Washing whole body Applying water, soap and other substances to the whole body in order to clean oneself, such as taking a bath or shower. Drying oneself Using a towel or other means for drying some part or parts of one's body, or the whole body, such as after washing. Washing oneself, other specified Washing oneself, unspecified Caring for body parts Looking after those parts of the body, such as skin, face, teeth, scalp, nails and genitals, that require more than washing and drying. Inclusions : caring for skin, teeth, hair, finger and toe nails, and nose Exclusions : washing oneself (d510); toileting (d530) Caring for skin Looking after the texture and hydration of one's skin, such as by removing calluses 162

171 정의에의한세부분류 d5201 d5202 d5203 d5204 화장품을바르는것처럼피부결과피부보습관리 치아관리칫솔질, 치실사용, 의치나치과교정장치관리같은치아위생관리 모발관리빗질, 머리치장, 면도또는모발손질처럼머리와얼굴위의모발관리 손톱관리손톱을깨끗이씻거나깎거나윤을냄 발톱관리발톱을깨끗이씻거나깎거나윤을냄 d5205 코관리코청결하게하기, 코위생관리 d5208 d5209 기타명시된신체부위관리 상세불명의신체부위관리 or corns and using moisturizing lotions or cosmetics. Caring for teeth Looking after dental hygiene, such as by brushing teeth, flossing, and taking care of a dental prosthesis or orthosis. Caring for hair Looking after the hair on the head and face, such as by combing, styling, shaving, or trimming. Caring for fingernails Cleaning, trimming or polishing the nails of the fingers. Caring for toenails Cleaning, trimming or polishing the nails of the toes. Caring for nose Cleaning the nose, looking after nasal hygiene. Caring for body parts, other specified Caring for body parts, unspecified d530 대소변처리 월경, 배뇨, 배변등신체내노폐물을밖으로배출하고그뒤처리를위한계획과실천 포함 : 배뇨조절, 배변조절, 월경관리 제외 : 씻기 (d510), 신체부위관리 (d520) d5300 d5301 배뇨조절배뇨욕구감지, 배뇨에적절한장소를찾기, 배뇨전옷을벗기, 배뇨후옷입기, 배뇨후적절히닦기등의배뇨조절과관리 배변조절배변욕구감지, 배변에적절한장소를찾기, 배변전옷벗기, 배변후옷입기, 배변후적절히닦기등의배변조절과관리 Toileting Planning and carrying out the elimination of human waste(menstruation, urination and defecation), and cleaning oneself afterwards. Inclusions : regulating urination, defecation and menstrual care Exclusions : washing oneself (d510); caring for body parts (d520) Regulating urination Coordinating and managing urination, such as by indicating need, getting into the proper position, choosing and getting to an appropriate place for urination, manipulating clothing before and after urination, and cleaning oneself after urination. Regulating defecation Coordinating and managing defecation such as by indicating need, getting into the proper position, choosing and getting to an appropriate place for defecation, 통계청 163

172 한국표준건강분류 d5302 d5308 d5309 월경관리월경조짐감지, 생리대사용하기등의월경준비, 조절, 관리 기타명시된대소변처리 상세불명의대소변처리 manipulating clothing before and after defecation, and cleaning oneself after defecation. Menstrual care Coordinating, planning and caring for menstruation, such as by anticipating menstruation and using sanitary towels and napkins. Toileting, other specified Toileting, unspecified d540 몸단장 셔츠, 스커트, 블라우스, 바지, 속옷, 사리, 기모노, 타이츠, 모자, 장갑, 코트, 신발, 부츠, 샌들, 슬리퍼등을날씨나사회적여건에맞추어입거나신고, 벗고, 옷매무새바로하기와옷을입고벗기, 신발을신고벗기등의동작을조화롭게하는것 포함 : 옷입기, 옷벗기, 신발신기, 신발벗기, 적절한옷차림 d5400 d5401 d5402 d5403 옷입기머리, 어깨, 팔을옷에바로집어넣고, 상의와하의를차려입고, 장갑을끼고, 모자를쓰는것처럼신체의다양한부위에적절한옷을착용하는일련의행위 옷벗기머리, 어깨, 팔을빼어옷을벗고, 상의와하의를벗고, 장갑을벗고, 모자를벗는것처럼신체의다양한부위에입혀져있는옷을벗는일련의행위 신발신기양말, 스타킹그리고신발을신는일련의행위 신발벗기양말, 스타킹그리고신발을벗는일련의행위 Dressing Carrying out the coordinated actions and tasks of putting on and taking off clothes and footwear in sequence and in keeping with climatic and social conditions, such as by putting on, adjusting and removing shirts, skirts, blouses, pants, undergarments, saris, kimono, tights, hats, gloves, coats, shoes, boots, sandals and slippers. Inclusions : putting on or taking off clothes and footwear and choosing appropriate clothing Putting on clothes Carrying out the coordinated tasks of putting clothes on various parts of the body, such as putting clothes on over the head, over the arms and shoulders, and on the lower and upper halves of the body; putting on gloves and headgear. Taking off clothes Carrying out the coordinated tasks of taking clothes off various parts of the body, such as pulling clothes off and over the head, off the arms and shoulders, and off the lower and upper halves of the body; taking off gloves and headgear. Putting on footwear Carrying out the coordinated tasks of putting on socks, stockings and footwear. Taking off footwear Carrying out the coordinated tasks of taking off socks, stockings and footwear

173 정의에의한세부분류 d5404 d5408 d5409 적절한옷차림옷차림과관련된명시적또는암묵적옷의규칙과사회적또는문화적관례를따를뿐아니라, 기후에맞는옷차림을하는것 기타명시된몸단장 상세불명의몸단장 Choosing appropriate clothing Following implicit or explicit dress codes and conventions of one's society or culture and dressing in keeping with climatic conditions. Dressing, other specified Dressing, unspecified d550 먹기 음식물을입으로가져가서문화적으로허용된방식으로먹기, 음식물잘게썰기, 병과캔따기, 식기이용하기, 식사나연회나외식등음식물을섭취하는일련의행위 제외 : 마시기 (d560) Eating Carrying out the coordinated tasks and actions of eating food that has been served, bringing it to the mouth and consuming it in culturally acceptable ways, cutting or breaking food into pieces, opening bottles and cans, using eating implements, having meals, feasting or dining. Exclusion : drinking (d560) d560 마시기 음료들기, 입으로가져가기, 문화적으로허용된방식으로마시기, 음료섞기, 음료를저어서따르기, 병과캔따기, 빨대로마시기또는수돗물이나샘물처럼흐르는물마시기, 젖빨기등 제외 : 먹기 (d550) Drinking Taking hold of a drink, bringing it to the mouth, and consuming the drink in culturally acceptable ways, mixing, stirring and pouring liquids for drinking, opening bottles and cans, drinking through a straw or drinking running water such as from a tap or a spring; feeding from the breast. Exclusion : eating (d550) d570 자신의건강돌보기 균형잡힌식생활, 적절한신체활동, 적절한온도조절, 인체유해물질기피, 콘돔사용등의안전한성생활, 예방접종, 정기적인건강검진등을통해신체적편안함, 건강, 신체적 정신적웰빙상태유지하기 포함 : 신체적편안함유지, 식생활및체력조절, 건강유지 Looking after one's health Ensuring physical comfort, health and physical and mental well-being, such as by maintaining a balanced diet, and an appropriate level of physical activity, keeping warm or cool, avoiding harms to health, following safe sex practices, including using condoms, getting immunizations and regular physical examinations. Inclusions : ensuring one's physical comfort; managing diet and fitness; maintaining one's health 통계청 165

174 한국표준건강분류 d5700 d5701 신체적편안함유지육체적으로편안하고, 너무덥지도, 너무춥지도또는습하지도않고, 적절히햇볕을쪼여야할필요를인식함으로써자신의신체적건강을스스로돌보는것 식사와체력관리식생활과체중조절의필요를인식하여영양이풍부한음식을선별 섭취하고, 체중을조절함으로써자신의신체적건강을스스로돌보는것 Ensuring one's physical comfort Caring for oneself by being aware that one needs to ensure, and ensuring, that one's body is in a comfortable position, that one is not feeling too hot or cold or wet and that one has adequate lighting. Managing diet and fitness Caring for oneself by being aware of the need and by selecting and consuming nutritious foods and maintaining physical fitness. d5702 d5708 d5709 건강유지건강에유해한요소에대응하고, 질병을예방하기위해서필요성을인식하고, 자신의건강을돌보기위해필요한일들을수행함으로써자신의건강을관리하는것예를들어도움 ( 전문적및비전문적 ) 을구하는것 ; 의료및기타건강상담에따르기 ; 손상들, 감염병, 약물복용, 성병과같은건강에유해한위험을처리 기타명시된자신의건강돌보기 상세불명의자신의건강돌보기 Maintaining one's health Caring for oneself by being aware of the need and doing what is required to look after one's health, both to respond to risks to health and to prevent ill-health, such as by seeking assistance (professional and non professional); following medical and other health advice; and managing risks to health such asinjuries, communicable diseases, drug-taking and sexually transmitted diseases. Looking after one's health, other specified Looking after one's health, unspecified d598 기타명시된자기관리 Self-care, other specified d599 상세불명의자기관리 Self-care, unspecified 166

175 정의에의한세부분류 제 6 장가정생활 (Domestic life) 이장은가정에서이루어지는일상행위와과제수행에대해서술하고있다. 가정생활범주에는주택, 식료 품, 옷과기타생필품획득, 집청소와수리, 가족물건관리, 가족구성원돌보기등이포함된다. 생필품획득 (d610-d629) Acquisition of necessities d610 주택획득 방, 단독주택, 아파트, 또는기타주택을구입하거나임차하고, 가구를설치하고정리하기포함 : 주택구입및임차, 주택가구설치 제외 : 물품획득과서비스받기 (d620), 가사도구관리 (d650) d6100 d6101 d6102 d6108 d6109 주택구입주택, 아파트, 또는기타주택의소유권획득 주택임차다른사람소유의주택, 아파트나기타주택에상응하는대가를지급하고사용권획득 주택가구설치가구, 설비, 비품, 장식품으로주거공간장식및정리, 자기공간배치 기타명시된주택획득 상세불명의주택획득 Acquiring a place to live Buying, renting, furnishing and arranging a room, house, apartment or other dwelling. Inclusions : buying or renting a place to live and furnishing a place to live Exclusions : acquisition of goods and services (d620); caring for household objects (d650) Buying a place to live Acquiring ownership of a house, apartment or other dwelling. Renting a place to live Acquiring the use of a house, apartment or other dwelling belonging to another in exchange for payment. Furnishing a place to live Equipping and arranging a living space with furniture, fixtures and other fittings and decorating rooms, arranging one s own space, room. Acquiring a place to live, other specified Acquiring a place to live, unspecified d620 물품획득과서비스받기 식품, 음료, 옷, 세제, 연료, 가사도구물품, 식기, 조리기구, 놀이와오락도구, 가전제품, 가정도구를선택, 획득, 배달, 저장하고, 전력을포함해기타가정용서비스를획득하는것처럼일상생활을영위하는데필요한모든물품과서비스의선택 획득 배달 Acquisition of goods and services Selecting, procuring and transporting all goods and services required for daily living, such as selecting, procuring, transporting and storing food, drink, clothing, cleaning materials, fuel, household items, utensils, cooking ware, play and recreational materials, domestic appliance and tools; procuring utilities and other household services. 통계청 167

176 한국표준건강분류 포함 : 일상필수품구매와모으기 제외 : 주택획득 (d610) d6200 d6201 d6208 d6209 구매시장이나상점에서식료품, 음료, 세제, 가족용품, 놀이와오락도구또는옷을선택하고구입제품의질과가격을비교하고가격을조정하고지불하고, 배달시키는것처럼시장이나상점에서 ( 쇼핑을하도록다른사람에게지시하거나감독하는것을포함하여 ) 일상생활에필요한상품이나서비스를돈을지불하고획득 일상생필품수집야채와과일을수확하고물과연료를얻는것처럼돈을지불하지않고 ( 일상생필품을얻도록다른사람에게지시하거나감독하는것을포함하여 ) 일상생활에필요한상품또는서비스획득 기타명시된물품획득과서비스받기 상세불명의물품획득과서비스받기 Inclusions : shopping and gathering daily necessities Exclusion : acquiring a place to live (d610) Shopping Obtaining, in exchange for money, goods and services required for daily living (including instructing and supervising an intermediary to do the shopping), such as selecting food, drink, cleaning materials, household items, play and recreational materials or clothing in a shop or market; comparing quality and price of the items required, negotiating and paying for selected goods or services, and transporting goods. Gathering daily necessities Obtaining, without exchange of money, goods and services required for daily living (including instructing and supervising an intermediate to gather daily necessities), such as by harvesting vegetables and fruits and getting water and fuel. Acquisition of goods and services, other specified Acquisition of goods and services, unspecified d629 기타명시된및상세불명의생필품획득 Acquisition of necessities, other specified and unspecified 가사 (d630-d649) Household tasks d630 식사준비 식단을짜고적절한식품및음료를선택하고, 식사준비에필요한재료를준비하고, 음식을가열하고, 차가운식품및음료를준비하고, 요리를대접하는것처럼자신을위해또는남을위해간단하거나복잡한식사를계획하고준비하고요리하고대접하는것포함 : 간단한식사준비, 복잡한식사준비 제외 : 먹기 (d550), 마시기 (d560), 물품획득과 Preparing meals Planning, organizing, cooking and serving simple and complex meals for oneself and others, such as by making a menu, selecting edible food and drink, getting together ingredients for preparing meals, cooking with heat and preparing cold foods and drinks, and serving the food. Inclusions : preparing simple and complex meals Exclusions : eating (d550); drinking (d560); 168

177 정의에의한세부분류 d6300 d6301 서비스받기 (d620), 가사돌보기 (d640), 가사도구관리 (d650), 다른사람돕기 (d660) 간단한식사준비간식또는간단한식사를만들거나, 쌀이나감자같은재료를썰거나저어서끓이거나가열하여재료를가공하는것처럼음식을준비하고대접하는방법이간편한, 간단한재료로만든식사를준비 요리 대접하기 복잡한식사준비여러가지요리를준비하고, 껍질을벗기고, 재료를썰고, 섞고, 반죽하고, 젓는등여러가지행위로재료를가공하고, 상황에그리고문화에맞도록예의를갖추어식사를대접하는것처럼음식을준비하고대접하는방법이복잡한, 많은재료를넣어만든식사를준비, 요리, 대접하기 제외 : 가전제품사용 (d6403) d6308 d6309 기타명시된식사준비 상세불명의식사준비 acquisition of goods and services (d620); doing housework (d640); caring for household objects (d650); caring for others (d660) Preparing simple meals Organizing, cooking and serving meals with a small number of ingredients that require easy methods of preparation and serving, such as making a snack or small meal, and transforming food ingredients by cutting and stirring, boiling and heating food such as rice or potatoes. Preparing complex meals Planning, organizing, cooking and serving meals with a large number of ingredients that require complex methods of preparation and serving, such as planning a meal with several dishes, and transforming food ingredients by combined actions of peeling, slicing, mixing, kneading, stirring, presenting and serving food in a manner appropriate to the occasion and culture. Exclusion : using household appliances (d6403) Preparing meals, other specified Preparing meals, unspecified d640 가사돌보기 싱크대, 벽, 기타바닥쓸고닦기, 쓰레기를모아버리기, 방, 옷장, 서랍청소, 옷세탁 건조 개기 다림질, 신발, 양말세탁, 빗자루 솔 진공청소기사용, 세탁기, 건조기, 다리미를사용하는것처럼집을청소하고, 옷을세탁하고, 가전제품을이용하고, 식품을저장하고, 쓰레기를처리함으로써가정을돌보는행위 포함 : 옷세탁및건조, 주방청소와식기세척, 생활공간청소, 가전제품사용, 일상생필품비축 ; 쓰레기처리 Doing housework Managing a household by cleaning the house, washing clothes, using household appliances, storing food and disposing of garbage, such as by sweeping, mopping, washing counters, walls and other surfaces; collecting and disposing of household garbage; tidying rooms, closets and drawers; collecting, washing, drying, folding and ironing clothes; cleaning footwear; using brooms, brushes and vacuum cleaners; using washing machines, driers and irons. Inclusions : washing and drying clothes and garments; cleaning cooking area and utensils; cleaning living area; using 통계청 169

178 한국표준건강분류 제외 : 주택획득 (d610), 물품획득과서비스받기 (d620), 식사준비 (d630), 가사도구관리 (d650), 다른사람돕기 (d660) d6400 d6401 d6402 d6403 d6404 d6405 d6408 d6409 옷과의류세탁및건조옷과의류를손으로세탁하여햇빛에건조시키기 주방청소와조리기구세척접시, 팬, 냄비, 조리기구세척, 주방주변바닥및식탁청소처럼요리후정리정돈하기 생활공간청소정리정돈, 먼지제거, 쓸기, 닦기, 바닥청소, 창문및벽청소, 욕실및화장실청소, 가구청소등실내생활공간청소하기 가전제품사용세탁기, 건조기, 다리미, 진공청소기, 식기세척기등모든종류의가전제품사용하기 일상생필품비축식품, 음료, 옷및일상생활에필요한기타가정용품비축 ; 통조림을만들거나, 소금을뿌리거나, 냉장고에넣는방법을이용한식품보관, 동물의손길이미치지않는곳에식품을신선하게저장하기 쓰레기처리집주변의쓰레기를모으고, 쓰레기배출준비하고, 쓰레기처리기기를이용하고, 쓰레기를태우는등쓰레기처리하기 기타명시된가사돌보기 상세불명의가사돌보기 household appliances, storing daily necessities and disposing of garbage Exclusions : acquiring a place to live (d610); acquisition of goods and services (d620); preparing meals (d630); caring for household objects (d650); caring for others (d660) Washing and drying clothes and garments Washing clothes and garments by hand and hanging them out to dry in the air. Cleaning cooking area and utensils Cleaning up after cooking, such as by washing dishes, pans, pots and cooking utensils, and cleaning tables and floors around cooking and eating area. Cleaning living area Cleaning the living areas of the household, such as by tidying and dusting, sweeping, swabbing, mopping floors, cleaning windows and walls, cleaning bathrooms and toilets, cleaning household furnishings. Using household appliances Using all kinds of household appliances, such as washing machines, driers, irons, vacuum cleaners and dishwashers. Storing daily necessities Storing food, drinks, clothes and other household goods required for daily living; preparing food for conservation by canning, salting or refrigerating, keeping food fresh and out of the reach of animals. Disposing of garbage Disposing of household garbage such as by collecting trash and rubbish around the house, preparing garbage for disposal, using garbage disposal appliances; burning garbage. Doing housework, other specified Doing housework, unspecified d649 기타명시된및상세불명의가사 Household tasks, other specified and unspecified 170

179 정의에의한세부분류 가사도구관리와다른사람돕기 (d650-d669) Caring for household objects and assisting others d650 가사도구관리 놀이와오락도구, 집, 시설, 옷, 차량, 보조기구같은가족공동의소유물또는가족구성원개인의소유물의관리와수리, 그리고식물과동물보살피기. 예를들어방에페인트칠하기, 벽지바르기, 가구수리, 배관수리, 차량점검, 화초에물주기, 애완동물및가축훈련, 먹이주기 포함 : 옷만들기와수선 ; 주택 가구 가정용구관리 ; 차량관리 ; 보조기구관리, ( 실 내외 ) 식물과동물보살피기 제외 : 주택획득 (d610), 물품획득과서비스받기 (d620), 가사돌보기 (d640), 다른사람돕기 (d660), 유급고용 (d850) d6500 옷만들기와수선바느질로옷을만들고수선, 단추와잠금장치다시달기, 다림질, 신발수선 닦기 제외 : 가전제품사용 (d6403) d6501 d6502 주택과가구관리페인트칠, 붙박이가구와가구의수리, 수리에필요한도구를사용하는것처럼집, 집내 외관및내용물관리와수리 가정용구관리용구기름칠과수리, 세탁기관리등요리, 청소, 수리에필요한모든가정용구관리와수리 Caring for household objects Maintaining and repairing household and other personal objects, including play material, house and contents, clothes, play and recreational materials, vehicles and assistive devices, and caring for plants and animals, such as painting or wallpapering rooms, fixing furniture, repairing plumbing, ensuring the proper working order of vehicles, watering plants, grooming and feeding pets and domestic animals. Inclusions : making and repairing clothes; maintaining dwelling, furnishings and domestic appliances; maintaining vehicles; maintaining assistive devices; taking care of plants (indoor and outdoor) and animals Exclusions : acquiring a place to live (d610); acquisition of goods and services (d620); doing housework (d640); caring for others (d660); remunerative employment (d850) Making and repairing clothes Making and repairing clothes, such as by sewing, producing or mending clothes; reattaching buttons and fasteners; ironing clothes, fixing and polishing footwear. Exclusion : using household appliances (d6403) Maintaining dwelling and furnishings Repairing and taking care of dwelling, its exterior, interior and contents, such as by painting, repairing fixtures and furniture, and using required tools for repair work. Maintaining domestic appliances Repairing and taking care of all domestic appliances for cooking, cleaning and repairing, such as by oiling and repairing 통계청 171

180 한국표준건강분류 d6503 d6504 d6505 d6506 d6508 d6509 차량관리자전거, 짐수레, 자동차, 보트를포함해개인용수동 자동운송수단관리와수리 보조기구관리의수족, 보조기, 가사와자기관리를돕는전문기구같은보조기구관리와수리, 휠체어, 보행기, 스쿠터, 지팡이같은이동보조기구관리와수리, 의사소통과레크리에이션을돕는보조기구관리 실내 외식물돌보기식물심기, 물주기, 비료주기등실내 외식물관리, 개인적사용을위한식용식물가꾸기 동물돌보기먹이주기, 씻기기, 훈련등동물및애완동물돌보기, 동물이나애완동물의건강검진, 집을비울때동물또는애완동물돌볼대안마련 기타명시된가사도구관리 상세불명의가사도구관리 tools and maintaining the washing machine. Maintaining vehicles Repairing and taking care of motorized and non-motorized vehicles for personal use, including bicycles, carts, automobiles and boats. Maintaining assistive devices Repairing and taking care of assistive devices, such as prostheses, orthoses and specialized tools and aids for housekeeping and personal care; maintaining and repairing aids for personal mobility such as canes, walkers, wheelchairs and scooters; and maintaining communication and recreational aids. Taking care of plants, indoors and outdoors Taking care of plants inside and outside the house, such as by planting, watering and fertilizing plants; gardening and growing foods for personal use. Taking care of animals Taking care of domestic animals and pets, such as by feeding, cleaning, grooming and exercising pets; watching over the health of animals or pets; planning for the care of animals or pets in one's absence. Caring for household objects, other specified Caring for household objects, unspecified d660 다른사람돕기 학습, 의사소통, 자기관리, 이동과관련하여집안팎에서가족이나다른사람돕기, 가족이나다른사람의건강상태에관심기울이기 포함 : 자기관리, 이동, 의사소통, 대인관계, 영양및건강관리측면에서가족구성원및다른사람돕기 제외 : 유급고용 (d850) Assisting others Assisting household members and others with their learning, communicating, self-care, movement, within the house or outside; being concerned about the well-being of household members and others. Inclusions : assisting others with self-care, movement, communication, interpersonal relations, nutrition and health maintenance Exclusion : remunerative employment (d850) 172

181 정의에의한세부분류 d6600 d6601 d6602 d6603 d6604 d6605 d6608 d6609 다른사람의자기관리돕기식사, 씻기, 몸단장을돕는것을포함해가족구성원및다른사람이자기관리를수행하는데도움주기, 아이들또는아프거나기본적인자기관리에어려움이있는다른사람이나가족돌보기, 다른사람의대소변처리돕기 다른사람의움직임돕기동네, 도시, 통학, 출퇴근, 또는기타목적지로의이동처럼가족이나다른사람이집밖으로이동및움직임돕기 다른사람의의사소통돕기말하기, 쓰기, 또는읽기보조처럼가족이나다른사람의의사소통돕기 다른사람의대인관계형성돕기대인관계형성시작, 유지, 종료처럼가족이나다른사람의대인관계형성돕기 다른사람의영양섭취돕기식사준비및식사보조처럼가족이나다른사람의영양섭취돕기 다른사람의건강관리돕기아동이정기적으로건강진단을받는지, 또는연로한친지가필요한약을잘먹는지확인하는것처럼의료건강이나다른사람의공식 비공식적건강관리돕기 기타명시된다른사람돕기 상세불명의다른사람돕기 Assisting others with self-care Assisting household members and others in performing selfcare, including helping others with eating, bathing and dressing; taking care of children or members of the household who are sick or have difficulties with basic self-care; helping others with their toileting. Assisting others in movement Assisting household members and others in movements and in moving outside the home, such as in the neighbourhood or city, to or from school, place of employment or other destination. Assisting others in communication Assisting household members and others with their communication, such as by helping with speaking, writing or reading. Assisting others in interpersonal relations Assisting household members and others with their interpersonal interactions, such as by helping them to initiate, maintain or terminate relationships. Assisting others in nutrition Assisting household members and others with their nutrition, such as by helping them to prepare and eat meals. Assisting others in health maintenance Assisting household members and others with formal and informal health care, such as by ensuring that a child gets regular medical check-ups, or that an elderly relative takes required medication. Assisting others, other specified Assisting others, unspecified d669 기타명시된및상세불명의가사도구관리와다른사람돕기 Caring for household objects and assisting others, other specified and unspecified d698 기타명시된가정생활 Domestic life, other specified d699 상세불명의가정생활 Domestic life, unspecified 통계청 173

182 한국표준건강분류 제 7 장대인상호작용과관계 (Interpersonal interactions and relationships) 이장은기본적인대인관계와복잡한대인관계 ( 낯선사람, 친구, 친척, 가족, 애인 ) 에필요한일상행위 와과제를예의와상황에맞게수행하는일에대해서술한다. 일반적대인상호작용 (d710-d729) General interpersonal interactions d710 기본적대인상호작용 적절한상황에다른사람에대해배려나존중을보이거나다른사람의감정을고려하는것처럼예의와상황에맞게다른사람과상호작용을하는것 포함 : 대인관계속에서존중, 온정, 감사, 인내표시, 대인관계속에서사회적자극및비난대응, 대인관계속에서적절한신체적접촉 d7100 d7101 d7102 d7103 d7104 관계내에서존중과온정상황및사회적으로적절한방법으로존중과온정의표현및대응 관계내에서감사상황및사회적으로적절한방법으로만족과감사의표현및대응 관계내에서관용상황및사회적으로적절한방법으로행동의이해와수용을표현및대응 관계내에서비판상황및사회적으로적절한방법으로견해차이또는반대의견을명료하고암시적으로표현및대응 관계내에서사회적자극사회적상호작용속에서발생한어떤징후나기미에대해적절히반응및표현 Basic interpersonal interactions Interacting with people in a contextually and socially appropriate manner, such as by showing consideration and esteem when appropriate, or responding to the feelings of others. Inclusions : showing respect, warmth, appreciation, and tolerance in relationships; responding to criticism and social cues in relationships; and using appropriate physical contact in relationships Respect and warmth in relationships Showing and responding to consideration and esteem, in a contextually and socially appropriate manner. Appreciation in relationships Showing and responding to satisfaction and gratitude, in a contextually and socially appropriate manner. Tolerance in relationships Showing and responding to understanding and acceptance of behaviour, in a contextually and socially appropriate manner. Criticism in relationships Providing and responding to implicit and explicit differences of opinion or disagreement, in a contextually and socially appropriate manner. Social cues in relationships Giving and reacting appropriately to signs and hints that occur in social interactions

183 정의에의한세부분류 d7105 d7106 d7108 d7109 관계내에서신체적접촉상황및사회적으로적절한방법으로다른사람과신체적접촉을하고, 적절히반응 친숙한사람구분친숙한사람에게연락을취하고낮선사람과구분하고적절한방법으로반응하는것처럼각개인에게차등반응 기타명시된기본적대인상호작용 상세불명의기본적대인상호작용 Physical contact in relationships Making and responding to bodily contact with others, in a contextually and socially appropriate manner Differentiation of familiar persons Showing differential responses to individuals, such as by reaching out for the familiar person and differentiating them from strangers and reacting in an appropriate manner. Basic interpersonal interactions, other specified Basic interpersonal interactions, unspecified d720 복잡한대인상호작용 예를들면다른사람과놀거나, 공부하거나, 일할때감정과충동조절, 언어적 신체적공격성통제, 사회적상호작용속에서자주적인행동, 사회적규칙과관습에맞는행동처럼상황과예의에맞게다른사람들과의상호작용을유지및관리 포함 : 관계를만들고끝내기, 상호관계속에서의행동규제, 사회적규율에맞게행동하기, 사회적공간유지 d7200 d7201 관계만들기자기소개, 우정또는사업상의관계찾기와형성, 영구적이고낭만적인또는애정관계형성처럼장 단기적으로상황과예의에맞게다른사람과관계를형성하기시작하여그상호관계를시작하고유지 관계끝내기방문을마치고돌아가며방문동안형성되었던일시적인관계종결, 이사로인해장기간에걸쳐형성된우정정리, Complex interpersonal interactions Maintaining and managing interactions with other people, in a contextually and socially appropriate manner, such as by regulating emotions and impulses, controlling verbal and physical aggression, acting independently in social interactions, and acting in accordance with social rules and conventions, when for example playing, studying or working with others. Inclusions : forming and terminating relationships; regulating behaviours within interactions; interacting according to social rules; and maintaining social space Forming relationships Beginning and maintaining interactions with others for a short or long period of time, in a contextually and socially appropriate manner, such as by introducing oneself, finding and establishing friendships and professional relationships, starting a relationship that may become permanent, romantic or intimate. Terminating relationships Bringing interactions to a close in a contextually and socially appropriate manner, such as by ending temporary 통계청 175

184 한국표준건강분류 d7202 d7203 d7204 d7208 d7209 동료애정리, 사업상의관계정리, 서비스제공자와의관계정리, 낭만적인또는친밀한관계정리처럼상황에맞게그리고예의에맞게상호관계를정리 상호관계에서행동조절상황에맞고사회적으로적절한방법으로감정과충동조절, 타인에대한언어적 신체적공격성통제 사회적규범에맞는상호작용사회적상호작용속에서자주적으로행동하고다른사람과의상호작용속에서자신의역할, 위치또는기타사회적위치를규정하는사회적관습에맞게행동 사회적거리유지사회적 상황적 문화적으로맞게자신과다른사람간의거리를인식하고유지 기타명시된복잡한대인상호작용 상세불명의복잡한대인상호작용 relationships at the end of a visit, ending long-term relationships with friends when moving to a new town or ending relationships with work colleagues, professional colleagues and service providers, and ending romantic or intimate relationships. Regulating behaviours within interactions Regulating emotions and impulses, verbal aggression and physical aggression in interactions with others, in a contextually and socially appropriate manner. Interacting according to social rules Acting independently in social interactions and complying with social conventions governing one's role, position or other social status in interactions with others. Maintaining social space Being aware of and maintaining a distance between oneself and others that is contextually, socially and culturally appropriate. Complex interpersonal interactions, other specified Complex interpersonal interactions, unspecified d729 기타명시된및상세불명의일반적대인상호작용 General interpersonal interactions, other specified and unspecified 특정대인상호작용 (d730-d779) Particular interpersonal relationships d730 d740 낯선사람과의관계 방향이나정보를묻거나, 길을묻거나물건을구입할때처럼특정한목적때문에낯선사람과일시적인관계형성 공식적관계 교사와의관계, 고용주와의관계, 전문가와의관계, 또는서비스공급자와의관계처럼공식적인자리에서특정한관계형성및유지 Relating with strangers Engaging in temporary contacts and links with strangers for specific purposes, such as when asking for directions or other information, or making a purchase. Formal relationships Creating and maintaining specific relationships in formal settings, such as with teachers, employers, professionals or service providers

185 정의에의한세부분류 포함 : 상급자와의관계, 하급자와의관계, 동료와의관계 d7400 d7401 d7402 d7408 d7409 상급자와의관계고용주처럼, 권력을지니거나자신의사회적지위와관련해보다높은직급이나권위를지닌사람과의관계형성및유지 하급자와의관계피고용자또는하인처럼자신의사회적위치와관련해보다낮은직급이나권위를지닌사람과의관계형성및유지 동급자와의관계사회적위치와관련해권위, 직급, 또는권력에있어동등한위치에있는사람과의공식적인관계형성및유지 기타명시된공식적관계 상세불명의공식적관계 Inclusions : relating with persons in authority, with subordinates and with equals Relating with persons in authority Creating and maintaining formal relations with people in positions of power or of a higher rank or prestige relative to one's own social position, such as an employer. Relating with subordinates Creating and maintaining formal relations with people in positions of lower rank or prestige relative to one's own social position, such as an employee or servant. Relating with equals Creating and maintaining formal relations with people in the same position of authority, rank or prestige relative to one's own social position. Formal relationships, other specified Formal relationships, unspecified d750 비공식적사회적관계 같은지역사회또는거주지에살고있는사람들, 직장동료들, 학생들, 놀이친구들, 유사한배경또는직업을지닌사람들과의일시적관계형성처럼다른사람과의관계형성 포함 : 친구, 이웃, 지인, 동거인, 동료와의비공식적인관계 d7500 d7501 d7502 친구와의비공식적관계상호존중그리고공동관심사라는특징을지닌우정관계형성및유지 이웃과의비공식적관계이웃또는근거리에거주하는사람들과의비공식적인관계형성및유지 지인과의비공식적관계서로안면은있지만그리절친한친구는아닌사람과의비공식적인관계형성및유지 Informal social relationships Entering into relationships with others, such as casual relationships with people living in the same community or residence, or with co-workers, students, playmates or people with similar backgrounds or professions. Inclusions : informal relationships with friends, neighbours, acquaintances, co-inhabitants and peers Informal relationships with friends Creating and maintaining friendship relationships that are characterized by mutual esteem and common interests. Informal relationships with neighbours Creating and maintaining informal relationships with people who live in nearby dwellings or living areas. Informal relationships with acquaintances Creating and maintaining informal relationships with people whom one knows but who are not close friends. 통계청 177

186 한국표준건강분류 d7503 d7504 d7508 d7509 동거인과의비공식적관계어떤목적을위해서라든가또는개인적이거나공적으로운영되는거주기관에같이사는사람들간의비공식적인관계형성및유지 동료와의비공식적관계연령, 관심사또는기타특징이같은사람들간의비공식적인관계형성및유지 기타명시된비공식적사회적관계 상세불명의비공식적사회적관계 Informal relationships with co-inhabitants Creating and maintaining informal relationships with people who are co-inhabitants of a house or other dwelling, privately or publicly run, for any purpose. Informal relationships with peers Creating and maintaining informal relationships with people who share the same age, interest or other common feature. Informal social relationships, other specified Informal social relationships, unspecified d760 가족관계 핵가족, 확대가족, 입양으로형성된가족, 그리고법적관계로형성된가족과같은친밀한관계와사촌또는법적인후견인같은보다먼가족과의관계형성및유지 포함 : 부모로서자녀와의관계, 자녀로서부모와의관계, 형제자매관계, 확대가족관계 d7600 d7601 d7602 부모 - 자녀관계친부모와양부모가되어친자녀에게또는양녀 자녀에게물리적, 지적및정서적양육을제공하는것처럼자녀출산으로친부모와입양으로아동의양부모되기 자녀 - 부모관계아동으로서부모에게복종하거나성인자녀로나이든부모를봉양하는것처럼자신의부모와관계형성및유지 형제 - 자매관계출생, 입양, 결혼으로부모가같은사람간에형제또는자매관계형성및유지 Family relationships Creating and maintaining kinship relationships, such as with members of the nuclear family, extended family, foster and adopted family and step-relationships, more distant relationships such as second cousins, or legal guardians. Inclusions : parent-child and child-parent relationships, sibling and extended family relationships Parent-child relationships Becoming and being a parent, both natural and adoptive, such as by having a child and relating to it as a parent or creating and maintaining a parental relationship with an adoptive child, and providing physical, intellectual and emotional nurture to one's natural or adoptive child. Child-parent relationships Creating and maintaining relationships with one's parent, such as a young child obeying his or her parents or an adult child taking care of his or her elderly parents. Sibling relationships Creating and maintaining a brotherly or sisterly relationship with a person who shares one or both parents by birth, 178

187 정의에의한세부분류 d7603 d7608 d7609 확대가족관계사촌, 숙모, 삼촌, 조부모처럼확대가족의가족구성원과가족관계형성및유지 기타명시된가족관계 상세불명의가족관계 adoption or marriage. Extended family relationships Creating and maintaining a family relationship with members of one's extended family, such as with cousins, aunts and uncles and grandparents. Family relationships, other specified Family relationships, unspecified d770 애정관계 부부, 애인, 성관계파트너등개인간의친근한또는낭만적인관계형성및유지 포함 : 낭만적인관계, 배우자관계, 성관계 d7700 d7701 d7702 d7708 d7709 낭만적관계장기적측면에서애정관계로발전할가능성을지닌, 감정적 육체적매력에기초한관계형성및유지. 배우자관계법적인아내또는남편, 결혼하지않은배우자를포함해법적관계에기초해다른사람과애정관계형성및유지 성관계배우자와또는다른상대와성적인관계형성및유지 기타명시된애정관계 상세불명의애정관계 Intimate relationships Creating and maintaining close or romantic relationships between individuals, such as husband and wife, lovers or sexual partners. Inclusions : romantic, spousal and sexual relationships Romantic relationships Creating and maintaining a relationship based on emotional and physical attraction, potentially leading to long-term intimate relationships. Spousal relationships Creating and maintaining an intimate relationship of a legal nature with another person, such as in a legal marriage, including becoming and being a legally married wife or husband or an unmarried spouse. Sexual relationships Creating and maintaining a relationship of a sexual nature, with a spouse or other partner. Intimate relationships, other specified Intimate relationships, unspecified d779 기타명시된및상세불명의특정대인관계 Particular interpersonal relationships, other specified and unspecified d798 d799 기타명시된대인상호작용과관계 상세불명의대인상호작용과관계 Interpersonal interactions and relationships, other specified Interpersonal interactions and relationships, unspecified 통계청 179

188 한국표준건강분류 제 8 장주요생활영역 (Major life areas) 이장은교육을받고, 취업을하고, 경제적거래를이행하는데필요한일상행위와과제를수행하는 것에대해서술한다. 교육 (d810-d839) Education d810 d815 d820 비공식적교육 부모나가족구성원으로부터다양한교육을배우는것, 또는가정교육처럼집이나기타비교육기관에서의학습 유치원교육 취학준비단계로서보육또는유사한환경속에서교육으로아이들에게학교와비슷한환경을제공하여정규교육에준비할수있도록고안된, 체계적인교육시작단계에서의학습 학교교육 입학허가를받고, 학교관련모든책임과권리를누리고, 초등또는중등의교과과정및기타필요한교육과정을배우는것. 여기에는학교에빠지지않고등교하기, 다른학생들과협력하기, 교사로부터지시받기, 숙제나조별과제를조직화하여공부하기, 다른교육단계로진학하기등이포함됨 Informal education Learning at home or in some other non-institutional setting, such as learning crafts and other skills from parents or family members, or home schooling. Preschool education Learning at an initial level of organized instruction, designed primarily to introduce a child to the school-type environment and prepare it for compulsory education, such as by acquiring skills in a day-care or similar setting as preparation for advancement to school. School education Gaining admission to school, education, engaging in all school-related responsibilities and privileges, and learning the course material, subjects and other curriculum requirements in a primary or secondary education programme, including attending school regularly, working cooperatively with other students, taking direction from teachers, organizing, studying and completing assigned tasks and projects, and advancing to other stages of education. d825 직업교육 자영업, 일반직이나전문직에필요한교육과정을배우고직업교육활동에참여하기 Vocational training Engaging in all activities of a vocational programme and learning the curriculum material in preparation for employment 180

189 정의에의한세부분류 in a trade, job or profession. d830 고등교육 대학의학사학위나석사학위, 의과대학이나기타전문교육기관의교육과정이수처럼대학, 단과대학, 전문교육기관의고등교육프로그램활동에참여하고학위, 졸업장, 자격증, 기타증서를획득하는데필요한교육과정에참여 Higher education Engaging in the activities of advanced educational programmes in universities, colleges and professional schools and learning all aspects of the curriculum required for degrees, diplomas, certificates and other accreditations, such as completing a university bachelor's or master's course of study, medical school or other professional school. d835 교육관련활동 학사과정의일부분이아닌, 클럽, 스포츠단체, 관련시민단체 ( 예를들면학교위원회 ), 기타조직화된단체를포함한, 대학및학교관련협회같은교육기관활동에다방면으로참여하기 Education life Engaging in aspects of life of education institutions, such as university and school related associations, including: clubs, sports, related civic bodies (e.g. school council), and other institutionally-organized initiatives that are not part of the academic curriculum. d839 기타명시된및상세불명의교육 Education, other specified and unspecified 일과고용 (d840-d859) Work and employment d840 견습연수 ( 취업준비 ) 견습, 인턴제, 계약고용, 직업훈련에필요한과제수행처럼취업준비관련프로그램참여제외 : 직업교육 (d825) Apprenticeship (work preparation) Engaging in programmes related to preparation for employment, such as performing the tasks required of an apprenticeship, internship, articling and in-service training. Exclusion : vocational training (d825) d845 구직 근속 퇴직 일반직또는전문직의구직, 취직, 근속, 승진그리고적절한방법으로퇴직 포함 : 구직, 이력서준비, 고용주와접촉, 면접준비, 근속, 자신의업무성과점검, 퇴직예고, 퇴직 Acquiring, keeping and terminating a job Seeking, finding and choosing employment, being hired and accepting employment, maintaining and advancing through a job, trade, occupation or profession, and leaving a job in an appropriate manner. Inclusions : seeking employment; preparing a resume or curriculum vitae; contacting employers and preparing interviews; 통계청 181

190 한국표준건강분류 d8450 d8451 d8452 d8458 d8459 구직일반직이든전문직이든기타다른직업이든직업을선택하고면접시험참여등취업에필요한과정수행 근속직업, 일반직, 전문직, 또는기타직종에서업무를수행하고승진과기타발전기회획득 퇴직적절한방법으로일을그만두기 기타명시된구직, 근속, 퇴직 상세불명의구직, 근속, 퇴직 maintaining a job; monitoring one's own work performance; giving notice; and terminating a job Seeking employment Locating and choosing a job, in a trade, profession or other form of employment, and performing the required tasks to get hired, such as showing up at the place of employment or participating in a job interview. Maintaining a job Performing job-related tasks to keep an occupation, trade, profession or other form of employment, and obtaining promotion and other advancements in employment. Terminating a job Leaving or quitting a job in the appropriate manner. Acquiring, keeping and terminating a job, other specified Acquiring, keeping and terminating a job, unspecified d850 유급고용 구직과취업, 과제수행, 정시출근, 다른근로자의근무현황감독또는다른사람으로부터근무지도받기, 독자적이거나집단적으로업무수행등직업, 일반직, 전문직, 또는기타직종에서근로자 ( 정규직또는시간제 ) 로서나자영업자로서급여를받고모든노동에참여 포함 : 자영업, 시간제근무, 정규직근무 d8500 자영업농사일, 프리랜서작가또는컨설턴트로활동, 계약직근무, 예술가또는장인으로활동, 상점또는기타사업을소유및운영등자신이운영하거나공식적인고용관계없이다른 Remunerative employment Engaging in all aspects of work, as an occupation, trade, profession or other form of employment, for payment, as an employee, full or part time, or self-employed, such as seeking employment and getting a job, doing the required tasks of the job, attending work on time as required, supervising other workers or being supervised, and performing required tasks alone or in groups. Inclusions : self-employment, part-time and full-time employment Self-employment Engaging in remunerative work sought or generated by the individual, or contracted from others without a formal employment relationship, such as migratory agricultural work, working as a 182

191 정의에의한세부분류 사람으로부터도급받은유급노동에참여 제외 : 시간제근무 (d8501), 정규직근무 (d8502) d8501 d8502 d8508 d8509 d855 시간제근무구직과취업, 책무완수, 정시출근, 다른근로자의근무현황감독, 또는다른사람으로부터근무지도받기, 독자적이거나집단적으로업무를수행하는등시간제로유급노동에참여 정규직근무구직, 취업, 책무완수, 제시간출근, 다른근로자의근무현황감독, 또는다른사람으로부터근무지도받기, 독자적이거나집단적으로업무를수행하는등정규직으로유급노동에참여 기타명시된유급고용 상세불명의유급고용 무급고용 조직적인업무활동, 책무이행, 제시간출근, 다른근로자의근무현황감독또는다른사람으로부터근무지도받기, 독자적이거나집단적으로업무수행을포함해, 예를들면자원봉사, 자선활동, 지역사회또는종교단체를위한봉사활동, 집안에서의무급노동등정규직이거나임시직이든대가를지급하지않는일에참여 제외 : 6 장가정생활 free-lance writer or consultant, short-term contract work, working as an artist or crafts person, owning and running a shop or other business. Exclusions : part-time and full-time employment (d8501, d8502) Part-time employment Engaging in all aspects of work for payment on a part-time basis, as an employee, such as seeking employment and getting a job, doing the tasks required of the job, attending work on time as required, supervising other workers or being supervised, and performing required tasks alone or in groups. Full-time employment Engaging in all aspects of work for payment on a full-time basis, as an employee, such as seeking employment and getting a job, doing the required tasks of the job, attending work on time as required, supervising other workers or being supervised, and performing required tasks alone or in groups. Remunerative employment, other specified Remunerative employment, unspecified Non-remunerative employment Engaging in all aspects of work in which pay is not provided, full-time or part-time, including organized work activities, doing the required tasks of the job, attending work on time as required, supervising other workers or being supervised, and performing required tasks alone or in groups, such as volunteer work, charity work, working for a community or religious group without remuneration, working around the home without remuneration. Exclusion : Chapter 6 Domestic Life d859 기타명시된및상세불명의일과고용 Work and employment, other specified and unspecified 통계청 183

192 한국표준건강분류 경제생활 (d860-d879) Economic life d860 기본적경제적거래 돈으로음식을구입하고, 물물교환을하고, 상품이나서비스를교환하고, 저축하기등의간단한경제적거래참여 Basic economic transactions Engaging in any form of simple economic transaction, such as using money to purchase food or bartering, exchanging goods or services; or saving money. d865 복잡한경제적거래 자본이나재산교환, 이익또는경제적가치창출, 예를들면사업체, 공장또는설비인수, 은행계좌유지, 상품매매등을포함해복잡한경제적거래참여 Complex economic transactions Engaging in any form of complex economic transaction that involves the exchange of capital or property, and the creation of profit or economic value, such as buying a business, factory, or equipment, maintaining a bank account, or trading in commodities. d870 경제적자립 현재와미래의필요를위해경제적안정을확보하기위한사적이거나공적인자원을조절하기 포함 : 개인적인경제적자원, 공적인경제적자격 권리 d8700 d8701 d8708 d8709 개인적인경제적자원현재및미래를위해경제적안정을확보하기위한개인적이거나사적인자원조절하기 공적인경제적자원현재및미래의필요에대비해경제적안정을확보하기위해공적인경제자원조절하기 기타명시된경제적자립 상세불명의경제적자립 Economic self-sufficiency Having command over economic resources, from private or public sources, in order to ensure economic security for present and future needs. Inclusions : personal economic resources and public economic entitlements Personal economic resources Having command over personal or private economic resources, in order to ensure economic security for present and future needs. Public economic entitlements Having command over public economic resources, in order to ensure economic security for present and future needs. Economic self-sufficiency, other specified Economic self-sufficiency, unspecified d879 d898 d899 기타명시된및상세불명의경제생활 기타명시된주요생활영역 상세불명의주요생활영역 Economic life, other specified and unspecified Major life areas, other specified Major life areas, unspecified 184

193 정의에의한세부분류 제 9 장지역사회생활, 사회생활및시민으로서의생활 (Community, social and civic life) 이장은가족테두리에서벗어나지역사회속에서, 사회의일원으로, 한사람의시민으로조직적인사 회생활에참여하는데필요한일상행위와과제에대해서술하고있다. d910 지역사회생활 Community life 자선기관, 서비스단체또는전문적인사회기관참여처럼각종사회생활과지역사회생활참여 포함 : 비공식적인조직, 공식적인조직, 의식 제외 : 무급고용 (d855), 레크리에이션과여가 (d920), 종교활동과영적활동 (d930), 정치생활그리고시민권행사 (d950) d9100 d9101 d9102 d9108 d9109 비공식적조직지역친목모임또는민족단체처럼공동의관심사를지닌사람들에의해조직된사회적또는지역사회조직에참여 공식적조직변호사협회, 의사협회또는학술단체처럼전문적이거나상위급사회단체에참여 의식결혼식, 장례식또는출범식처럼비종교적의식이나사회의식에참여 기타명시된지역사회생활 상세불명의지역사회생활 Engaging in aspects of community social life, such as engaging in charitable organizations, service clubs or professional social organizations. Inclusions : informal and formal associations; ceremonies Exclusions : non-remunerative employment (d855); recreation and leisure (d920); religion and spirituality (d930); political life and citizenship (d950) Informal associations Engaging in social or community associations organized by people with common interests, such as local social clubs or ethnic groups. Formal associations Engaging in professional or other exclusive social groups, such as associations of lawyers, physicians or academics. Ceremonies Engaging in non-religious rites or social ceremonies, such as marriages, funerals or initiation ceremonies. Community life, other specified Community life, unspecified d920 레크리에이션과여가 비공식적이거나조직적인놀이와스포츠, 신체건강증진프로그램, 휴식, 오락또는기분전환, 영화관 극장 미술관 박물관구경, 수공예 취미활동, 독서생활, 악기연주, 관람, 관광과즐거움을위한여행처럼여러형태의놀이, 레크리에이션또는여가활동참여 포함 : 놀이, 스포츠, 예술및교양, 수공예, 취미, 사회화 Recreation and leisure Engaging in any form of play, recreational or leisure activity, such as informal or organized play and sports, programmes of physical fitness, relaxation, amusement or diversion, going to art galleries, museums, cinemas or theatres; engaging in crafts or hobbies, reading for enjoyment, playing musical instruments; sightseeing, tourism and travelling for pleasure. Inclusions : play, sports, arts and culture, crafts, hobbies and socializing 통계청 185

194 한국표준건강분류 제외 : 운송수단으로동물등에타기 (d480), 유급과무급고용 (d850, d855), 종교활동과영적활동 (d930), 정치생활과시민권행사 (d950) d9200 d9201 d9202 d9203 d9204 d9205 d9208 d9209 놀이체스또는카드놀이또는아이들의놀이처럼나름대로규칙을갖고있는게임또는비체계적이거나비조직적인게임과자발적인레크리에이션활동참여 스포츠볼링, 축구, 체조처럼혼자서또는여러사람이참여하는공식적이거나비공식적인경기와운동경기참여 예술과교양즐거움을위한극장, 영화관, 박물관또는미술관방문이나연극출연, 독서생활, 낭독듣기, 춤추기, 노래부르기, 악기연주처럼예술행사, 문화행사에참여또는감상 수공예도자기또는뜨개질같은수공예활동참여 취미우표, 동전, 골동품수집처럼취미활동참여 사회화친구또는친지방문, 공공장소에서다른사람과의비공식적인만남처럼비공식적인모임또는다른사람들과의일상적인모임참여 기타명시된레크리에이션과여가 상세불명의레크리에이션과여가 Exclusions : riding animals for transportation (d480); remunerative and non-remunerative work (d850 and d855); religion and spirituality (d930); political life and citizenship (d950) Play Engaging in games with rules or unstructured or unorganized games and spontaneous recreation, such as playing chess or cards or children's play. Sports Engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group, such as bowling, gymnastics or soccer. Arts and culture Engaging in, or appreciating, fine arts or cultural events, such as going to the theatre, cinema, museum or art gallery, or acting in a play, reading, being read to, dancing, singing or playing a musical instrument for enjoyment. Crafts Engaging in handicrafts, such as pottery or knitting. Hobbies Engaging in pastimes such as collecting stamps, coins or antiques. Socializing Engaging in informal or casual gatherings with others, such as visiting friends or relatives or meeting informally in public places. Recreation and leisure, other specified Recreation and leisure, unspecified d930 종교활동과영적활동 교회, 절, 사원또는회당참석, 종교적목적에서의기도또는찬송, 영적묵상처럼자기수행을위한조직화및활동, 종교적또는영적가치를찾고, 신과의관계구축하는종교활동이나영적활동에참여 Religion and spirituality Engaging in religious or spiritual activities, organizations and practices for self-fulfilment, finding meaning, religious or spiritual value and establishing connection with a divine power, such as is involved in attending a church, temple, mosque or synagogue, praying or chanting 186

195 정의에의한세부분류 포함 : 종교활동, 영적활동 d9300 d9301 d9308 d9309 종교활동조직적인종교의식, 활동과행사참여 영적활동조직적인종교활동이외의영적인활동이나행사에참여 기타명시된종교활동과영적활동 상세불명의종교활동과영적활동 for a religious purpose, and spiritual contemplation. Inclusions : organized religion and spirituality Organized religion Engaging in organized religious ceremonies, activities and events. Spirituality Engaging in spiritual activities or events, outside an organized religion. Religion and spirituality, other specified Religion and spirituality, unspecified d940 인권 UN 의세계인권선언 (1948 년 ) 과아동권리협약 (1989), 장애인의기회균등에관한표준규칙 (1993 년 ); 장애인의권리에관한협약 (2006 년 ) 에의해인정되고있는자결권또는자율권, 자신의운명을통제할권리, 인권처럼인간에게만부여된국내 외적으로인정되는모든권리를누리는것 제외 : 정치생활과시민권행사 (d950) d950 정치생활과시민권행사 시민으로서사회적, 정치적생활에참여하고, 시민으로서법적인위치에기초해투표권, 공직에출마할권리, 정치단체를형성할권리같은권리와특권을누리고법적인보호를받고, 시민으로서의역할과관련된의무이행, 시민권과관련해각종권리와자유 ( 예를들면언론의자유, 사회와종교활동의자유, 불합리한조사와체포에거부할권리, 변호사선임권, 재판권, 기타법적권리와차별로부터보호받음 ) 향유, 시민으로서의법적지위갖기 Human rights Enjoying all nationally and internationally recognized rights that are accorded to people by virtue of their humanity alone, such as human rights as recognized by the United Nations Universal Declaration of Human Rights (1948), the United Nations Convention on the Rights of the Child(1989), the United Nations Standard Rules for the Equalization of Opportunities for Persons with Disabilities (1993), and the United Nations Convention on the Rights of Persons with Disabilities(2006); the right to self-determination or autonomy; and the right to control over one's destiny. Exclusion : political life and citizenship (d950) Political life and citizenship Engaging in the social, political and governmental life of a citizen, having legal status as a citizen and enjoying the rights, protections, privileges and duties associated with that role, such as the right to vote and run for political office, to form political associations; enjoying the rights and freedoms associated with citizenship (e.g. the rights of freedom of speech, association, religion, protection against unreasonable search and seizure, the right to counsel, to a trial and other legal rights and protection against 통계청 187

196 한국표준건강분류 제외 : 인권 (d940) discrimination); having legal standing as a citizen. Exclusion : human rights (d940) d998 기타명시된지역사회생활, 사회생활및시민으로서의생활 Community, social and civic life, other specified d999 상세불명의지역사회생활, 사회생활및시민으로서의생활 Community, social and civic life, unspecified 188

197 정의에의한세부분류 환경요인 (Environmental factors) 정의 : 환경요인은사람들이살아가는신체적 사회적 태도적환경을형성한다. 환경요인분류 환경요인은제 2 부 ( 배경요인 ) 의구성요소다. 기능수행의각구성요소마다환경요인을고려해야하며 그에따라분류해야한다. [ 부록 2 참조 ] 환경요인은개인이처한상황측면에서분류된다. 예를들면요철이없는횡단로는휠체어사용자 에게는촉진요인으로분류될수있지만, 시각장애인에게는저해요인으로분류될수있다. 제1평가값은한요소가촉진요인으로또는저해요인으로작용하는정도를가리킨다. 환경요인이왜촉진요인또는저해요인으로작용하며어느정도로작용하는가하는데에는몇가지이유가있다. 촉진요인을분류할경우, 자원의접근성, 접근의의존성또는가변성, 질적으로좋거나나쁨등과같은문제에유념해야한다. 저해요인의경우에는그방해정도나회피가능성여부에상관없이그요소가특정인에게얼마나자주저해요인으로작용하느냐와관련이있다. 환경요인은그것의존재 ( 예를들면장애인에대한부정적인태도 ) 또는부재 ( 예를들면필요한서비스의결여 ) 때문에저해요인으로작용할수있다는사실을명심해야한다. 특정한건강상태에있는사람들의생활에환경요인이미치는영향은다양하고복잡하다. 향후지속적인연구로이상호작용에대한이해가확대되고그결과이러한요소들을설명하기위해제2평가값을이용할방법들이제시되기를바란다. 몇몇경우에있어다양한환경요인들은빈곤, 개발, 농촌환경또는도시환경, 사회자본같이하나의용어로요약될수있다. 이렇게요약된용어는분류에는포함되어있지않다. 오히려코더가환경요인을구분하여분류해야한다. 이러한각각의약어를구성하는, 분명하고일관성있는일련의환경요인들의존재여부를판단하기위해선보다많은연구가필요하다는점이다시강조된다. 제 1 평가값 다음은환경요인이촉진요인으로또는저해요인으로활동하는정도를측정하는양 (+) 및음 (-) 의 척도다. 다음과같이점 (. ) 또는분리기호만있으면그것은저해요인을의미하고, 양 (+) 의표시가 있으면그것은촉진요인을의미한다. 통계청 189

198 한국표준건강분류 xxx.0 저해요인없음 (No barrier) 없는, 부재의, 하찮은 (none, absent, negligible) 0-4% xxx.1 경도저해요인 (Mild barrier) 약간의, 낮은 (slight, low) 5-24% xxx.2 중등도저해요인 (Moderate barrier) 중간의, 보통의 (medium, fair) 25-49% xxx.3 중증저해요인 (Severe barrier) 높은, 심각한 (high, extreme) 50-95% xxx.4 완전저해요인 (Complete barrier) 전체 (total) % xxx+0 촉진요인없음 (No facilitator) 없는, 부재의, 하찮은 (none, absent, negligible) 0-4% xxx+1 경도촉진요인 (Mild facilitator) 약간의, 낮은 (slight, low) 5-24% xxx+2 중등도촉진요인 (Moderate facilitator) 중간의, 보통의 (medium, fair) 25-49% xxx+3 중증촉진요인 (Severe facilitator) 높은, 심각한 (high, extreme) 50-95% xxx+4 완전촉진요인 (Complete facilitator) 전체 (total) % xxx.8 저해요인이명시되지않음 (Barrier, not specified) xxx+8 촉진요인이명시되지않음 (facilitator, not specified) xxx.9 해당없음 (Not applicable) 몇단계로나눈백분율이제시함으로써보정된평가도구나기타표준들을사용하여환경내에서저해요인이나촉진요인의정도를수량화한다. 예를들면 저해요인없음 이나 완전저해요인 은최대 5% 의오차범위를가진다. 중등도저해요인 은완전저해요인의절반수준미만을의미한다. 이백분율은표준인구백분위수를참조하여다른영역에서조정할수있다. 이러한측정법을일관된방식으로사용하기위해서는, 향후연구를통하여평가절차개발이필요하다. 제 2 평가값 : 개발중 190

199 정의에의한세부분류 제 1 장제품과기술 (Products and technology) 이장은개인의현재환경속에서채집또는창조, 생산, 제조되고있는자연제품이나인공제품또는일련의제품체제, 장비, 그리고기술에관한것이다. 기술지원에대한 ISO 9999 분류는이것을 장애를예방하거나보완, 점검, 완화, 중화하기위해장애인에의해이용되고있는제품, 도구, 장비, 또는기술체제 로정의한다. 어떤제품이나기술은보조적인것도있다 (ISO 9999: 장애인을위한기술지원 - 분류, 2차개정판, ISO/TC 173/SC 2; ISO/DIS 9999 개정판참조 ). 하지만환경요인분류에있어서보조기기와기술은장애인의기능을향상시키기위해특별히고안된또는개조된제품, 도구, 장비, 또는기술로보다좁게정의되어있다. e110 개인소비용제품또는물건 식용으로수확, 가공, 제조된천연또는가공물건이나제품 포함 : 식품과약품 e1100 e1101 e1108 e1109 식품자연식품, 가공처리된식품, 여러가지농도의액체 ( 모유포함 ), 약초, 미네랄 ( 비타민과기타보충제 ) 처럼소비를위해수확, 가공, 제조된자연또는가공물건이나제품등 약품대증요법이나자연요법약품처럼의료목적으로수확, 가공, 제조된천연이나가공의물건이나제품 기타명시된개인소비용제품또는물건 상세불명의소비용제품또는물건 Products or substances for personal consumption Any natural or human-made object or substance gathered, processed or manufactured for ingestion. Inclusions : food and drugs Food Any natural or human-made object or substance gathered, processed or manufactured to be consumed, such as raw, processed and prepared food and liquids of different consistencies(including breast milk), herbs and minerals (vitamin and other supplements). Drugs Any natural or human-made object or substance gathered, processed or manufactured for medicinal purposes, such as allopathic and naturopathic medication. Products or substances for personal consumption, other specified Products or substances for personal consumption, unspecified e115 개인의일상생활용제품과기술 일상행위속에서사람들이사용하는장비, 제품및기술로서그것을사용하는사람들이갖고다니거나착용하도록또는사람들가까이있도록특별히고안된또는개조된장비, 제품, 기술이포함됨 Products and technology for personal use in daily living Equipment, products and technologies used by people in daily activities, including those adapted or specially designed, located in, on or near the person using them. 통계청 191

200 한국표준건강분류 포함 : 개인용일반제품과기술, 개인용보조제품과기술제외 : 개인의실내 외이동및운송용제품과기술 (e120); 커뮤니케이션용제품과기술 (e125) e1150 e1151 e1158 e1159 개인의일상생활용일반제품과기술세탁기기, 세탁용품, 옷, 직물, 가구, 가전제품처럼일상행위속에서사람들이사용하되특별히고안되거나개조되지않은장비, 제품및기술 개인의일상생활용보조제품과기술인공보철기구, 신경계의인공보철물 ( 예를들면내장, 방광, 호흡, 그리고심장박동을통제하는기능유지장치 ), 실내환경에대한개인의통제력을강화시키는환경통제장비 ( 예를들면스캐너, 원격조정출입장치, 음성 통제시스템, 타이머스위치 ) 처럼일상생활에서사람들을돕기위해특별히고안된또는개조된제품과기술 기타명시된개인의일상생활용제품과기술 상세불명의개인의일상생활용제품과기술 Inclusions : general and assistive products and technology for personal use Exclusions : Products and technology for personal indoor and outdoor mobility and transportation (e120); Products and technology for communication (e125) General products and technology for personal use in daily living Equipment, products and technologies used by people in daily activities, such as clothes, textiles, furniture, appliances, cleaning products and tools, not adapted or specially designed. Assistive products and technology for personal use in daily living Adapted or specially designed equipment, products and technologies that assist people in daily living, such as prosthetic and orthotic devices, neural prostheses (e.g. functional stimulation devices that control bowels, bladder, breathing and heart rate), and environmental control units aimed at facilitating individuals' control over their indoor setting (scanners, remote control systems, voice-controlled systems, timer switches). Products and technology for personal use in daily living, other specified Products and technology for personal use in daily living, unspecified e120 개인의실내 외이동및운송용제품과기술 건물안팎으로이동할때사람들이이용하는장비, 제품과기술로서여기에는그것들을사용하는사람들이갖고다니거나착용, 또는사람들가까이에있는장비, 제품과기술이포함됨포함 : 개인의실내 외이동및운송용일반제품과보조제품및기술 e1200 개인의실내 외이동및운송용일반제품과기술 Products and technology for personal indoor and outdoor mobility and transportation Equipment, products and technologies used by people in activities of moving inside and outside buildings, including those adapted or specially designed, located in, on or near the person using them. Inclusions : general and assistive products and technology for personal indoor and outdoor mobility and transportation General products and technology for personal indoor and outdoor mobility and 192

201 정의에의한세부분류 e1201 e1208 e1209 육 해 공에서사람들이운송수단으로사용하는자동과수동운송수단 ( 예를들면, 버스, 자동차, 밴, 기타자동운송수단, 그리고동물에의한수동운동수단 ) 처럼건물안팎으로이동할때사람들이이용하되특별히고안되거나개조되지않은장비, 제품과기술 개인의실내 외이동및운송용보조제품과기술보행기구, 개조차량, 기타개조운송수단, 휠체어, 스쿠터, 이동장비처럼사람들이건물안팎으로이동하는것을돕기위해특별히고안되거나개조된장비, 제품과기술 기타명시된개인의실내 외이동및운송용제품과기술 상세불명의개인의실내 외이동및운송용제품과기술 transportation Equipment, products and technologies used by people in activities of moving inside and outside buildings, such as motorized and non-motorized vehicles used for the transportation of people over ground, water and air (e.g. buses, cars, vans, other motor-powered vehicles and animal-powered transporters), not adapted or specially designed. Assistive products and technology for personal indoor and outdoor mobility and transportation Adapted or specially designed equipment, products and technologies that assist people to move inside and outside buildings, such as walking devices, special cars and vans, adaptations to vehicles, wheelchairs, scooters and transfer devices. Products and technology for personal indoor and outdoor mobility and transportation, other specified Products and technology for personal indoor and outdoor mobility and transportation, unspecified e125 커뮤니케이션용제품과기술 정보를보내고받는과정에서사람들이이용하는장비, 제품과기술로서여기에는그것들을이용하는사람들이갖고다니거나착용하거나또는사람들가까이에있는, 특별히고안된또는개조된장비, 제품과기술이포함됨포함 : 커뮤니케이션용일반제품, 커뮤니케이션용보조기기와기술 e1250 커뮤니케이션용일반제품과기술시청각장비, 오디오녹음기와수신기, 텔레비전장비, 비디오장비, 전화기기, 음성전송시스템, 일대일커뮤니케이션장비처럼정보를보내고받는과정에서사람들이이용하는, 특별히고안되거나개조되지않은장비 Products and technology for communication Equipment, products and technologies used by people in activities of sending and receiving information, including those adapted or specially designed, located in, on or near the person using them. Inclusions : general and assistive products and technology for communication General products and technology for communication Equipment, products and technologies used by people in activities of sending and receiving information, such as optical and auditory devices, audio recorders and receivers, television and video equipment, telephone devices, sound 통계청 193

202 한국표준건강분류 e1251 e1258 e1259 커뮤니케이션용보조제품과기술특수시각장비, 전자시각장비, 특수기록장치, 수기장비, 제도장비, 신호시스템과컴퓨터특수소프트웨어와하드웨어시스템, 와우이식기기, 보청기, FM 청각훈련기, 음성보조장치, 의사소통판, 안경과콘택트렌즈처럼사람들이정보를보내고받는것을돕기위해특별히고안되거나개조된장비, 제품과기술 기타명시된커뮤니케이션용제품과기술 상세불명의커뮤니케이션용제품과기술 transmission systems and face-to-face communication devices, not adapted or specially designed. Assistive products and technology for communication Adapted or specially designed equipment, products and technologies that assist people to send and receive information, such as specialized vision devices, electro-optical devices, specialized writing devices, drawing or handwriting devices, signalling systems and special computer software and hardware, cochlear implants, hearing aids, FM auditory trainers, voice prostheses, communication boards, glasses and contact lenses. Products and technology for communication, other specified Products and technology for communication, unspecified e130 교육용제품과기술 일반지식, 전문지식또는기술을습득하는데사용되는장비, 제품, 프로세스, 방법과기술. 이에는특별히고안된또는개조된장비, 제품, 프로세스, 방법과기술이포함됨포함 : 교육용일반제품과기술, 교육용보조제품과기술 e1300 e1301 교육용일반제품과기술책, 매뉴얼, 교육용놀이기구, 컴퓨터하드웨어또는소프트웨어처럼모든수준의기술, 일반지식, 또는전문지식을습득하는데이용되는, 특별히고안되거나개조되지않은장비, 제품, 프로세스, 방법과기술 교육용보조제품과기술전문적인컴퓨터기술처럼일반지식, 전문지식또는기술습득에이용되는것으로서특별히고안된또는개조된장비, 제품, 프로세스, 방법과기술 Products and technology for education Equipment, products, processes, methods and technology used for acquisition of knowledge, expertise or skill, including those adapted or specially designed. Inclusions : general and assistive products and technology for education General products and technology for education Equipment, products, processes, methods and technology used for acquisition of knowledge, expertise or skill at any level, such as books, manuals, educational toys, computer hardware or software, not adapted or specially designed. Assistive products and technology for education Adapted and specially designed equipment, products, processes, methods and technology used for acquisition of knowledge, expertise or skill, such as 194

203 정의에의한세부분류 e1308 e1309 기타명시된교육용제품과기술 상세불명의교육용제품과기술 specialized computer technology. Products and technology for education, other specified Products and technology for education, unspecified e135 업무용제품과기술 업무의능률을향상시키기위해이용되는장비, 제품과기술 포함 : 업무용일반제품과기술, 업무용보조제품과기술 e1350 e1351 e1358 e1359 업무용일반제품과기술업무용도구, 기기, 사무장비처럼일의능률을향상하기위해업무에이용되는것으로서특별히고안되거나개조되지않은장비, 제품과기술 업무용보조제품과기술업무의능률향상을위해이용되는, 특별히고안된또는개조된장비, 제품및기술로서높이조절작업대, 책상과서류함, 원격조정사무실출입문, 개인의업무수행능력을향상시키고근무환경조절을목적으로하는환경조절장비와컴퓨터하드웨어, 소프트웨어, 부속기기 ( 예를들면스캐너, 원격조정시스템, 음성 통제시스템, 타이머스위치 ) 기타명시된업무용제품과기술 상세불명의업무용제품과기술 Products and technology for employment Equipment, products and technology used for employment to facilitate work activities. Inclusions : general and assistive products and technology for employment General products and technology for employment Equipment, products and technology used for employment to facilitate work activities, such as tools, machines and office equipment, not adapted or specially designed. Assistive products and technology for employment Adapted or specially designed equipment, products and technology used for employment to facilitate work activities, such as adjustable tables, desks and filing cabinets; remote control entry and exit of office doors; computer hardware, software, accessories and environmental control units aimed at facilitating an individual's conduct of work-related tasks and aimed at control of the work environment (e.g. scanners, remote control systems, voice-controlled systems and timer switches). Products and technology for employment, other specified Products and technology for employment, unspecified e140 문화, 레크리에이션및스포츠용제품과기술 문화활동, 레크리에이션활동, 스포츠활동을수행및강화에이용되는장비, 제품및기술로서특별히고안된또는 Products and technology for culture, recreation and sport Equipment, products and technology used for the conduct and enhancement of cultural, recreational and sporting 통계청 195

204 한국표준건강분류 개조된장비, 제품과기술이포함됨 포함 : 문화, 레크리에이션, 스포츠용일반제품과기술, 문화, 레크리에이션, 스포츠용보조제품과기술 e1400 e1401 e1408 e1409 문화, 레크리에이션및스포츠용일반제품과기술특별히고안되거나개조되지않은장비로모형, 스키장비, 테니스공, 악기처럼문화활동, 레크리에이션활동, 스포츠활동을수행및강화하는데이용되는제품과기술 문화, 레크리에이션및스포츠용보조제품과기술개조된스포츠용이동장비, 연주와기타예술활동을위해개조된장비처럼문화활동, 레크리에이션활동, 스포츠활동을수행및강화하는데이용되는, 특별히고안된또는개조된장비, 제품과기술 기타명시된문화, 레크리에이션및스포츠용제품과기술 상세불명의문화, 레크리에이션및스포츠용제품과기술 activities, including those adapted or specially designed. Inclusions : general and assistive products and technology for culture, recreation and sport General products and technology for culture, recreation and sport Equipment, products and technology used for the conduct and enhancement of cultural, recreational and sporting activities, such as toys, skis, tennis balls and musical instruments, not adapted or specially designed. Assistive products and technology for culture, recreation and sport Adapted or specially designed equipment, products and technology used for the conduct and enhancement of cultural, recreational and sporting activities, such as modified mobility devices for sports, adaptations for musical and other artistic performance. Products and technology for culture, recreation and sport, other specified Products and technology for culture, recreation and sport, unspecified e145 종교활동과영적활동수행을위한제품과기술 종교활동이나영적활동수행과정에상징적인의미를부여받거나지닌, 유일하거나대중화된제품과기술로서특별히고안된또는개조된제품과기술이포함됨 포함 : 종교활동과영적활동수행을위한일반제품과기술, 종교활동과영적활동수행을위한보조제품과기술 e1450 종교활동과영적활동수행을위한일반제품과기술성전, 미사보, 5 월의기둥, 머리에쓰는것, 장식촛대, 십자가, 예배용깔개처럼종교활동과영적활동수행과정에상징적인의미를부여받거나지닌, 특별히고안되거나개조되지않은, Products and technology for the practice of religion and spirituality Products and technology, unique or mass-produced, that are given or take on a symbolic meaning in the context of the practice of religion or spirituality, including those adapted or specially designed. Inclusions : general and assistive products and technology for the practice of religion and spirituality General products and technology for the practice of religion or spirituality Products and technology, unique or mass-produced, that are given or take on a symbolic meaning in the context of the practice of religion or spirituality, such as spirit houses, maypoles, headdresses, 196

205 정의에의한세부분류 e1451 유일무이한또는대량생산되는제품과기술 종교활동과영적활동수행을위한보조제품과기술점자종교서적, 점자타로카드, 성전에들어갈때이용하는휠체어바퀴덮개처럼종교활동과영적활동수행과정에상징적인의미를부여받거나지닌, 특별히고안되거나개조된제품과기술 masks, crucifixes, menorahs and prayer mats, not adapted or specially designed. Assistive products and technology for the practice of religion or spirituality Adapted or specially designed products and technology that are given, or take on a symbolic meaning in the context of the practice of religion or spirituality, such as Braille religious books, Braille tarot cards, and special protection for wheelchair wheels when entering temples. e1458 e1459 기타명시된종교활동과영적활동수행을위한제품과기술 상세불명의종교활동과영적활동수행을위한제품과기술 Products and technology for the practice of religion or spirituality, other specified Products and technology for the practice of religion or spirituality, unspecified e150 공공건물설계, 축조및건축관련제품과기술 공공으로사용되기위해설계 건축된실내외인공환경을구성하는제품과기술로서특별히고안된또는개조된제품과기술도포함됨 포함 : 출입시설, 편의시설, 길안내시설설계, 축조및건축관련제품과기술 e1500 공공건물출입시설설계 축조 건축관련제품과기술사무실, 상점, 극장같은공공건물과공공기관출입구, 이동식경사로, 고정경사로, 자동문, 레버도어핸들, 문턱없는출입구설계및건축처럼공공으로설계 건축된인공구조물의출입제품과기술 Design, construction and building products and technology of buildings for public use Products and technology that constitute an individual's indoor and outdoor human-made environment that is planned, designed and constructed for public use, including those adapted or specially designed. Inclusions : design, construction and building products and technology of entrances and exits, facilities and routing Design, construction and building products and technology for entering and exiting buildings for public use Products and technology of entry and exit from the human-made environment that is planned, designed and constructed for public use, such as design, building and construction of entries and exits to buildings for public use (e.g. workplaces, shops and theatres), public buildings, portable and stationary ramps, power-assisted doors, lever door handles and level door thresholds. 통계청 197

206 한국표준건강분류 e1501 e1502 e1503 e1508 e1509 공공건물의실내편의시설설계 축조 건축관련제품과기술세면편의시설, 전화, 오디오시설, 엘리베이터, 에스컬레이터, 자동온도조절장치, 강당또는운동장의수용시설처럼공공건물의편의시설에의한설계, 축조및건축제품과기술 공공건물내경로 위치안내편의시설설계, 축조및건축관련제품과기술글자나점자로쓰인표지판, 복도의크기표시판, 층표시판, 간이시설안내판과기타안내판처럼사람들이건물내에서그리고건물주변에서길을찾고, 자신이가고싶은장소를찾을수있도록돕기위해공공건물에설계, 축조및건축된실내외제품과기술 공공건물에서사람의물리적안전을위한설계, 축조및건축관련제품과기술침대난간, 긴급신호와같이안전을보장하기위하여공공에서사용하는실내외제품과기술 기타명시된공공건물설계, 축조및건축관련제품과기술 상세불명의공공건물설계, 축조및건축관련제품과기술 Design, construction and building products and technology for gaining access to facilities inside buildings for public use Products and technology of indoor facilities in design, building and construction for public use, such as washroom facilities, telephones, audio loops, lifts or elevators, escalators, thermostats (for temperature regulation) and dispersed accessible seating in auditoriums or stadiums. Design, construction and building products and technology for way finding, path routing and designation of locations in buildings for public use Indoor and outdoor products and technology in design, building and construction for public use to assist people to find their way inside and immediately outside buildings and locate the places they want to go to, such as signage, in Braille or writing, size of corridors, floor surfaces, accessible kiosks and other forms of directories. Design, construction and building products and technology for physical safety of persons in buildings for public use Indoor and outdoor products and technology for public use to assure safety such as (e.g. guardrails for beds), emergency signals. Design, construction and building products and technology of buildings for public use, other specified Design, construction and building products and technology of buildings for public use, unspecified e155 민간건물설계, 축조및건축관련제품과기술 개인전용으로설계 건축된 ( 예를들면집, 주거지 ) 실내외인공환경을구성하는제품과기술. 이에는특별히고안된또는개조된제품및기술이포함됨 Design, construction and building products and technology of buildings for private use Products and technology that constitute an individual's indoor and outdoor human-made environment that is planned, designed and constructed (e.g

207 정의에의한세부분류 포함 : 민간건물의출입시설, 편의시설, 길안내시설설계, 축조및건축관련제품과기술 e1550 e1551 민간건물의출입시설설계, 축조및건축관련제품과기술 개인주택의출입구, 이동식경사로, 고정경사로, 자동문, 레버도어핸들, 문턱없는출입구처럼개인용으로설계및건축된인공구조물의출입시설관련제품과기술 민간건물의실내편의시설설계, 축조및건축관련제품과기술세면편의시설, 전화, 오디오시설, 찬장, 가전제품, 가정용구처럼개인전용건물내부설계, 축조및건축과관련된제품과기술 e1552 민간건물내경로 위치안내시설설계, 축조및건축관련제품과기술점자나글자로된표지판, 복도의크기와층표시판처럼사람들이건물내에서또는건물주변에서길을찾고자신이가고싶은장소를찾을수있도록돕는길안내시설설계, 축조및건축과관련된실내외제품과기술 e1553 민간건물에서사람의물리적안전을위한설계, 축조및건축관련제품과기술난간, 긴급신호, 위험물체 ( 예를들면총 ) 나위험물질 ( 예를들면용제, 살충제 ) 의안전한보관과같이안전을보장하기위하여민간에서사용하는실내외제품과기술 home, dwelling) for private use, including those adapted or specially designed. Inclusions : design, construction and building products and technology of entrances and exits, facilities and routing Design, construction and building products and technology for entering and exiting of buildings for private use Products and technology of entry and exit from the humanmade environment that is planned, designed and constructed for private use, such as entries and exits to private homes, portable and stationary ramps, power-assisted doors, lever door handles and level door thresholds. Design, construction and building products and technology for gaining access to facilities in buildings for private use Products and technology related to design, building and construction inside buildings for private use, such as washroom facilities, telephones, audio loops, kitchen cabinets, appliances and electronic controls in private homes. Design, construction and building products and technology for way finding, path routing and designation of locations in buildings for private use Indoor and outdoor products and technology in the design, building and construction of path routing, for private use, to assist people to find their way inside and immediately outside buildings and locate the places they want to go to, such as signage, in Braille or writing, size of corridors and floor surfaces. Design, construction and building products and technology for physical safety of persons in buildings for private use Indoor and outdoor products and technology for private use to assure safety such as guardrails, emergency signals, and secure storage of hazardous objects (e.g. weapons) or materials (e.g. 통계청 199

208 한국표준건강분류 solvents, insecticides). e1558 e1559 기타명시된민간건물설계, 축조및건축관련제품과기술 상세불명의민간건물설계, 축조및건축관련제품과기술 Design, construction and building products and technology of buildings for private use, other specified Design, construction and building products and technology of buildings for private use, unspecified e160 지역개발관련제품과기술 지역개발정책실행, 공간설계, 계획및개발을통해개인의실외환경에영향을미치는지역의제품과기술로서특별히고안된또는개조된제품과기술이포함됨 포함 : 농촌지역, 도시외곽지역, 도시지역, 공원, 자연보호지역, 야생동물보호지역처럼지역개발정책실행으로조직화된지역의제품과기술 e1600 e1601 e1602 농촌지역개발관련제품과기술농촌지역개발정책실행, 그리고농지, 좁은길과푯말처럼공간의설계, 계획및개발을통해개인의실외환경에영향을미치는농촌지역의제품과기술 교외지역개발관련제품과기술교외지역개발정책실행, 횡단로, 좁은길, 교통표지판과가로등처럼공간설계, 계획, 및개발을통해개인의실외환경에영향을미치는교외지역의제품과기술 도시지역개발관련제품과기술도시지역개발정책실행, 횡단로, 경사로, 교통표지판과가로등처럼공간 Products and technology of land development Products and technology of land areas, as they affect an individual's outdoor environment through the implementation of land use policies, design, planning and development of space, including those adapted or specially designed. Inclusions : products and technology of land areas that have been organized by the implementation of land use policies, such as rural areas, suburban areas, urban areas, parks, conservation areas and wildlife reserves Products and technology of rural land development Products and technology in rural land areas, as they affect an individual's outdoor environment through the implementation of rural land use policies, design, planning and development of space, such as farm lands, pathways and signposting. Products and technology of suburban land development Products and technology in suburban land areas, as they affect an individual`s outdoor environment through the implementation of suburban land use policies, design, planning and development of space, such as kerb cuts, pathways, signposting and street lighting. Products and technology of urban land development Products and technology in urban land 200

209 정의에의한세부분류 e1603 e1608 e1609 설계, 계획및개발을통해개인의실외환경에영향을미치는도시지역의제품과기술 공원, 자연보호지역그리고야생동물보호지역관련제품과기술지역개발정책과계획의실행, 공원표지판과야생동물이동로처럼공간설계, 계획및개발을통해개인의실외환경에영향을미치는공원, 자연보호지역, 야생동물보호지역을구성하는제품과기술 기타명시된지역개발관련제품과기술 상세불명의지역개발관련제품과기술 areas as they affect an individual`s outdoor environment through the implementation of urban land use policies, design, planning and development of space, such as kerb cuts, ramps, signposting and street lighting. Products and technology of parks, conservation and wildlife areas Products and technology in land areas making up parks, conservation and wildlife areas, as they affect an individual`s outdoor environment through the implementation of land use policies and design, planning and development of space, such as park signage and wildlife trails. Products and technology of land development, other specified Products and technology of land development, unspecified e165 자산 돈, 상품, 자산그리고개인이소유권또는사용권을갖고있는기타귀중품처럼, 경제적교환가치를지닌제품또는대상 Assets Products or objects of economic exchange such as money, goods, property and other valuables that an individual owns or of which he or she has rights of use. 포함 : 유형자산, 무형자산, 금융자산 e1650 e1651 e1652 e1658 금융자산노동, 자본재및서비스와교환가능한매개체로서금전과기타금융도구같은제품 유형자산노동, 자본재및서비스와교환가능한매개체로서주택, 토지, 옷, 식품, 그리고공산품같은제품또는대상 무형자산노동, 자본재및서비스와교환가능한매개체로서지적재산, 지식, 그리고기술같은제품 기타명시된자산 Inclusions : tangible and intangible products and goods, financial assets Financial assets Products, such as money and other financial instruments, which serve as a medium of exchange for labour, capital goods and services. Tangible assets Products or objects, such as houses and land, clothing, food and technical goods, which serve as a medium of exchange for labour, capital goods and services. Intangible assets Products, such as intellectual property, knowledge and skills, which serve as a medium of exchange for labour, capital goods and services. Assets, other specified 통계청 201

210 한국표준건강분류 e1659 상세불명의자산 Assets, unspecified e198 기타명시된제품과기술 Products and technology, other specified e199 상세불명의제품과기술 Products and technology, unspecified 202

211 정의에의한세부분류 제2장자연환경과인위적환경변화 (Natural environment and human-made changes to environment) 이장은환경내인구학적특성뿐만아니라자연적또는물리적인환경속의생물과무생물그리고그런환경안에서사람에의해변화된구성요소등에관한것이다. e210 자연지리 지형과수역의특징 포함 : 지리학 ( 지질, 기복, 고도, 표고를포함하는지형 ) 과수로학 ( 호수, 강, 바다같은수역 ) 에포함되어있는지리적특징 e2100 e2101 e2108 e2109 지형산, 언덕, 계곡, 평야같은지형의특징 수역호수, 댐, 강, 시내같은수역의특징 기타명시된자연지리 상세불명의자연지리 Physical geography Features of land forms and bodies of water. Inclusions : features of geography included within orography (relief, quality and expanse of land and land forms, including altitude) and hydrography (bodies of water such as lakes, rivers, sea) Land forms Features of land forms, such as mountains, hills, valleys and plains. Bodies of water Features of bodies of water, such as lakes, dams, rivers and streams. Physical geography, other specified Physical geography, unspecified e215 인구 주민 동일한유형의환경적변화를공유하는, 일정한환경속에서생활하고있는사람들의집단포함 : 인구통계적변화, 인구밀도 e2150 e2151 e2158 e2159 인구통계적변화출생, 사망, 인구의고령화그리고이주로인해특정지역에거주하는총인구수의변화처럼사람집단내에서발생하는변화 인구밀도고밀도, 저밀도같은특징을포함해거주지역의단위면적당거주하는사람수 기타명시된인구 주민 상세불명의인구 주민 Population Groups of people living in a given environment who share the same pattern of environmental adaptation. Inclusions : demographic change; population density Demographic change Changes occurring within groups of people, such as the composition and variation in the total number of individuals in an area caused by birth, death, ageing of a population and migration. Population density Number of people per unit of land area, including features such as high and low density. Population, other specified Population, unspecified 통계청 203

212 한국표준건강분류 e220 식물상과동물상 식물과동물제외 : 가금류 (e350), 인구 주민 (e215) e2200 e2201 식물나무, 꽃, 관목, 덩굴식물처럼특성상배아를만들고, 엽록체를갖고있고, 셀룰로오스세포벽이있고이동능력이없는, 식물계의광합성 진핵세포 다세포생명체 동물야생동물, 가금류, 파충류, 조류, 어류, 포유류에서볼수있듯이이동능력, 비광합성신진대사, 자극에뚜렷이반응, 제한된성장, 고정된신체구조등일반적인특성상식물과는다른, 동물계의다세포생명체 제외 : 자산 (e165), 가금류 (e350) e2208 e2209 기타명시된식물상과동물상 상세불명의식물상과동물상 Flora and fauna Plants and animals. Exclusions : domesticated animals (e350); population (e215) Plants Any of various photosynthetic, eukaryotic, multicellular organisms of the kingdom Plantae characteristically producing embryos, containing chloroplasts, having cellulose cell walls, and lacking the power of locomotion, such as trees, flowers, shrubs and vines. Animals Multicellular organisms of the kingdom Animalia, differing from plants in certain typical characteristics such as capacity for locomotion, non-photosynthetic metabolism, pronounced response to stimuli, restricted growth, and fixed bodily structure, such as wild or farm animals, reptiles, birds, fish and mammals. Exclusions : assets (e165); domesticated animals (e350) Fauna and flora, other specified Fauna and flora, unspecified e225 기후 날씨처럼기상적인특징과현상 포함 : 기온, 습도, 기압, 강수량, 풍속, 계절변화 e2250 e2251 e2252 기온고온, 저온, 정상기온, 또는이상기온처럼더운또는추운정도 습도저습, 또는고습처럼대기중습한정도 기압해발고도또는기상상태와관련이있는압력처럼주변대기의압력 Climate Meteorological features and events, such as the weather. Inclusions : temperature, humidity, atmospheric pressure, precipitation, wind and seasonal variations Temperature Degree of heat or cold, such as high and low temperature, normal or extreme temperature. Humidity Level of moisture in the air, such as high or low humidity. Atmospheric pressure Pressure of the surrounding air, such as pressure related to height above sea level 204

213 정의에의한세부분류 e2253 e2254 강수량비, 이슬, 눈, 진눈깨비, 우박처럼대기중수분 ) 의강하 바람미풍, 강풍, 돌풍처럼대기의보다빠르거나느린자연적움직임 or meteorological conditions. Precipitation Falling of moisture, such as rain, dew, snow, sleet and hail. Wind Air in more or less rapid natural motion, such as a breeze, gale or gust. e2255 e2258 e2259 계절변화여름, 가을, 겨울그리고봄처럼한계절에서다음계절로의자연적이고규칙적이며예측가능한변화 기타명시된기후 상세불명의기후 Seasonal variation Natural, regular and predictable changes from one season to the next, such as summer, autumn, winter and spring. Climate, other specified Climate, unspecified e230 e235 자연재해 토네이도, 허리케인, 태풍, 홍수, 삼림화재, 우박등의혹독하거나난폭한날씨, 지진처럼개인의물리적환경에혼란을야기하는, 규칙적이나불규칙적으로발생하는지리적변화와대기변화 인재 인구이동, 사회적기간망, 거주지, 그리고토지의파괴, 환경재해, 토지, 물또는공기의오염 ( 예를들면, 유독성물질배출 ) 등과사건및전쟁과관련된사건또는상황을포함해인간에의해야기된자연환경상의변화또는대혼란으로인간의일상생활에혼란을가져오는것. Natural events Geographic and atmospheric changes that cause disruption in an individual's physical environment, occurring regularly or irregularly, such as earthquakes and severe or violent weather conditions, e.g. tornadoes, hurricanes, typhoons, floods, forest fires and ice-storms. Human-caused events Alterations or disturbances in the natural environment, caused by humans, that may result in the disruption of people's day-to-day lives, including events or conditions linked to conflict and wars, such as the displacement of people, destruction of social infrastructure, homes and lands, environmental disasters and land, water or air pollution (e.g. toxic spills). e240 빛 사물이보이게끔햇빛또는인공빛 ( 촛불, 석유또는파라핀램프, 불, 그리고전기같은 ) 에의한전자기방사로서, 세상에대한유용한또는혼란스러운정보를제공할수도있는것 포함 : 빛의강도, 빛의질. 색채대비 Light Electromagnetic radiation by which things are made visible by either sunlight or artificial lighting (e.g. candles, oil or paraffin lamps, fires and electricity), and which may provide useful or distracting information about the world. Inclusions : light intensity; light quality; colour contrasts 통계청 205

214 한국표준건강분류 e2400 e2401 e2408 e2409 빛의강도자연빛 ( 예컨대태양 ) 또는인공빛이발산하는에너지의정도또는양 빛의질제공된빛의본질그리고시각적환경속에서창출된관련색채대비. 이는세상에대한유용한정보 ( 예를들면계단또는문이있다는시각정보 ) 를제공할수도있고혼란 ( 예를들면너무많은시각이미지 ) 을가중시킬수도있음 기타명시된빛 상세불명의빛 Light intensity Level or amount of energy being emitted by either a natural (e.g. sun) or an artificial source of light. Light quality The nature of the light being provided and related colour contrasts created in the visual surroundings, and which may provide useful information about the world (e.g. visual information on the presence of stairs or a door) or distractions (e.g. too many visual images). Light, other specified Light, unspecified e245 시간적변화 자연적이고규칙적이고예측가능한시간변화포함 : 하루밤낮주기, 음력주기 e2450 e2451 e2458 e2459 하루밤낮주기낮, 밤, 새벽, 황혼처럼낮에서밤으로그리고다시낮으로의자연적이고규칙적이며예측가능한변화 음력주기지구와관련해달의자연적이고규칙적이며예측가능한위치변화 기타명시된시간적변화 상세불명의시간적변화 Time-related changes Natural, regular or predictable temporal change. Inclusions : day/night and lunar cycles Day/night cycles Natural, regular and predictable changes from day through to night and back to day, such as day, night, dawn and dusk. Lunar cycles Natural, regular and predictable changes of the moon's position in relation to the earth. Time-related changes, other specified Time-related changes, unspecified e250 소리 벨소리, 탁하는소리, 쾅하는소리, 노래소리, 휘파람소리, 고함치는소리, 윙윙거리는소리처럼음색이나음조, 음량에상관없이귀에들리는현상. 이는외부에대한유용하거나혼란스런정보를제공할수도있음포함 : 음의감도, 음질 e2500 음의감도생산된에너지양에따라결정되는소리현상의수준또는양. 여기서많은양의에너지는큰소리로인식되고적은양의에너지는부드러운소리로인식되는것 Sound A phenomenon that is or may be heard, such as banging, ringing, thumping, singing, whistling, yelling or buzzing, in any volume, timbre or tone, and that may provide useful or distracting information about the world. Inclusions : sound intensity; sound quality Sound intensity Level or volume of auditory phenomenon determined by the amount of energy being generated, where high energy levels are perceived as loud sounds and low 206

215 정의에의한세부분류 e2501 e2508 e2509 음질음파와음파유형에의해결정되는, 그리고선율이아름다운소리, 거친소리처럼음색과음조로인식되는소리의본질. 이는세상에대한유용한정보 ( 예를들면개가멍멍하는소리와고양이가야옹하는소리 ) 또는혼란스런정보 ( 예를들면주변소음 ) 를제공할수도있음 기타명시된소리 상세불명의소리 energy levels as soft sounds. Sound quality Nature of a sound as determined by the wavelength and wave pattern of the sound and perceived as the timbre and tone, such as harshness or melodiousness, and which may provide useful information about the world (e.g. sound of dog barking versus a cat miaowing) or distractions (e.g. background noise). Sound, other specified Sound, unspecified e255 진동 대형또는소형장비, 비행기, 그리고폭발로인해야기된대상, 건물또는사람의떨림, 흔들림, 경련처럼물리적동요로야기된, 규칙적인또는불규칙적인대상이나사람의흔들리는움직임. 제외 : 지진으로인한땅의흔들림또는떨림같은자연적인현상 (e230) Vibration Regular or irregular to and fro motion of an object or an individual caused by a physical disturbance, such as shaking, quivering, quick jerky movements of things, buildings or people caused by small or large equipment, aircraft and explosions. Exclusion : natural events (e230), such as vibration or shaking of the earth caused by earthquakes e260 공기의질 실외또는실내공기의특성으로서외부에대한유용한또는혼란스런정보를제공할수도있다. 포함 : 실내공기의질, 실외공기의질 e2600 e2601 실내공기의질냄새, 연기, 습도, 공기정화 ( 통제된공기의질 ), 통제되지않은공기의질에의해결정된, 건물또는밀폐된공간내부공기의성질. 이것은외부에대한유용한정보 ( 예를들면가스새는냄새 ) 또는혼란스런정보 ( 예를들면지독한향수냄새 ) 를제공할수있다. 실외공기의질냄새, 연기, 습도, 오존수치, 그리고 Air quality Characteristics of the atmosphere (outside buildings) or enclosed areas of air (inside buildings), and which may provide useful or distracting information about the world. Inclusions : indoor and outdoor air quality Indoor air quality Nature of the air inside buildings or enclosed areas, as determined by odour, smoke, humidity, air conditioning (controlled air quality) or uncontrolled air quality, and which may provide useful information about the world (e.g. smell of leaking gas) or distractions (e.g. overpowering smell of perfume). Outdoor air quality Nature of the air outside buildings or 통계청 207

216 한국표준건강분류 e2608 e2609 대기의기타특성에의해결정된, 건물또는밀폐된공간외부공기의특질. 이것은외부에대한유용한정보 ( 예를들면비냄새 ), 또는혼란스런정보 ( 예를들면유독한냄새 ) 를제공할수도있다. 기타명시된공기의질 상세불명의공기의질 enclosed areas, as determined by odour, smoke, humidity, ozone levels, and other features of the atmosphere, and which may provide useful information about the world (e.g. smell of rain) or distractions (e.g. toxic smells). Air quality, other specified Air quality, unspecified e298 기타명시된자연환경과인위적환경변화 Natural environment and human-made changes to environment, other specified e299 상세불명의자연환경과인위적환경변화 Natural environment and human-made changes to environment, unspecified 208

217 정의에의한세부분류 제 3 장지원과관계 (Support and relationships) 이장은가정, 직장, 학교, 또는놀이나기타일상활동중다른사람에게신체적또는심리적지원, 양육, 보호, 보조, 관계를제공하는사람이나동물에관한것이다. 이장은지원을제공하는사람이나그들의태도에대해서는거론하지않는다. 환경요인에서설명하는것은지원을제공하는사람이나동물자체가아니라, 사람이나동물이제공하는신체적 심리적지원의 정도 이다. e310 직계가족 출생, 결혼또는기타관계로인해문화적으로직계가족으로인정받는개인으로배우자, 파트너, 부모, 형제자매, 자녀, 양부모, 조부모등 제외 : 확대가족 (e315), 개인적도움제공자와개인보조자 (e340) e315 확대가족 가족, 결혼, 기타관계로인해문화적으로확대가족으로인정받는사람으로숙모, 삼촌, 조카, 질녀등 제외 : 직계가족 (e310) Immediate family Individuals related by birth, marriage or other relationship recognized by the culture as immediate family, such as spouses, partners, parents, siblings, children, foster parents, adoptive parents and grandparents. Exclusions : extended family (e315); personal care providers and personal assistants (e340) Extended family Individuals related through family or marriage or other relationships recognized by the culture as extended family, such as aunts, uncles, nephews and nieces. Exclusion : immediate family (e310) e320 친구 신뢰와상호지원을특징으로하는관계속에서지속적이고도밀접한관련을맺고있는사람 Friends Individuals who are close and ongoing participants in relationships characterized by trust and mutual support. e325 지인, 동년배, 동료, 이웃, 지역사회구성원 직장, 학교, 레크리에이션, 또는생활의기타측면에서연령, 성별, 종교, 민족성같은인구학적특징을공유하거나공동이익을추구하는, 지인, 동년배, 동료, 이웃, 지역사회구성원으로서로친한개인 제외 : 단체와조직에관련된서비스 (e5550) Acquaintances, peers, colleagues, neighbours and community members Individuals who are familiar to each other as acquaintances, peers, colleagues, neighbours, and community members, in situations of work, school, recreation, or other aspects of life, and who share demographic features such as age, gender, religious creed or ethnicity or pursue common interests. Exclusions : associations and organizational services (e5550) 통계청 209

218 한국표준건강분류 e330 권위자 다른사람에대한의결권을지닌, 또는사회적, 경제적, 문화적, 종교적지위에기초해사회적으로명백한영향력이나힘을발휘하는개인. 교사, 고용주, 감독관, 종교지도자, 대리의결권자, 후견인, 수탁자등 People in positions of authority Individuals who have decision-making responsibilities for others and who have socially defined influence or power based on their social, economic, cultural or religious roles in society, such as teachers, employers, supervisors, religious leaders, substitute decision-makers, guardians or trustees. e335 하위위치에있는사람 학생, 근로자, 종교단체구성원등직장, 학교또는기타환경속에서권위자에의해일상생활에영향을받는사람. 제외 : 직계가족 (e310) People in subordinate positions Individuals whose day-to-day life is influenced by people in positions of authority in work, school or other settings, such as students, workers and members of a religious group. Exclusion : immediate family (e310) e340 개인적도움제공자와개인보조자 공적또는사적자금지원을받고, 자원봉사를기반으로, 개인이일상활동을하고직장, 학교또는기타생활환경속에서역할을수행하는데있어필요한지원서비스를제공하는사람으로서여기에는가사도우미, 개인보조원, 교통도우미, 유급도우미, 유모등기타기본적도움을제공하는사람이속함 제외 : 직계가족 (e310), 확대가족 (e315), 친구 (e320), 일반적인사회지원서비스 (e5750), 보건전문가 (e355) e345 낯선사람 협력적대체교사나서비스제공자처럼함께생활공간을공유하고있음에도불구하고잘알지못하는사람을포함해아무관련도없고친하지않은개인또는관계를형성한적이없는사람 Personal care providers and personal assistants Individuals who provide services as required to support individuals in their daily activities and maintenance of performance at work, education or other life situation, provided either through public or private funds, or else on a voluntary basis, such as providers of support for home-making and maintenance, personal assistants, transport assistants, paid help, nannies and others who function as primary caregivers. Exclusions : immediate family (e310); extended family (e315); friends (e320); general social support services (e5750); health professionals (e355) Strangers Individuals who are unfamiliar and unrelated, or those who have not yet established a relationship or association, including persons unknown to the individual but who are sharing a life situation with them, such as substitute teachers co-workers or care providers

219 정의에의한세부분류 e350 애완동물 애완동물 ( 개, 고양이, 새, 물고기등의 ), 길안내동물, 운송수단용동물처럼신체적또는감정적, 심리적지원을제공하는동물 Domesticated animals Animals that provide physical, emotional, or psychological support, such as pets (dogs, cats, birds, fish, etc.) and animals for personal mobility and transportation. 포함 : 동물 (e2201); 자산 (e165) Exclusions : animals (e2201); assets (e165) e355 보건전문가 의사, 간호사, 물리치료사, 작업치료사, 언어치료사, 청각치료전문가, 인공보철전문가, 의료사회사업가처럼보건관련각종서비스제공자 제외 : 기타전문가 (e360) Health professionals All service providers working within the context of the health system, such as doctors, nurses, physiotherapists, occupational therapists, speech therapists, audiologists, orthotist-prosthetists, medical social workers. Exclusion : other professionals (e360) e360 기타전문가 사회복지사, 변호사, 교사, 건축가, 디자이너등을포함해보건제도이외분야의각종서비스제공자 제외 : 보건전문가 (e355) Other professionals All service providers working outside the health system, including social workers, lawyers, teachers, architects, and designers. Exclusion : health professionals (e355) e398 기타명시된지원과관계 Support and relationships, other specified e399 상세불명의지원과관계 Support and relationships, unspecified 통계청 211

220 한국표준건강분류 제 4 장태도 (Attitudes) 이장은습관, 관행, 이념, 가치관, 규범, 사실과관계된믿음, 종교적믿음등의가시적인결과인태도에대해서술한다. 이러한태도는개인의행동그리고대인관계와지역사회활동에서부터정치, 경제, 법적활동에이르는사회생활전반에영향을미친다. 예를들면인간으로서한사람이갖는가치에대한개인이나사회의태도가존경하는긍정적인습관을자극하기도하고차별하는부정적인습관 ( 예를들면비난 무시 경시 정형화된습관 ) 을자극할수도있다. 여기에분류되어있는태도는자신의태도가아니라주변사람이보여주는태도다. 개인의태도는 3장환경요인에목록화되어있는관계에따라분류되어있다. 태도와별도로가치와신념이분류되어있지는않다. 그것은가치와신념이태도를배경으로한일종의추진력으로간주되기때문이다. e410 직계가족구성원의태도 장애당사자나본인의행동과태도에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한직계가족구성원의일반적인또는특수한의견과신념 Individual attitudes of immediate family members General or specific opinions and beliefs of immediate family members about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e415 e420 e425 확대가족구성원의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한확대가족구성원의일반적인또는특수한의견과신념 친구의태도 본인의개인적행동과태도에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한친구의일반적인또는특수한의견과신념 지인, 동년배, 동료, 이웃과지역사회구성원의태도 본인의개인적인태도와행동에영향을미치는기타문제 ( 예를들면사회적, Individual attitudes of extended family members General or specific opinions and beliefs of extended family members about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. Individual attitudes of friends General or specific opinions and beliefs of friends about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. Individual attitudes of acquaintances, peers, colleagues, neighbours and community members General or specific opinions and beliefs of acquaintances, peers, colleagues, 212

221 정의에의한세부분류 정치적, 경제적현안들 ) 에대한지인, 동년배, 동료, 이웃, 그리고지역사회구성원의일반적인또는특수한의견과신념 neighbours and community members about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e430 권위자의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한권위자의일반적인또는특수한의견과신념 Individual attitudes of people in positions of authority General or specific opinions and beliefs of people in positions of authority about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e435 하위위치에있는사람의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한하위위치에있는사람들의일반적인또는특수한의견과신념 Individual attitudes of people in subordinate positions General or specific opinions and beliefs of people in subordinate positions about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e440 서비스제공자와활동보조원의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한개인서비스제공자와보조원의일반적인또는특수한의견과신념 Individual attitudes of personal care providers and personal assistants General or specific opinions and beliefs of personal care providers and personal assistants about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e445 낯선사람의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한낯선사람의일반적인또는특수한의견과신념 Individual attitudes of strangers General or specific opinions and beliefs of strangers about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. 통계청 213

222 한국표준건강분류 e450 보건전문가의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한보건전문가의일반적인또는특수한의견과신념 Individual attitudes of health professionals General or specific opinions and beliefs of health professionals about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. e455 e460 기타전문가의태도 본인의개인적태도와행동에영향을미치는기타문제 ( 예를들면사회적, 정치적, 경제적현안들 ) 에대한보건관련전문가와기타전문가의일반적인또는특수한의견과신념 사회적태도 문화, 사회, 다른문화의사람이나기타사회집단이다른사람에대해또는집단이나개인의행동과활동에영향을미치는기타의사회적, 정치적, 경제적현안들에대해일반적으로갖고있는일반적인또는특수한의견과신념 Individual attitudes of other professionals General or specific opinions and beliefs of health-related and other professionals about the person or about other matters (e.g. social, political and economic issues), that influence individual behaviour and actions. Societal attitudes General or specific opinions and beliefs generally held by people of a culture, society, subcultural or other social group about other individuals or about other social, political and economic issues, that influence group or individual behaviour and actions. e465 사회적표준, 관행과이념 도덕규범, 종교적행동또는예의, 종교적규율과그에따른표준과관행, 의식또는사교모임의규범처럼사회적배경속에서발생하는그리고사회적인또는개인적인습관과태도에영향을미치는가치와표준적인신념 ( 예를들면이념, 규범적세계관과윤리적철학 ) 과관련된관념, 습관, 관행, 규칙 Social norms, practices and ideologies Customs, practices, rules and abstract systems of values and normative beliefs (e.g. ideologies, normative world views and moral philosophies) that arise within social contexts and that affect or create societal and individual practices and behaviours, such as social norms of moral and religious behaviour or etiquette; religious doctrine and resulting norms and practices; norms governing rituals or social gatherings. e498 기타명시된태도 Attitudes, other specified e499 상세불명의태도 Attitudes, unspecified 214

223 정의에의한세부분류 제 5 장서비스, 제도와정책 (Services, systems and policies) 이장은아래와같이서비스, 제도, 그리고정책에대해다루고있다. 1. 서비스사회의여러부분에서개인의필요를충족시키기위해마련된, 각종혜택과체계적인프로그램및그것들을운영하는서비스 ( 서비스에는서비스를제공하는사람들도포함된다 ). 서비스는지방단위, 지역사회단위, 지역단위, 시도단위, 주단위, 국가단위, 국제단위로개인, 협회, 기관, 에이전트, 또는정부에의해조직화될수있다. 이러한서비스에의해제공되는상품들은일반적인상품일수도있고, 특별히고안되거나개조된상품일수도있다. 2. 제도지역, 지방, 국가, 국제적차원에서의정부나기타공식기관에의한행정상의통제수단및조직적인기구. 제도는사회여러부분에서각종혜택과조직적인프로그램을제공하고그것들을운영하는서비스를조직화하고통제하고모니터링하도록설계되었다. 3. 정책지역, 지방, 국가, 국제차원에서정부나기타공식기관에의해제정된규칙, 규정, 관례및표준으로구성된정책. 정책은사회여러부분에서각종혜택과조직적인프로그램을제공하고그것들을운영하는서비스를조직화하고통제하고모니터링하는, 시스템자체를규제한다. e510 소비재생산을위한서비스, 제도와정책 사람에의해소비되거나사용되는제품과대상의생산을통제하고지원하는서비스, 제도와정책 Services, systems and policies for the production of consumer goods Services, systems and policies that govern and provide for the production of objects and products consumed or used by people. e5100 소비재생산을위한서비스이동, 커뮤니케이션, 교육, 운송수단, 고용, 가사에이용되는제품과기술처럼, 소비재수집, 창출, 생산, 제조과정에이용되는서비스와프로그램 제외 : 교육과훈련서비스 (e5850), 커뮤니케이션서비스 (e5350), 1 장 Services for the production of consumer goods Services and programmes for the collection, creation, production and manufacturing of consumer goods and products, such as for products and technology used for mobility, communication, education, transportation, employment and housework, including those who provide these services. Exclusions : education and training services (e5850); communication services (e5350); Chapter 1 통계청 215

224 한국표준건강분류 e5101 e5102 소비재생산을위한제도표준을정하는지방기관, 국가기관, 국제기관 ( 예를들면, 국제표준화기구 International Organization for Standardization) 같은또는소비재의수집, 창출, 생산, 제조를통제하는소비자기관같은행정상의통제수단과모니터링기구 소비재생산을위한정책채택된어떤표준처럼, 소비재의수집, 창출, 생산과제조를위한법규, 규정과표준 e5108 기타명시된소비재생산을위한서비스, 제도와정책 e5109 상세불명의소비재생산을위한서비스, 제도와정책 Systems for the production of consumer goods Administrative control and monitoring mechanisms, such as regional, national or international organizations that set standards (e.g. International Organization for Standardization) and consumer bodies, that govern the collection, creation, production and manufacturing of consumer goods and products. Policies for the production of consumer goods Legislation, regulations and standards for the collection, creation, production and manufacturing of consumer goods and products, such as which standards to adopt. Services, systems and policies for the production of consumer goods, other specified Services, systems and policies for the production of consumer goods, unspecified e515 건축및축조서비스, 제도와정책 공공이나민간건물설계및축조를위한서비스, 제도와정책 제외 : 야외공간개발계획서비스, 제도와정책 (e520) e5150 e5151 건축과축조서비스주택건축, 설계원칙및건축법규, 규정, 표준준수처럼, 거주용, 상업용, 산업용및공공건물의설계, 축조, 관리를위한서비스와프로그램으로서서비스를제공하는사람들도포함 건축과축조제도건축법, 건축표준, 화재와생활안전수칙을실행하고모니터링하는수단과기구처럼, 거주용, 상업용, 산업용및공공건물의계획, 설계, 축조, 관리를 Architecture and construction services, systems and policies Services, systems and policies for the design and construction of buildings, public and private. Exclusion : open space planning services, systems and policies (e520) Architecture and construction services Services and programmes for design, constructionand maintenance of residential, commercial, industrial and public buildings, such as house-building, the operationalization of design principles, building codes, regulations and standards, including those who provide these services. Architecture and construction systems Administrative control and monitoring mechanisms that govern the planning, design, construction and maintenance of residential, commercial, industrial and 216

225 정의에의한세부분류 e5152 e5158 e5159 통제하는행정상의통제수단과모니터링기구 건축과축조정책건축법, 건축표준, 화재와생활안전수칙관련정책처럼, 거주용, 상업용, 산업용및공공건물의계획, 설계, 축조, 관리를통제하는법규, 규정및표준 기타명시된건축및축조서비스, 제도와정책 상세불명의건축및축조서비스, 제도와정책 public buildings, such as for implementing and monitoring building codes, construction standards, and fire and life safety standards. Architecture and construction policies Legislation, regulations and standards that govern the planning, design, construction and maintenance of residential, commercial, industrial and public buildings, such as policies on building codes, construction standards, and fire and life safety standards. Architecture and construction services, systems and policies, other specified Architecture and construction services, systems and policies, unspecified e520 야외공간계획과관련된서비스, 제도와정책 공유지 ( 예를들면공원, 숲, 해변, 습지대 ) 와시골, 도시외곽, 도시지역사유지의토지계획, 설계, 개발, 관리를위한서비스, 제도와정책 제외 : 건축및축조서비스, 제도와정책 (e515) e5200 야외공간계획과관련된서비스시골, 도시외곽, 도시, 레크리에이션공간, 자연보호공간, 자연공간, 야외미팅공간, 상업용야외공간 ( 플라자, 야외시장 ), 특정한목적을위한보행자및운송차량이동경로를계획, 창출, 관리하기위한서비스와프로그램으로서서비스를제공하는사람들도포함됨 제외 : 공공건물설계 건축 축조관련제품 (e150), 민간건물설계 건축 축조관련제품 (e155), 지역개발관련제품 (e160) e5201 야외공간계획과관련된제도지역, 지방또는국가의개발계획법, 설계법, 문화재또는보호정책과환경개발정책실행기구처럼지방, Open space planning services, systems and policies Services, systems and policies for the planning, design, development and maintenance of public lands, (e.g. parks, forests, shorelines, wetlands) and private lands in the rural, suburban and urban context. Exclusion : architecture and construction services, systems and policies (e515) Open space planning services Services and programmes aimed at planning, creating and maintaining urban, suburban, rural, recreational, conservation and environmental space, meeting and commercial open spaces (plazas, open-air markets) and pedestrian and vehicular transportation routes for intended uses, including those who provide these services. Exclusions : products for design, building and construction for public (e150) and private (e155) use; products of land development (e160) Open space planning systems Administrative control and monitoring mechanisms, such as for the implementation of local, regional or 통계청 217

226 한국표준건강분류 e5202 e5208 e5209 도시외곽, 도시, 공원, 자연보호지역, 야생동물보호지역을포함해야외공간을계획, 설계, 개발, 관리를총괄하는행정상의통제수단과모니터링기구 야외공간계획과관련된정책지역, 지방, 또는국가의개발계획법, 설계법, 문화재또는보호정책, 환경개발정책처럼지방, 도시외곽지역, 도시지역, 공원, 자연보호지역, 야생동물보호지역을포함해야외공간을계획, 설계, 개발, 관리를통제하는법규, 규정및표준 기타명시된야외공간계획과관련된서비스, 제도와정책 상세불명의야외공간계획과관련된서비스, 제도와정책 national planning acts, design codes, heritage or conservation policies and environmental planning policy, that govern the planning, design, development and maintenance of open space, including rural, suburban and urban land, parks, conservation areas and wildlife reserves. Open space planning policies Legislation, regulations and standards that govern the planning, design, development and maintenance of open space, including rural land, suburban land, urban land, parks, conservation areas and wildlife reserves, such as local, regional or national planning acts, design codes, heritage or conservation policies, and environmental planning policies. Open space planning services, systems and policies, other specified Open space planning services, systems and policies, unspecified e525 e5250 e5251 e5252 주택공급서비스, 제도와정책 사람들의임시거주지, 주거지, 또는숙박시설공급을위한서비스, 제도와정책 주택공급서비스부동산중개소, 주택공급기관, 집없는사람들을위한임시거주지제공처럼사람들이살주택또는임시거주지위치선정, 공급그리고관리를위한서비스와프로그램으로서서비스를제공하는사람들도포함됨 주택공급제도주택공급정책수행과모니터링제도처럼주택공급또는임시거주지제공을관리하는행정상의통제수단과모니터링기구 주택공급정책주택또는임시거주지를공급받을자격심사관련법규와정책, 정부의주택공급 Housing services, systems and policies Services, systems and policies for the provision of shelters, dwellings or lodging for people. Housing services Services and programmes aimed at locating, providing and maintaining houses or shelters for persons to live in, such as estate agencies, housing organizations, shelters for homeless people, including those who provide these services. Housing systems Administrative control and monitoring mechanisms that govern housing or sheltering of people, such as systems for implementing and monitoring housing policies. Housing policies Legislation, regulations and standards that govern housing or sheltering of people, 218

227 정의에의한세부분류 개발과관리참여관련정책, 주택공급개발방법과장소관련정책처럼사람들의주택공급또는피난처제공을통제하는법규, 규정및표준 such as legislation and policies for determination of eligibility for housing or shelter, policies concerning government involvement in developing and maintaining housing, and policies concerning how and where housing is developed. e5258 e5259 기타명시된주택공급서비스, 제도와정책 상세불명의주택공급서비스, 제도와정책 Housing services, systems and policies, other specified Housing services, systems and policies, unspecified e530 공공사업서비스, 제도와정책 상하수도, 연료, 전기, 위생시설, 공공운송수단, 그리고기타기본적인서비스처럼공공으로제공되는공익설비관련서비스, 제도와정책제외 : 시민보호서비스, 제도와정책 (e545) e5300 e5301 e5302 e5308 공공사업서비스기본적인에너지 ( 예를들면연료, 전기 ), 위생시설, 상하수도, 기타기본적인서비스 ( 예를들면긴급수리서비스 ) 를각가정과각상가에전체적으로제공하는서비스와프로그램으로서서비스를제공하는사람들도포함됨 공공사업제도건강및안전관리위원회, 그리고소비자상담실처럼공공사업서비스를통제하는행정상의통제수단과모니터링기구 공공사업정책상수도및연료공급과배달을통제하는건강및안전관리표준, 지역사회의위생시설관행, 기타기본적인서비스를위한정책, 공급부족또는자연재해로인한서비스중단시의수급정책처럼공공사업서비스를통제하는법규, 규정과표준 기타명시된공공사업서비스, 제도와정책 Utilities services, systems and policies Services, systems and policies for publicly provided utilities, such as water, fuel, electricity, sanitation, public transportation and essential services. Exclusion : civil protection services, systems and policies (e545) Utilities services Services and programmes supplying the population as a whole with essential energy (e.g. fuel and electricity), sanitation, water and other essential services (e.g. emergency repair services) for residential and commercial consumers, including those who provide these services. Utilities systems Administrative control and monitoring mechanisms that govern the provision of utilities services, such as health and safety boards and consumer councils. Utilities policies Legislation, regulations and standards that govern the provision of utilities services, such as health and safety standards governing delivery and supply of water and fuel, sanitation practices in communities, and policies for other essential services and supply during shortages or natural disasters. Utilities services, systems and policies, other specified 통계청 219

228 한국표준건강분류 e5309 상세불명의공공사업서비스, 제도와정책 Utilities services, systems and policies, unspecified e535 커뮤니케이션서비스, 제도와정책 정보전달및교환을위한서비스, 제도와정책 Communication services, systems and policies Services, systems and policies for the transmission and exchange of information. e5350 커뮤니케이션서비스전화, 팩스, 일반우편과항공우편, 전자우편, 그리고기타컴퓨터기반시스템 ( 예를들면전화중계, 텔레타이프, 텔레텍스트, 인터넷서비스 ) 같은여러가지방법에의한정보전송을위한서비스와프로그램으로서서비스를제공하는사람들도포함됨 제외 : 미디어서비스 (e5600) Communication services Services and programmes aimed at transmitting information by a variety of methods such as telephone, fax, surface and air mail, electronic mail and other computer-based systems (e.g. telephone relay, teletype, teletext, and internet services), including those who provide these services. Exclusion : media services (e5600) e5351 e5352 e5358 e5359 커뮤니케이션제도전화, 팩스, 일반우편과항공우편, 전자우편그리고기타컴퓨터기반제도에의한정보전송을규제하는, 정보통신규제기관과여러관련기관같은행정상의통제수단과모니터링기구 커뮤니케이션정책커뮤니케이션서비스제공자격, 우편주소의필요조건, 정보통신공급표준처럼전화, 팩스, 우편, 전자우편, 그리고기타컴퓨터기반시스템에의한정보통신을규제하는법규, 규정과표준 기타명시된커뮤니케이션서비스, 제도와정책 상세불명의커뮤니케이션서비스, 제도와정책 Communication systems Administrative control and monitoring mechanisms, such as telecommunication regulation authorities and other such bodies, that govern the transmission of information by a variety of methods, including telephone, fax, surface and air mail, electronic mail and computer-based systems. Communication policies Legislation, regulations and standards that govern the transmission of information by a variety of methods including telephone, fax, post office, electronic mail and computer-based systems, such as eligibility for access to communication services, requirements for a postal address, and standards for provision of telecommunications. Communication services, systems and policies, other specified Communication services, systems and policies, unspecified 220

229 정의에의한세부분류 e540 운송서비스, 제도와정책 한장소에서다른장소로사람을또는사물을옮기는것과관련된서비스, 제도, 그리고정책 e5400 운송서비스철로, 육로, 해로, 또는항공로를통해, 개인또는공공운송수단을통해사람을또는사물을옮기기위한서비스와프로그램으로서서비스를제공하는사람들도포함됨제외 : 개인의이동과운송용제품 (e120) e5401 운송제도자동차운전면허심사제도, 다양한유형의운송수단이용관련건강과안전관리규칙실행및모니터링시스템처럼철로, 육로, 해로또는항공로를통한사람또는물건의이동을통제하는행정상의통제수단과모니터링기구 제외 : 사회보장서비스, 제도와정책 (e570) e5402 e5408 e5409 운송정책운송계획법과정책, 공공운송제공관련정책처럼철로, 육로, 해로또는항공로를통한사람또는물건의이동을통제하는법규, 규정및표준 기타명시된운송서비스, 제도와정책 상세불명의운송서비스, 제도와정책 Transportation services, systems and policies Services, systems and policies for enabling people or goods to move or be moved from one location to another. Transportation services Services and programmes aimed at moving persons or goods by road, paths, rail, air or water, by public or private transport, including those who provide these services. Exclusion : products for personal mobility and transportation (e120) Transportation systems Administrative control and monitoring mechanisms that govern the moving of persons or goods by road, paths, rail, air or water, such as systems for determining eligibility for operating vehicles and, implementation and monitoring of health and safety standards related to use of different types of transportation. Exclusion : social security services, systems and policies (e570) Transportation policies Legislation, regulations and standards that govern the moving of persons or goods by road, paths, rail, air or water, such as transportation planning acts and policies, policies for the provision and access to public transportation. Transportation services, systems and policies, other specified Transportation services, systems and policies, unspecified e545 시민보호서비스, 제도와정책 시민및시민의재산을보호하기위한서비스, 제도와정책 제외 : 공공사업서비스, 제도와정책 (e530) e5450 시민보호서비스화재서비스, 치안서비스, 응급 Civil protection services, systems and policies Services, systems and policies aimed at safeguarding people and property. Exclusion : utilities services, systems and policies (e530) Civil protection services Services and programmes organized by the 통계청 221

230 한국표준건강분류 e5451 e5452 e5458 e5459 서비스처럼시민과시민의재산을보호하기위해지역사회에의해조직화된서비스와프로그램, 서비스를제공하는사람들도포함됨 시민보호제도화재서비스, 치안서비스, 응급서비스를공급하기위해조직된기구처럼시민과시민의재산보호를관장하는행정상의통제수단과모니터링기구 시민보호정책화재서비스, 치안서비스, 응급서비스공급을규정하는정책처럼시민과시민의재산보호를규제하는법규, 규정및표준 기타명시된시민보호서비스, 제도와정책 상세불명의시민보호서비스, 제도와정책 community and aimed at safeguarding people and property, such as fire, police, emergency and ambulance services, including those who provide these services. Civil protection systems Administrative control and monitoring mechanisms that govern the safeguarding of people and property, such as systems by which provision of police, fire, emergency and ambulance services are organized. Civil protection policies Legislation, regulations and standards that govern the safeguarding of people and property, such as policies governing provision of police, fire, emergency and ambulance services. Civil protection services, systems and policies, other specified Civil protection services, systems and policies, unspecified e550 e5500 e5501 법률서비스, 제도와정책 한국가의법령및기타법조문관련서비스, 제도와정책 법률서비스법원, 법정, 민 형사소송을심리하는기타대행기관, 변호사사무소, 공증서비스기관, 중재기관, 교도소또는유치장처럼법에정의된정부의권한을행사하는서비스와프로그램으로서서비스를제공하는사람도포함 법률제도공식적인규범 ( 예를들면법률, 규제, 관습법, 종교법, 국제법, 그리고관례 ) 을집행하고모니터링하는시스템처럼, 법집행을통제하는행정상의통제수단과모니터링기구 Legal services, systems and policies Services, systems and policies concerning the legislation and other law of a country. Legal services Services and programmes aimed at providing the authority of the state as defined in law, such as courts, tribunals and other agencies for hearing and settling civil litigation and criminal trials, attorney representation, services of notaries, mediation, arbitration and correctional or penal facilities, including those who provide these services. Legal systems Administrative control and monitoring mechanisms that govern the administration of justice, such as systems for implementing and monitoring formal rules (e.g. laws, regulations, customary law, religious law, international laws and conventions)

231 정의에의한세부분류 e5502 e5508 e5509 법률정책법률, 관습법, 종교법, 국제법, 그리고관례처럼법의집행을제한하는법규, 규정및표준 기타명시된법률서비스, 제도와정책 상세불명의법률서비스, 제도와정책 Legal policies Legislation, regulations and standards, such as laws, customary law, religious law, international laws and conventions, that govern the administration of justice. Legal services, systems and policies, other specified Legal services, systems and policies, unspecified e555 e5550 e5551 e5552 협회및단체관련서비스, 제도와정책 비영리적인공동관심사를추구하기위해모인사람들의단체 이단체들은흔히직급구조를갖추고있다 관련서비스, 제도와정책 협회및단체관련서비스레크리에이션과여가, 스포츠, 종교, 문화서비스그리고상호부조서비스를제공하는협회와단체처럼동일한관심사를지닌사람들과함께비영리적인공동관심사를추구하려모인사람들에의해제공되는서비스와프로그램 협회및단체관련제도상호부조조직, 레크리에이션과여가활동을위한조직, 문화와종교단체, 비영리조직같은협회와조직설립 운영을포함해비상업적인공동관심사를추구하는사람들의관계와활동을규제하는행정상의통제수단과모니터링기구 협회및단체관련정책상호부조모임, 레크리에이션과여가관련조직, 문화와종교단체, 그리고비영리조직을포함해협회와조합설립 운영을규제하는수단처럼비영리적인공동관심사를갖고모인 Associations and organizational services, systems and policies Services, systems and policies relating to groups of people who have joined together in the pursuit of common, noncommercial interests, often with an associated membership structure. Associations and organizational services Services and programmes provided by people who have joined together in the pursuit of common, noncommercial interests with people who have the same interests, where the provision of such services may be tied to membership, such as associations and organizations providing recreation and leisure, sporting, cultural, religious and mutual aid services. Associations and organizational systems Administrative control and monitoring mechanisms that govern the relationships and activities of people coming together with common noncommercial interests and the establishment and conduct of associations and organizations such as mutual aid organizations, recreational and leisure organizations, cultural and religious associations and not-forprofit organizations. Associations and organizational policies Legislation, regulations and standards that govern the relationships and activities of people coming together with common noncommercial interests, such as policies that govern the establishment and 통계청 223

232 한국표준건강분류 사람들의관계와활동을규제하는법규, 규정및표준 e5558 기타명시된협회및조합관련서비스, 제도와정책 e5559 상세불명의협회및조합관련서비스, 제도와정책 conduct of associations and organizations, including mutual aid organizations, recreational and leisure organizations, cultural and religious associations and not-for-profit organizations. Associations and organizational services, systems and policies, other specified Associations and organizational services, systems and policies, unspecified e560 미디어서비스, 제도와정책 라디오, 텔레비전, 신문그리고인터넷을통해매스커뮤니케이션을제공하는서비스, 제도와정책 e5600 미디어서비스라디오, 텔레비전, 한정자막서비스, 언론보도서비스, 신문, 점자서비스, 컴퓨터기반대중커뮤니케이션 ( 예를들면월드와이드웹, 인터넷 ) 처럼, 매스커뮤니케이션을제공하기위한서비스와프로그램제외 : 커뮤니케이션서비스 (e5350) e5601 미디어제도라디오, 텔레비전, 언론보도서비스, 신문, 컴퓨터기반대중커뮤니케이션 ( 예를들면월드와이드웹, 인터넷 ) 을통해전달되는콘텐츠, 배포와보급방법, 커뮤니케이션접근과방법을규제하는표준처럼일반대중에게뉴스와정보를제공하는것을규제하는행정상의통제수단과모니터링기구 포함 : 텔레비전을통해한정자막을제공할필요, 점자판신문또는기타점자출판물, 텔레텍스트라디오송신제외 : 커뮤니케이션시스템 (e5351) e5602 미디어정책라디오, 텔레비전, 언론보도서비스, Media services, systems and policies Services, systems and policies for the provision of mass communication through radio, television, newspapers and internet. Media services Services and programmes aimed at providing mass communication, such as radio, television, closed captioning services, press reporting services, newspapers, Braille services and computer-based mass communication (world wide web, internet), including those who provide these services. Exclusion : communication services (e5350) Media systems Administrative control and monitoring mechanisms that govern the provision of news and information to the general public, such as standards that govern the content, distribution, dissemination, access to and methods of communicating via radio, television, press reporting services, newspapers and computer-based mass communication (world wide web, internet). Inclusions : requirements to provide closed captions on television, Braille versions of newspapers or other publications, and teletext radio transmissions Exclusion : communication systems (e5351) Media policies Legislation, regulations and standards that 224

233 정의에의한세부분류 신문, 컴퓨터기반매스커뮤니케이션 ( 예를들면월드와이드웹, 인터넷 ) 을통해전달되는콘텐츠, 배포및보급방법, 커뮤니케이션접근과방법을규제하는정책처럼, 일반대중에게뉴스와정보를제공하는것을규제하는법규, 규정및표준제외 : 커뮤니케이션정책 (e5352) e5608 e5609 기타명시된미디어서비스, 제도와정책 상세불명의미디어서비스, 제도와정책 govern the provision of news and information to the general public, such as policies that govern the content, distribution, dissemination, access to and methods of communicating via radio, television, press reporting services, newspapers and computer-based mass communication (world wide web, internet). Exclusion : communication policies (e5352) Media services, systems and policies, other specified Media services, systems and policies, unspecified e565 경제서비스, 제도와정책 재화와서비스의생산, 배포, 소비, 그리고이용제도전반과관련된서비스, 제도와정책 제외 : 사회보장서비스, 제도와정책 (e570) e5650 경제서비스개인적인상업부문 ( 예를들면, 비즈니스, 기업, 개인영리단체 ), 공공부문 ( 예를들면협동조합과기업같은기관에의한상업적인공공서비스 ), 금융기관 ( 예를들면은행과보험기관서비스 ) 처럼재화와서비스의생산, 배포, 소비및이용전반에걸친서비스와프로그램으로서서비스를제공하는사람도포함 제외 : 공익시설관련서비스 (e5300), 노동및고용서비스 (e5900) e5651 경제제도경제정책수행과모니터링제도처럼, 재화와서비스의생산, 배포, 소비그리고이용을규제하는행정상의통제수단과모니터링기구 제외 : 공익시설관련제도 (e5301), 노동및고용시스템 (e5901) Economic services, systems and policies Services, systems and policies related to the overall system of production, distribution, consumption and use of goods and services. Exclusion : social security services, systems and policies (e570) Economic services Services and programmes aimed at the overall production, distribution, consumption and use of goods and services, such as the private commercial sector (e.g. businesses, corporations, private for-profit ventures), the public sector (e.g. public, commercial services such as cooperatives and corporations), financial organizations (e.g. banks and insurance services), including those who provide these services. Exclusions : utilities services (e5300 ); labour and employment services (e5900) Economic systems Administrative control and monitoring mechanisms that govern the production, distribution, consumption and use of goods and services, such as systems for implementing and monitoring economic policies. Exclusions : utilities systems (e5301); labour and employment systems (e5901) 통계청 225

234 한국표준건강분류 e5652 경제정책정부에의해채택 실행되고있는경제정책처럼재화와서비스의생산, 배포, 소비그리고이용을규제하는법규, 규정및표준 제외 : 공익시설관련정책 (e5302), 노동및고용정책 (e5902) e5658 e5659 기타명시된경제서비스, 제도와정책 상세불명의경제서비스, 제도와정책 Economic policies Legislation, regulations and standards that govern the production, distribution, consumption and use of goods and services, such as economic doctrines adopted and implemented by governments. Exclusions : utilities policies (e5302); labour and employment policies (e5902) Economic services, systems and policies, other specified Economic services, systems and policies, unspecified e570 사회보장서비스, 제도와정책 연령, 빈곤, 실업, 건강상태또는장애때문에일반적인세수나기부금으로부터자금지원을받는공공부조를필요로하는사람들에게소득보장을하는서비스, 제도와정책 제외 : 경제서비스, 제도와정책 (e565) e5700 사회보장서비스사회보조프로그램 ( 보조금성격의복지제도, 빈곤또는기타필요에기초한보상제도 ), 사회보험프로그램 ( 예를들면상해또는고용보험 ) 장애와관련연금제도 ( 예를들면소득보장 ) 등의프로그램을위한자격심사, 보조금전달또는지급처럼연령, 빈곤, 실업, 건강이상또는장애때문에보조금이나기부금으로부터자금지원을받는공공부조를필요로하는사람들에게소득지원을해주는서비스와프로그램 Social security services, systems and policies Services, systems and policies aimed at providing income support to people who, because of age, poverty, unemployment, health condition or disability, require public assistance that is funded either by general tax revenues or contributory schemes. Exclusion : economic services, systems and policies (e565) Social security services Services and programmes aimed at providing income support to people who, because of age, poverty, unemployment, health condition or disability, require public assistance that is funded either by general tax revenues or contributory schemes, such as services for determining eligibility, delivering or distributing assistance payments for the following types of programmes: social assistance programmes (e.g. non-contributory welfare, poverty or other needs-based compensation), social insurance programmes (e.g. contributory accident or unemployment insurance), and disability and related pension schemes (e.g. income replacement), including those who provide these services

235 정의에의한세부분류 제외 : 건강서비스 (e5800) Exclusions : health services (e5800) e5701 e5702 e5708 e5709 사회보장제도사회지원, 복지제도, 고용보험금지급, 연금및장애관련복지혜택을받을수있는자격을규제하는법규와규제실행제도처럼, 연령, 빈곤, 실업, 건강상태또는장애때문에공공부조를필요로하는사람들에게소득보장을해주는프로그램과제도를규제하는행정상의통제수단과모니터링기구 사회보장정책사회지원, 복지제도, 고용보험금지급, 연금과장애관련복지혜택을받을수있는자격을규제하는법규와규제처럼, 연령, 빈곤, 실업, 건강이상또는장애때문에공공부조를필요로하는사람들에게소득보장을제공하는프로그램과제도를규제하는법규, 규정및표준 기타명시된사회보장서비스, 제도와정책 상세불명의사회보장서비스, 제도와정책 Social security systems Administrative control and monitoring mechanisms that govern the programmes and schemes that provide income support to people who, because of age, poverty, unemployment, health condition or disability, require public assistance, such as systems for the implementation of rules and regulations governing the eligibility for social assistance, welfare, unemployment insurance payments, pensions and disability benefits. Social security policies Legislation, regulations and standards that govern the programmes and schemes that provide income support to people who, because of age, poverty, unemployment, health condition or disability, require public assistance, such as legislation and regulations governing the eligibility for social assistance, welfare, unemployment insurance payments, disability and related pensions and disability benefits. Social security services, systems and policies, other specified Social security services, systems and policies, unspecified e575 일반적인사회지원서비스, 제도와정책 사회적으로보다완전한역할을하기위해쇼핑, 가사, 운송, 일시적보호, 자기보호, 그리고다른사람보호같은부문에서도움을필요로하는사람들에게도움을제공하기위한서비스, 제도와정책 General social support services, systems and policies Services, systems and policies aimed at providing support to those requiring assistance in areas such as shopping, housework, transport, childcare, respitecare, self-care and care of others, in order to function more fully in society. 제외 : 사회보장서비스, 제도와정책 (e570), 개인적도움제공자와개인보조자 (e340), 보건서비스, 제도와정책 (e580) Exclusions : social security services, systems and policies (e570); personal care providers and personal assistants (e340); health services, systems and policies (e580) 통계청 227

236 한국표준건강분류 e5750 e5751 e5752 일반적인사회지원서비스연령, 빈곤, 실업, 건강상태또는장애때문에쇼핑, 가사, 운송, 자기보호, 그리고다른사람보호같은부문에서사회적으로보다완전한역할을하기위해도움을필요로하는사람들에게사회적지원을제공하는서비스및프로그램 일반적인사회지원제도사회지원서비스와그러한서비스제공관련자격을규제하는규정과규칙을시행하는시스템을포함해, 연령, 빈곤, 실업, 건강상태또는장애때문에그런지원을필요로하는사람들에게사회적지원을제공하는프로그램과제도를규제하는행정상의통제수단과모니터링기구 일반적인사회지원정책사회지원관련자격을규정하는법규와규정을포함해연령, 빈곤, 실업, 건강이상또는장애때문에그런지원을필요로하는사람들에게사회지원을제공하는프로그램및제도를규제하는법규, 규정및표준 e5758 기타명시된일반적인사회지원서비스, 제도와정책 e5759 상세불명의일반적인사회지원서비스, 제도와정책 General social support services Services and programmes aimed at providing social support to people who, because of age, poverty, unemployment, health condition or disability, require public assistance in the areas of shopping, housework, transport, self-care and care of others, in order to function more fully in society. General social support systems Administrative control and monitoring mechanisms that govern the programmes and schemes that provide social support to people who, because of age, poverty, unemployment, health condition or disability, require such support, including systems for the implementation of rules and regulations governing eligibility for social support services and the provision of these services. General social support policies Legislation, regulations and standards that govern the programme and schemes that provide social support to people who, because of age, poverty, unemployment, health condition or disability, require such support, including legislation and regulations governing eligibility for social support. General social support services, systems and policies, other specified General social support services, systems and policies, unspecified e580 보건서비스, 제도와정책 건강이상을예방 해결하고, 의료재활서비스를제공하고건강한생활방식을활성화하기위한서비스, 제도와정책 제외 : 일반적인사회지원서비스, 제도와정책 (e575) e5800 보건서비스건강증진과질병예방서비스, 주요보호서비스, 급성환자치료, 재활서비스, Health services, systems and policies Services, systems and policies for preventing and treating health problems, providing medical rehabilitation and promoting a healthy lifestyle. Exclusion : general social support services, systems and policies (e575) Health services Services and programmes at a local, community, regional, state or national 228

237 정의에의한세부분류 e5801 e5802 장기보호서비스, 그리고지역사회, 가정, 학교, 직장, 일반병원, 특수병원, 클리닉, 숙박시설이갖춰진그리고숙박시설이갖춰지지않은요양시설같은다양한서비스환경속에서장기적으로또는단기적으로, 정기적으로또는일회적으로, 사기금또는공기금에의한자금지원서비스처럼개인의신체적, 심리적, 사회적복지를향상시키기위해지역, 지역사회, 지방, 주또는국가단위로시행되고있는서비스와프로그램 보건제도서비스를받을자격, 기기, 보조기술또는기타개조장비보급자격을결정하는규정과표준그리고접근성, 보편성, 이동가능성, 공공자금지원그리고포괄성등보건시스템의특징을규제하는보건법같은법규를실행하는기구처럼, 지역사회, 가정, 학교, 직장, 일반병원, 특수병원, 클리닉, 숙박시설이갖춰진그리고숙박시설이갖춰지지않은요양시설같은다양한서비스환경속에서신체적, 심리적, 사회적복지를위해개인에게제공되는서비스들을규제하는행정상의통제수단과모니터링기구 보건정책서비스받을자격, 기기, 보조기술또는기타개조장비보급자격을결정하는규정과기준그리고접근성, 보편성, 이동가능성, 공공자금지원그리고포괄성등보건시스템의특징을규제하는보건법같은법규처럼, 지역사회, 가정, 학교, 직장, 일반병원, 특수병원, 클리닉, 숙박시설이갖춰진그리고숙박시설이갖춰지지않은요양시설같은다양한서비스환경속에서신체적, level, aimed at delivering interventions to individuals for their physical, psychological and social wellbeing, such as health promotion and disease prevention services, primary care services, acute care, rehabilitation and long-term care services; services that are publicly or privately funded, delivered on a short-term, long-term, periodic or onetime basis, in a variety of service settings such as community, home-based, school and work settings, general hospitals, speciality hospitals, clinics, and residential and non-residential care facilities, including those who provide these services. Health systems Administrative control and monitoring mechanisms that govern the range of services provided to individuals for their physical, psychological and social well-being, in a variety of settings including community, home-based, school and work settings, general hospitals, speciality hospitals, clinics, and residential and non-residential care facilities, such as systems for implementing regulations and standards that determine eligibility for services, provision of devices, assistive technology or other adapted equipment, and legislation such as health acts that govern features of a health system such as accessibility, universality, portability, public funding and comprehensiveness. Health policies Legislation, regulations and standards that govern the range of services provided to individuals for their physical, psychological and social well-being, in a variety of settings including community, home-based, school and work settings, general hospitals, speciality hospitals, clinics, and residential and non-residential care facilities, such as policies and standards that determine 통계청 229

238 한국표준건강분류 e5808 e5809 심리적, 사회적복지를위해개인에게제공되는서비스들을규제하는법규, 규정및표준 기타명시된보건서비스, 제도와정책 상세불명의보건서비스, 제도와정책 eligibility for services, provision of devices, assistive technology or other adapted equipment, and legislation such as health acts that govern features of a health system such as accessibility, universality, portability, public funding and comprehensiveness. Health services, systems and policies, other specified Health services, systems and policies, unspecified e585 e5850 e5851 교육및훈련서비스, 제도와정책 일반지식, 전문지식, 직업적또는예술적기술을습득, 유지, 향상시키기위한서비스, 제도와정책. 유네스코의교육에관한국제표준분류참고 (ISCED-1997 년 ) 교육및훈련서비스상이한수준의교육이제공되는교육프로그램 ( 예를들면유치원, 초등학교, 중등학교, 고등교육기관, 전문가양성프로그램, 훈련과기술증진프로그램, 견습연수와평생교육등 ) 처럼일반지식, 전문지식, 직업적또는예술적기술을교육하고습득 유지 향상시키기위한서비스와프로그램. 서비스를제공하는사람들도포함됨 교육및훈련제도사교육또는공교육그리고특수교육을제공할자격을결정하는정책과표준실행기구, 교과과정, 학급규모, 한지방의학교수, 학비와보조금, 간식프로그램, 방과후교실서비스를포함해교육시스템의특징을규제하는지역또는지방, 국가의교육위원회나기타권력단체처럼교육프로그램제공을규제하는행정상의통제수단과모니터링기구 Education and training services, systems and policies Services, systems and policies for the acquisition, maintenance and improvement of knowledge, expertise and vocational or artistic skills. See UNESCO's International Standard Classification of Education (ISCED-1997). Education and training services Services and programmes concerned with education and the acquisition, maintenance and improvement of knowledge, expertise and vocational or artistic skills, such as those provided for different levels of education (e.g. preschool, primary school, secondary school, post-secondary institutions, professional programmes, training and skills programmes, apprenticeships and continuing education), including those who provide these services. Education and training systems Administrative control and monitoring mechanisms that govern the delivery of education programmes, such as systems for the implementation of policies and standards that determine eligibility for public or private education and special needs-based programmes; local, regional or national boards of education or other authoritative bodies that govern features of the education systems, including curricula, size of classes, numbers of 230

239 정의에의한세부분류 e5852 e5858 e5859 교육및훈련정책사교육또는공교육그리고특수교육을제공할자격을결정하는정책및표준처럼교육프로그램제공을규제하고, 지역, 지방또는국가의교육위원회또는학급규모, 교과과정, 한지방의학교수, 학비와보조금, 간식프로그램, 방과후교실서비스를포함해교육시스템의특징을규정하는기타정책결정기구의구조를규정하는정책처럼교육프로그램의전달을규제하는법규, 규정과표준 기타명시된교육및훈련서비스, 제도와정책 상세불명의교육및훈련서비스, 제도와정책 schools in a region, fees and subsidies, special meal programmes and after-school care services. Education and training policies Legislation, regulations and standards that govern the delivery of education programme, such as policies and standards that determine eligibility for public or private education and special needs-based programmes, and dictate the structure of local, regional or national boards of education or other authoritative bodies that govern features of the education system, including curricula, size of classes, numbers of schools in a region, fees and subsidies, special meal programmes and after-school care services. Education and training services, systems and policies, other specified Education and training services, systems and policies, unspecified e590 노동및고용서비스, 제도와정책 실업자또는다른일자리를찾고있는사람들에게적절한일자리를찾아주거나승진을원하는근로자를지원하기위한서비스, 제도와정책 제외 : 경제서비스, 제도와정책 (e565) e5900 노동및고용서비스구직및취업준비서비스, 재취업서비스, 취업알선서비스, 이직알선서비스, 취업후사후관리서비스, 직업상의건강및안전서비스, 근로환경서비스 ( 예를들면인간공학, 인력과인력관리서비스, 노동관련서비스, 전문직협회서비스 ) 처럼, 실업자또는다른일자리를찾고있는사람들에게적절한일자리를찾아주거나승진을원하는근로자를지원하기위해지역, 지방, 또는정부기관에의해또는 Labour and employment services, systems and policies Services, systems and policies related to finding suitable work for persons who are unemployed or looking for different work, or to support individuals already employed who are seeking promotion. Exclusion : economic services, systems and policies (e565) Labour and employment services Services and programmes provided by local, regional or national governments, or private organizations to find suitable work for persons who are unemployed or looking for different work, or to support individuals already employed, such as services of employment search and preparation, reemployment, job placement, outplacement, vocational follow-up, occupational health and safety services, and work environment services 통계청 231

240 한국표준건강분류 e5901 e5902 e5908 e5909 사설기관에의해제공되는서비스와프로그램으로서비스를제공하는사람들도포함됨 노동및고용제도고용창출, 고용안정, 계획적이고경쟁력있는고용, 노동표준과노동법, 노동조합관련정책과표준을실행하기위한제도처럼, 직업과경제사회의기타형태의유급노동분포를규제하는행정상의통제수단과모니터링기구 노동및고용정책고용창출, 고용안정, 계획적이고경쟁력있는고용, 노동표준과노동법, 노동조합관련정책과표준처럼, 직업그리고경제사회의기타형태의유급노동분포를규제하는법규, 규정및표준 기타명시된노동및고용서비스, 제도와정책 상세불명의노동및고용서비스, 제도와정책 (e.g. ergonomics, human resources and personnel management services, labour relations services, professional association services), including those who provide these services. Labour and employment systems Administrative control and monitoring mechanisms that govern the distribution of occupations and other forms of remunerative work in the economy, such as systems for implementing policies and standards for employment creation, employment security, designated and competitive employment, labour standards and law, and trade unions. Labour and employment policies Legislation, regulations and standards that govern the distribution of occupations and other forms of remunerative work in the economy, such as standards and policies for employment creation, employment security, designated and competitive employment, labour standards and law, and trade unions. Labour and employment services, systems and policies, other specified Labour and employment services, systems and policies, unspecified e595 e5950 정치적서비스, 제도와정책 국제적기구뿐아니라, 국가, 지방, 그리고지역사회의선거, 투표, 통치와관련된서비스, 제도와정책 정치적서비스지방, 지역및국가정부, 국제기구와 UN, 유럽연합, 각국정부, 지방정부, 지역마을정부, 전형적인리더처럼이러한기구에서선출되거나임명된특정한자리를차지하고있는사람들이제공하는서비스 Political services, systems and policies Services, systems and policies related to voting, elections and governance of countries, regions and communities, as well as international organizations. Political services Services and structures such as local, regional and national governments, international organizations and the people who are elected or nominated to positions within these structures, such as the United Nations, European Union, governments, regional authorities, local village authorities, traditional leaders

241 정의에의한세부분류 e5951 e5952 e5958 e5959 정치적제도정부의사법또는행정기관, 그리고정부의조직, 정치적조직관련정책, 행정기관과사법기관의대행기관, 군대처럼정부로부터특정한권한을부여받은헌법또는기타법률같이사회에서정치적 경제적영향력을조직화하는조직과관련효력 정치적정책선거운동, 정당등록, 투표, 그리고국제정치기구회원등록을규제하는정책처럼정치시스템운영을규제하는정치조직에의해법제화된그리고강화된법률및정책으로서조약, 법규와규정을통제하는헌법과기타법률도포함 기타명시된정치적서비스, 제도와정책 상세불명의정치적서비스, 제도와정책 Political systems Structures and related operations that organise political and economic power in a society, such as executive and legislative branches of government, and the constitutional or other legal sources from which they derive their authority, such as political organizational doctrine, constitutions, agencies of executive and legislative branches of government, the military. Political policy Laws and policies formulated and enforced through political systems that govern the operation of the political system, such as policies governing election campaigns, registration of political parties, voting, and members in international political organizations, including treaties, constitutional and other law governing legislation and regulation. Political services, systems and policies, other specified Political services, systems and policies, unspecified e598 기타명시된서비스, 제도와정책 Services, systems and policies, other specified e599 상세불명의서비스, 제도와정책 Services, systems and policies, unspecified 통계청 233

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243 한국표준건강분류 Korean Standard Classification of Functioning, Disability and Health 부 록 Annexes

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245 부 록 부록 1 분류와용어 (Taxonomic and terminological issues) 한국표준건강분류는다음과같은표준분류원칙에따라계층형으로체계화되어있다 ; 신체기능과구조, 활동과참여, 그리고 환경요인 의각구성요소는독립적으로분류된다. 따라서하나의구성요소에포함되어있는용어는다른구성요소에포함되지않는다. 각구성요소내범주는 줄기-가지-잎 구조로배열되어있기때문에하위단계범주는속해있는상위단계범주의속성을공유한다. 범주들은상호배타적이다. 즉, 같은분류단계에있는두개의범주가동일한속성을공유하지않는다. 그러나이러한배타적특성을특정개인의기능수행을분류하기위해하나이상의항목을사용하는것과혼동해서는안된다. 필요한경우에권고는가능하다. 1. KCF 용어 용어는단어나문구와같이언어적표현을통해정의된개념을지칭한다. 혼동을일으키는대부분의용어는일상생활의말하기와쓰기에서상식적인의미로사용된다. 예를들면장해 (impairment), 장애 (disability) 및핸디캡 (handicap) 은 ICIDH 1980년판에서명확하게용어가규정되었음에도불구하고일상생활에서는자주혼용된다. 이에 ICIDH 개정과정에서 사회적불리 (handicap) 라는용어의사용을중지하고 장애 (disability)' 가모든신체적 개인적 사회적관점을아우르는포괄적용어로선택되었다. 그러나적절한용어를선택하여각각의기본개념을모호함없이표현하려면여러개념들을분명하고정확하게정의할필요가있다. 이것이특히중요한이유는 KCF가글로표현된분류로서많은언어로번역될것이기때문이다. 개념에대한공통적이해수준을넘어서용어에대해각각의언어로그내용을최적으로반영한합의에도달하는것역시매우중요하다. 용어선택에대해여러대안이있을수있으며, 그결정은정확성, 용이성, 전체적인유용성에근거하여내려져야한다. KCF의유용성은명료성과병행되는것이바람직하다. 이러한목적을염두에두고, KCF 의일부용어에대해다음과같이설명한다. 웰빙 (well-being) 은신체적ㆍ심리적ㆍ사회적측면을포함하여 좋은삶 (good life) 을구성하는 인간의삶의영역전반을아우르는일반용어이다. 건강영역은인간의삶전체의부분집합이다. 이러 한관계를웰빙을표현하는도식으로제시하면다음과같다. 부 통계청 237 록

246 한국표준건강분류 그림 28. 웰빙 (well-being) 의영역 웰빙 (well-being) 의기타영역 교육 고용 환경 기타 웰빙 (well-being) 의건강영역 보기 말하기 기억 기타 건강상태 (health state) 와건강영역 (health domain) : 건강상태는 KCF의건강영역내에서 기능수행의수준 을의미한다. 건강영역은보건의료제도의목적을위해제도의일차적책임으로정의할수있는 건강 개념내에해당되는생활영역을의미한다. KCF는건강영역과건강관련영역사이에고정된경계를두지않는다. KCF는건강및건강관련요소개념화의변화에따라달라지는회색지대가존재한다. 건강관련상태 (health-related state) 와건강관련영역 (health-related domain) : 건강관련상태는 KCF의건강관련영역내에서 기능수행의수준 을의미한다. 건강관련영역은건강상태 (health condition) 와밀접한관계가있지만, 보건의료제도의일차적책임보다전반적인웰빙 (well-being) 에기여하는기타제도와관련된기능의생활영역을의미한다. KCF는건강과관련된웰빙 (well-being) 의영역만다룬다. 건강상태 (health condition) 또는병태는질환 ( 급성또는만성 ), 장애, 손상또는외상을포괄하는 용어이다. 건강상태는임신, 노령화, 스트레스, 선천적이상, 유전적소인과같은기타상태도포함할 수있다. 건강상태는 KCD 로분류한다. 기능수행 (functioning) 은신체기능, 신체구조, 활동과참여를포괄하는용어다. 기능수행은개인 ( 병태를가진 ) 과개인의배경요인 ( 환경요인과개인요인 ) 간상호작용의긍정적측면을의미한다. 장애 (disability) 는장해, 활동제한, 참여제약을포괄하는용어다. 장애는개인 ( 병태를가진 ) 과개인의 238

247 부 록 배경요인 ( 환경요인과개인요인 ) 간상호작용의부정적측면을의미한다. 신체기능 (body function) 은심리적기능을포함한신체계통의생리적기능이다. 신체 (body) 는 뇌를포함한인간유기체전체를의미한다. 그러므로정신적 ( 또는심리적 ) 기능은신체기능에포함된다. 이러한기능에대한표준은인간에대한통계적기준이된다. 신체구조 (body structure) 는신체계통에따라분류된기관, 사지및구성요소와같은신체의구 조적또는해부학적부위를의미한다. 이러한구조에대한표준은인간에대한통계표준이된다. 장해 (impairment) 는신체구조또는생리적기능 ( 정신기능포함 ) 의손실또는이상을의미한다. 여기서이상 (abnormality) 은통계기준 ( 측정표준내모평균과의편차 ) 에서크게벗어난경우에만 엄격하게적용할수있고, 반드시이러한의미로만이용되어야한다. 활동 (activity) 은개인이수행하는행위또는과제를의미하며, 기능수행의개인적측면을의미한다. 활동제한 (activity limitation) 18) 은개인이활동을수행하는데겪을수있는어려움을의미한다. 활동제한은병태가없는사람에게기대하는활동수행방식이나정도를질적또는양적측면에서비교 하며경미한이탈에서부터심각한이탈까지이른다. 참여 (participation) 는개인이삶의상황에관여하는것을의미하며, 기능수행의사회적측면을 의미한다. 참여제약 (participation restriction) 19) 은일상생활상황에관여할때개인이경험할수있는문제를 의미한다. 참여제약의존재여부는그문화나사회에서장애가없는개인에게요구되는참여정도와 비교하여결정한다. 배경요인 (contextual factor) 은개인의삶의배경전체를구성하는요인이며, 특히 KCF 에분류 된건강상태에대한배경이다. 배경요인은환경요인과개인요인으로구성된다. 환경요인 (environmental factor) 은 KCF의구성요소중하나로, 개인삶의배경을형성하는외적또는외부세계의모든측면을의미하며개인의기능수행에영향을준다. 환경요인에는물리적세계와그특징, 인공적인물리적세계, 다른사람과의관계및역할, 태도와가치관, 사회제도와서비스, 정책, 규범과법률을포함한다. 18) 활동제한 은 ICIDH 1980 년판에서사용된 장애 라는용어를대신한다. 19) 참여제약 은 ICIDH 1980 년판에서사용된 사회적불리 라는용어를대신한다. 부 통계청 239 록

248 한국표준건강분류 개인요인 (personal factor) 은연령, 성별, 사회적지위, 생활경험등과같이개인과관련된배경 요인을의미한다. 개인요인은현재 KCF 분류에는없지만사용자가개인요인을추가하여분류할수도 있다. 촉진요인 (facilitator) 은개인의환경내에존재하는요인으로촉진요인의유무에따라기능수행을향상시키고장애를감소시킨다. 촉진요인은접근가능한물리적환경, 관련보조기술의유용성, 장애에대한사람들의긍정적인태도, 삶의모든영역에서병태를지닌모든사람의참여를장려하는서비스, 제도및정책등을포함한다. 어떤요인이없는경우촉진상황이될수있으며낙인또는부정적태도가그예다. 촉진요인은장해나활동제한이참여제한으로이어지는것을방지할수있다. 그이유는어떤개인의능력에문제가있음에도불구하고촉진요인으로인해실제행위또는과제수행이향상될수있기때문이다. 저해요인 (barrier) 은개인의환경내에존재하는요인으로저해요인의유무에따라기능수행을제한하고장애를야기하는요인이다. 저해요인은접근이어려운물리적환경, 관련보조기술의부재, 장애에대한사람들의부정적태도, 삶의모든영역에서병태를가진사람들의참여를장려하거나방해하는서비스, 제도및정책등을포함한다. 능력 (capacity) 은하나의평가값으로서, 사람이주어진순간에활동과참여영역에서도달할수있는최고단계의기능을나타내는구성개념이다. 능력은동일한환경또는표준환경에서측정되며환경적으로보정된개인의능력을반영한다. 환경요인구성요소는동일한환경또는표준환경의특징을설명하는데사용할수있다. 수행 (performance) 은하나의평가값으로서, 현재환경에서개인의행위를설명함으로써실제삶의상황에 개인이관여하는측면을나타내는구성개념이다. 현재환경또한환경요인의구성요소를사용하여 설명할수있다

249 부 록 그림 29. 한국표준건강분류구조 한국표준건강분류 (KCF) 분류 제 1 부 : 기능수행과장애제 2 부 : 배경요인부문 신체기능과구조활동과참여환경요인개인요인구성요소 신체기능상의 변화 신체구조상의 변화 능력 수행 촉진요인 / 저해요인 구성 / 평가값 항목단계 항목단계 항목단계 항목단계 항목단계 - 첫째 - 첫째 - 첫째 - 첫째 - 첫째 다른범주에서의 - 둘째 - 둘째 - 둘째 - 둘째 - 둘째 영역과항목 - 셋째, 넷째 - 셋째, 넷째 - 셋째, 넷째 - 셋째, 넷째 - 셋째, 넷째 통계청 241

250 한국표준건강분류 2. KCF 분류 KCF 분류의전반을이해하기위해서는 KCF 구조를이해하는것이중요하다. 다음과같은용어들의 정의를 [ 그림 3. 한국표준건강분류구조 ] 와같이도식화하였다. 분류 (classification) 는 KCF 의전체적인구조와종합적인체계이다. [ 그림 3] 의계층구조에서 분류 는 최상위용어다. 분류의부분 (part) 은분류의하위단계로두부분으로구성되어있다. 제 1 부기능수행과장애 제 2 부배경요인 구성요소 (component) 는부분 (parts) 의하위단계로각각두부분으로구성되어있다. 제 1 부의구성요소 신체기능과구조 활동과참여 제 2 부의구성요소 환경요인 개인요인 (KCF 에분류되어있지않음 ) 구성개념 (construct) 은관련코드와평가값을사용해정의한다. 제 1 부에는 4 개의구성개념이, 제 2 부에는 1 개의구성개념이있다. 제1부의구성개념 신체기능상의변화 신체구조상의변화 능력 242

251 부 록 수행 제 2 부의구성개념 환경요인중촉진요인또는저해요인 영역 (domain) 은생리학적기능, 해부학적구조, 행위, 과제또는생활영역의실질적인의미있는 집합이다. 영역은각구성요소내에서서로다른장 (chapter) 과항목군을구성하고있다. 범주 (category) 는구성요소의영역에포함되는분류와하위분류, 즉분류의단위다. 단계 (level) 는범주의세부항목의계층적인순서를의미한다.( 즉영역과범주의상세성 ) 1 단계는 2 단계의모든항목을포함하며, 그하위의단계에서도동일하다. 3. KCF 범주의정의 정의는범주에의해정해진개념의필수적인속성 ( 즉본질, 특성또는관계 ) 을의미한다. 정의는 그용어가어떤종류의사물이나현상을가리키는지설명하고, 그용어가기타관련사물이나현상과 어떻게다른지설명한다. KCF 범주에대한정의를체계화하는과정에서포함과제외를포함하여다음의조작적정의 (operational definition) 의특성을염두에두었다. 정의는의미있고, 논리적일관성이있어야한다. 정의는범주에의해의도된개념을정확히확인할수있어야한다. 정의는내적 ( 개념의본질적의미 ) 및외적 ( 사물또는현상 ) 개념의필수속성을둘다제시하여야한다. 정의는정확하고명확해야하며용어의모든의미를포함하고있어야한다. 정의는조작적용어 ( 예를들면심각성, 지속성, 상대적중요도, 관련가능성 ) 로표현되어야한다. 정의는순환성을피해야한다. 즉정의하고자하는용어자체나그와비슷한용어를정의에사용해서는안되며, 이전에정의된용어를포함해서도안된다. 정의는가능한병인학적또는상호작용적요인을적절히언급해야한다. 부 통계청 243 록

252 한국표준건강분류 정의는상위단계용어의속성을충족시켜야한다. ( 예 : 3단계용어는자신이속한 2단계범주의일반적인속성을포함해야한다 ) 정의는하위단계용어의속성과일치해야한다. ( 예 : 2단계용어의속성이그아래인 3단계의속성과상충되어서는안된다 ) 정의는비유적이거나형이상학적이어서는안되며조작적이어야한다. 정의는간접적인방법으로관찰, 검증, 추론가능한경험적진술이어야한다. 정의는과도한부정적의미를함축하지않고, 가능한중립적인용어로표현해야한다. 정의는간결해야하고가능한전문용어의사용을피해야한다.( 신체기능및구조와관련된일부용어는제외 ) 정의는생활전반의문화적다양성과차이를고려하여동의어와사례를제공하는 포함 (Inclusion) 사항이있어야한다. 정의는사용자들이관련용어로인한혼란을피하기위해 제외 (Exclusion) 사항이있어야한다. 4. 용어에대한추가설명 분류에사용되고있는모든용어의기본개념은분류대상인현상과분류구조간에근본적인차이가존재한다는것이다. 일반적으로현실세계와그세계를설명하기위해사용하는용어를구분하는것은중요하다. 예를들어, 차원 (dimension) 또는 영역 (domain) 은현실세계를나타내는용어로정확하게정의될수있으나, 구성요소 와 범주 는단지 분류 를나타내기위해정의된다. 동시에이러한용어들사이에는대응, 즉연계기능 (matching function) 이존재하며다양한사용자들은이러한용어들을혼용할수있다. 고도의전문적인요구를위해, 예를들면데이터베이스구축과연구모형설정을위해사용자가개념모형의구성요소와분류구조의구성요소를개별적으로명확하게구별되는용어로분별해내는것은중요하다. 그러나현재는이러한접근방식의정확도 (precision) 와순수성은 KCF의유용성을훼손하거나잠재적인분류사용자의범위를제한할만큼가치가있지않다

253 부 록 부록 2 한국표준건강분류코드적용지침 KCF 는여러양상의건강과건강관련상태를분류하기위한것이다 20). 이용자는분류규칙과지침을 익히기전에반드시서론을읽기를권장한다. 또한이용자가 WHO 와통계청을통해 KCF 이용방법에 관한교육을받는것이바람직하다. 다음은 KCF 사용과관련된분류의특징이다. 1. 조직과구조 분류의두가지부분 KCF 는두개부분 (part) 으로구성되어있다. 제 1 부는다음구성요소로구성되어있다. 신체기능과신체구조 활동과참여 제 2 부는다음구성요소로구성되어있다. 환경요인 개인요인 (KCF 에분류되어있지않음 ) 이구성요소들은각코드의제일앞에표시한다. 신체기능 : b 신체구조 : s 활동과참여 : d 환경요인 : e 20) 이것은질병자체를분류하는것이아니다. 질병은질병자체와기타건강문제를진단하여얻어지는사망률이나유병률자료를체계적으로기록, 분석, 해석및비교하기위해고안된한국표준질병 사인분류 (KCD) 를이용하여분류할수있다. KCF 의이용자들도 KCD 을함께이용하는것이바람직하다 (4 쪽 서론 참조 ) 통계청 245

254 한국표준건강분류 d' 는활동과참여의구성요소영역을가리킨다. 사용자에따라, 활동 (activity) 과참여 (participation) 를각각나타내기위해 d 를 a' 나 p' 로대체할수있다. b, s, d, e 뒤에는각장 (chapter) 의숫자 ( 한자리 ) 가오고그뒤에는 2 단계 ( 두자리 ) 와 3, 4 단계 21) ( 각각한자리 ) 를나타내는코드가붙는다. 예를들면신체기능분류에는다음과같은코드들이있다. b2 감각기능과통증 1 단계항목 b210 시각기능 2 단계항목 b2102 시각의질 3 단계항목 b21022 대비민감도 4 단계항목 사용자의필요에따라각단계마다해당하는코드를이용할수있다. 개인상황을설명하기위해 각단계에서하나이상의코드를적용할수도있다. 이코드들은서로독립적이거나밀접한관계가 있다. KCF에서한개인의건강상태는분류의구성요소의전체영역에걸친일련의코드로부여할수있다. 적용가능한코드의최대개수는장 (chapter) 단계에서 30개 ( 신체기능 8개, 신체구조 8개, 활동과참여 9개, 환경요인 5개 ) 이고, 2단계에서는 370개이다. 그리고 3, 4단계에서는최대 1,141개이며이들모두를모아놓은것이바로 KCF 상세버전이다. KCF 분류의실생활적용에있어, 2단계 ( 세자리숫자 ) 로사례를정확하게표현하는데는 3~18개코드가적합하다. 일반적으로더상세한 4단계분류는전문서비스 ( 예 : 재활치료결과, 노인의학또는정신보건 ) 에사용되며, 반면 2단계분류버전은설문조사와건강결과평가에사용될수있다. 특정한시점에서영역이적용가능할때코드로분류되어야한다. 즉, 우연히마주친상황을스냅 사진찍듯이묘사하는것이다. 하지만시간의흐름이나진행과정을설명하기위해서시간경과에따라 코드를적용할수있다. 그경우사용자는자신의분류방식과시간단위를분명히해야한다. 장 (chapter) 분류의각구성요소는장 (chapter) 으로이루어져있고, 장 (chapter) 아래의영역제목이공통범주나 세부항목으로체계화되어있다. 예를들면신체기능분류의제 1 장은정신적기능을다룬다. 21) 신체기능과신체구조분류에서만 4 단계까지나누어진다

255 부 록 항목군 (block) 장 (chapter) 은범주의항목군으로세분화된다. 예를들면제3장활동과참여중 의사소통 에는세개의항목군인의사소통 - 수용 (d310-d329), 의사소통 - 표현 (d330-d349), 대화와의사소통기기및기술의이용 (d350-d369) 이있다. 항목군은사용자의편의를위해제공된것으로, 엄밀히말해 KCF 분류체계에속하지않으며, 일반적으로분류목적으로사용되지않는다. 범주 (category) 각장마다 2 단계, 3 단계, 4 단계범주가있다. 그리고적절한코드부여를돕기위해각범주마다 간략한 정의 (definition) 와 포함 (inclusion), 제외 (exclusion) 가제시되어있다. 정의 (definition) KCF는건강과건강관련항목의조작적정의 ( 일상적이거나비전문적정의와반대되는 ) 를제시한다. 이정의는각영역의기본적인특성 ( 예 : 본질, 성질, 관계 ) 을설명하고, 각항목에포함사항과제외사항에대한정보를담고있다. 또한평가, 연구, 설문조사, KCF로분류된평가도구의결과에공통으로사용되는지표를포함하고있다. 예를들면시력 (visual acuity) 은근거리와원거리에서단안과양안의시력으로정의되며, 시력이상정도는없음 (none), 경도 (mild), 중등도 (moderate), 중증 (severe) 또는 완전 (total) 으로분류할수있다. 포함 (inclusion) 용어범주정의다음에포함용어가제시된다. 포함은해당범주의내용을설명하는지침으로제공되나, 그범주의전체내용을다루지않는다. 2단계항목은 3단계항목의모든포함 (inclusion) 내용을포괄한다. 제외 (exclusion) 용어다른용어와유사하여분류하기어려운부분에제외용어가제시된다. 예를들면 대소변처리 범주는 신체부위관리 범주에포함한다고생각할수도있다. 하지만이두가지를구분하기위해 대소변처리 는 d520 신체부위관리 범주에서제외하고 d530으로분류한다. 기타명시된 (other specified) 3단계또는 4단계의항목과각장 (chapter) 의마지막에는 기타명시된 범주가있다.( 마지막코드번호가 8로끝나는항목 ) 이범주는다른특정범주에포함되지않은기능수행의측면을분류하기위한것이다. 기타명시된 을적용할때이용자는추가목록에새로운항목을구체적으로명시해야한다. 통계청 247

256 한국표준건강분류 상세불명의 (unspecified) 상세불명 항목은 3단계나 4단계항목의맨마지막범주이거나각장 (chapter) 의마지막에제시되며, 이범주는어떤그룹에속하긴하나특정항목으로분류하기엔정보가충분하지않은기능을분류할때적용한다. 이코드는어떤추가정보가없으면그상위단계인 2단계또는 3단계분류용어와동일한의미를가진다.( 항목군에서 기타명시된 항목과 상세불명 범주가하나의항목으로결합되어도, 마지막코드번호는항상 9이다.) 평가값 (qualifier) KCF 코드는예를들어건강수준정도또는발생한문제의중증도를의미하는평가값을하나이상분류해야한다. 평가값은점 (.) 뒤에하나이상의숫자로분류한다. 모든코드를분류할때적어도하나의평가값이동반되어야한다. 평가값이없는코드는고유한의미가없기때문이다. WHO는평가값이없는불완전한코드를 이상없음, xxx.00' 로간주한다 ) 신체기능과신체구조의제 1 평가값, 활동과참여의 수행및능력 평가값, 환경요인의제 1 평가값은 모두각각의구성요소에서문제의정도를설명한다. 모든구성요소는동일한일반척도를이용하여수치로표현한다. 이상이있다는것은구성개념에 따라장해, 제한, 제약또는저해를의미한다. 아래에제시된바와같이적절히수치로표현된단어를 관련분류영역에따라선택한다.(xxx 는 2 단계분류숫자를나타낸다 ). xxx.0 xxx.1 xxx.2 xxx.3 xxx.4 xxx.8 xxx.9 이상없음 (No problem) 경도이상 (Mild problem) 중등도이상 (Modeerate problem) 중증이상 (Severe problem) 완전이상 (Complete problem) 명시되지않음 (Not specified) 해당없음 (Not applicable) 없는, 부재의, 하찮은 % 약간의, 낮은 % 중간의, 보통의 % 높은, 심각한 % 전체 % 장해, 능력제한, 수행문제또는저해요인을수량화할수있는보정된평가도구나기타표준들이 있을경우를위하여넓은범위의백분율을제공한다. 예를들면, 이상없음 이나 완전이상 로분류 된경우는최대 5% 의오차범위를가진다. 중등도이상 은완전이상의최대절반수준을의미한다

257 부 록 백분율은백분위와같이관련있는인구표준을참고하여다양한영역에서조정할수있다. 이러한 보편적으로사용되는측정법을마련하기위해연구를통한평가절차의개발이필요하다. 환경요인구성요소의경우제1평가값은환경이나촉진요인의긍정적인영향정도를나타내는데사용될수있다. 촉진요인은동일한 0~4척도를사용하며점 (.) 은대신덧셈표시 (+) 로바꾸어사용한다. ( 예 : e110+2) 환경요인은 (1) 각구성요소와연관되거나 (2) 각구성요소와무관하게분류할수있다. ( 아래 3번참조 ) 전자가더선호되며이는영향과속성을더명확히파악하기때문이다. 추가평가값 (additional qualifiers) 각기다른사용자를위해각항목의분류에다른종류의정보를추가하는것은타당하고유용하다. 뒤에서보다자세히언급하겠지만사용할수있는다양한추가평가값이있다. 긍정적측면의분류 (coding positive aspects) 사용자재량으로기능수행의긍정적인측면을정확히표현하기위해분류척도를개발할수있다. 통계청 249

258 한국표준건강분류 2. 일반분류원칙 아래원칙은분류를다양하게이용하는데정확한정보검색을위한필수사항이다. 개인프로필을형성하는일련의코드선정 KCF는건강과건강관련상태를분류하므로한사람의기능수행에관한주요내용을가장잘설명하는일련의코드를부여하는것이필요하다. KCF는특정병태를하나의코드로분류하는 KCD와같이 사건중심의분류 가아니다. 한개인의기능수행은신체, 개인및사회수준에영향을받을수있으므로사용자는분류의구성요소인신체기능과구조, 활동과참여및환경요인모두를항상고려해야한다. 매번가능한모든코드를사용하는것은무리지만, 당시주변환경에따라사용자들은주어진건강경험을표현하려는목적을위해가장중요한코드를부여할수있다. 관련정보분류분류된정보는항상건강상태의맥락속에존재한다. 코드를사용해서건강상태와분류된기능수행및장애의양상간의관련성을추적할필요가없더라도, KCF는건강분류이므로어떤종류든건강상태가존재함을추정한다. 그러므로어떤사람이무엇을하거나하지않기로결심한것에관한정보는건강상태와관련된기능수행문제와연관이없고분류해서는안된다. 예를들면한사람이건강이아닌다른이유로이웃과새로운관계를맺지않기로결심한경우에관계형성과관련된행위를포함하는 d7200 항목을사용하는것은바람직하지않다. 반대로그사람의결정이건강상태 ( 예 : 우울증 ) 와관련이있다면 d7200 코드를적용해야한다. 참여에대한개인의감정과기능수행수준에대한만족을반영한정보는아직까지 KCF 에분류되어 있지않다. 보다지속적인연구를통해이러한정보를분류할수있는추가평가값이마련될것이다. 사전에정의된기간과관련된개인의기능수행측면만분류되어야한다. 이전시점과관련된기능과 현재경험하지않은기능은분류되어서는안된다. 명확한정보분류코드를부여할때사용자는신체기능이나신체구조의장해, 활동제한또는참여제약간의상관관계를추정해서는안된다. 예를들면돌아다니는데제약이있는사람이라고해서그사람의이동기능에장해가있다고추정하는것은타당하지않다. 마찬가지로움직이는데제한된능력을가진사람이라는사실만으로그사람이움직이는데어려움을겪을것이라짐작하는것은부적절하다. 사용자는신체기능과구조, 능력과수행에대해각각정확한정보를확보해야한다.( 예를들면정신기능에서, 기타 250

259 부 록 관찰을통한추론이필요한이유는문제가되는신체이상을바로관찰할수없기때문이다.) 상세한정보분류건강과건강관련상태는가장적합한 KCF항목을부여함으로써가능한한구체적으로분류해야한다. 예를들면야맹증을가진사람의적합한코드부여는 b21020 광민감도 (light sensitivity) 이다. 하지만어떤이유때문에세부분류를적용할수없는경우이를대신하여해당하는계층구조의상위코드를이용할수있다. ( 이경우 b2102 시각의질, b210 시각기능, 또는 b2 감각기능과통증이대신이용될수있다 ) 3. 환경요인 구성요소의분류규칙 환경요인분류를위한세가지분류규칙은다음과같다. 규칙 1 환경요인을신체기능, 신체구조, 활동과참여와관련시키지않고, 환경요인만을분류한다. 신체기능신체구조활동과참여환경 규칙 2 환경요인은모든구성요소마다분류한다. 신체기능신체구조활동과참여 E 코드 E 코드 E 코드 규칙 3 활동과참여구성요소의모든항목에서환경요인을능력과수행평가값에대해분류한다. 수행평가값 E 코드 능력평가값 E 코드 통계청 251

260 한국표준건강분류 4. 구성요소별분류규칙 4.1 신체기능분류 정의 신체기능은신체계통의생리적기능이다 ( 심리적기능포함 ). 장해는의미있는변형이나손실로서 신체기능이나신체구조의이상이다. 신체기능분류를위한평가값적용 신체기능은장해의정도나규모를나타내는하나의평가값과함께분류된다. 장해의존재여부는 손실이나결핍, 감소, 추가, 초과또는일탈로파악할수있다. 편마비를겪는사람의장해는다음과같이 b7302 신체의편측근력으로분류한다. 장해의정도 ( 제1평가값 ) b7302. 장해가있다면, 장해정도는일반평가값을이용해측정할수있다. 예를들면다음과같다. b7302.1경도의신체의편측근력장해 (5-24%) b7302.2중등도의신체의편측근력장해 (25-49%) b7302.3중증의신체의편측근력장해 (50-95%) b7302.4완전신체의편측근력장해 (96-100%) 장해 ( 미리정의된한계수준에따라 ) 가없으면일반평가값은 0 으로표시된다. 예를들면다음과 같다. b 신체의편측근력장해없음 장해중증도를세분화하기에정보가불충분하다면, 일반평가값에 8 을사용해야한다. 예를들면 개인의건강기록에자세한정보없이오른편신체허약만작성되어있다면다음코드를적용할수 있다

261 부 록 b 명시되지않은신체의편측근력장해 특정코드를적용하기에부적절한상황이있을수있다. 이를테면 b650 월경기능 은초경이전 또는폐경이후여성에게는적용할수없다. 이경우평가값 9 를사용한다. b650.9 해당되지않는월경기능 신체기능의구조적연관성신체기능과신체구조의분류는병렬구조다. 신체기능을분류할때사용자는그에상응하는신체구조코드를적용할수있는지를확인해야한다. 예를들면신체기능은 b210-b229 시각과관련기능과같은인간의기본적인감각을포함하고눈과관련된구조로서 s210-s230 범위내에서구조적연관성이있다. 장해간의상관관계 장해는다른장해를초래할수있다. 예를들면근력은이동기능을손상시킬수있고, 심장기능은 호흡기능과, 인식은사고기능과서로관련이있을수있다. 신체기능의장해파악직접적으로관찰할수없는장해 ( 예 : 정신적기능 ) 의경우, 이용자는행동관찰을통해장해를추론할수있다. 예를들면임상치료환경에서표준화된검사를통해기억력을평가할수있고, 실제로뇌의기능을관찰하는것은불가능하지만검사결과에따라기억력과관련된정신적기능장해여부를추정할수있다. 4.2 신체구조분류 정의 신체구조는기관, 사지및그구성요소와같은신체의해부학적부위이다. 장해는의미있는손실이 나변형으로신체기능또는구조의이상이다. 평가값을이용한신체구조분류 신체구조는세개의평가값과함께분류된다. 제 1 평가값은장해의정도나규모를설명하고, 제 2 평가값은장해의특징을나타내기위해사용하며, 제 3 평가값은장해의부위를가리킨다. 통계청 253

262 한국표준건강분류 장해의정도 ( 제 1 평가값 ) 장해의특징 ( 제 2 평가값 ) 장해의위치 ( 제 3 평가값 ) s7300. _ 세개의평가값에대한상세한설명은아래 [ 표 4] 에제시되어있다. 표 4. 신체구조평가값의측정기준 0 장해없음 1 경도장해 2 중등도장해 3 중증장해 4 완전장해 8 명시되지않음 9 해당없음 제 1 평가값장해의정도 제 2 평가값장해의특징 0 구조상의변화없음 1 완전결여 2 부분결여 3 부가부분 4 크기이상 5 불연속성 6 위치를벗어남 7 구조상의질적변화, 체액축적포함 8 명시되지않음 9 해당없음 제 3 평가값장해의위치 0 2 개부위이상 1 오른쪽 2 왼쪽 3 양쪽 4 전면 5 후면 6 근위 7 원위 8 명시되지않음 9 해당없음 4.3 활동과참여구성요소분류 정의 활동은개인의과제또는행위수행이다. 참여는일상생활상황에참여하는것이다. 활동제한은 개인이활동하는데있어겪을수있는어려움이다. 참여제약은개인이일상생활상황에관여하는 과정에서경험하는문제이다. 활동과참여분류는여러영역을포괄하는단일목록으로되어있다

263 부 록 능력과수행평가값이용활동과참여는두개의평가값과함께분류한다. 코드의점 (.) 다음첫번째자리에수행평가값과두번째자리에참여평가값을분류한다. 활동과참여목록의특정항목을구분하는코드와두개의평가값으로기본정보매트릭스가형성된다. 수행평가값 ( 제1평가값 ) 능력 ( 도움없이 ) 평가값 ( 제2평가값 ) d4500. _ _ 정보매트릭스 ( 기본 ) 수행평가값은개인이현재환경에서무엇을하고있는지설명한다. 현재환경은사회적배경에서형성되므로, 이평가값은 삶의상황에관여 또는사람들이살고있는실제환경속에서겪는 삶의경험 으로이해될수있다. 이배경은환경요인 ( 생리적, 사회적, 태도적환경의모든측면 ) 을포함한다. 현재환경의이러한특징은환경요인코드를이용하여분류할수있다. 능력평가값은행위또는과제를이행하는개인의능력을나타낸다. 이구성개념은주어진영역에서개인이한정된시간에도달할수있는최대한의능력을나타내는것을목적으로한다. 개인의최대능력을평가하려면각기다른환경으로인해개인능력에미치는영향을통제한표준화된환경이필요하다. 이런표준화된환경은 (a) 테스트환경에서능력평가를위해통상적으로사용하는실제환경이거나, (b) (a) 가불가능할경우, 동일한영향이있다고여겨지는가상환경이다. 이환경은 동일한 또는 표준 환경이라한다. 따라서능력구성개념은환경적으로보정된개인의능력을반영한다. 이러한환경적조정의내용은모든국가모든사람들을국제적으로비교할수있도록같아야한다. 더정확히표현하자면, 동일하거나표준화된환경의특징은환경요인의구성요소를이용해분류할수있다. 능력과수행간의격차는현재환경과표준환경사이의영향력차이를반영하므로, 수행을향상시키기위해개인의환경을어떻게변화시켜야하는가에대한유용한지침을제공한다. 일반적으로도움을받지않은상태의능력평가값은보조기구나인적지원으로능력이향상되지않는개인의실제능력을설명한다. 수행평가값이개인의현재환경을다루므로, 보조기구, 인적지원, 저해요인의유무를직접관찰할수있다. 촉진요인과저해요인의특징은환경요인분류를이용해설명할수있다. 선택적평가값 세번째, 네번째 ( 선택적 ) 평가값을이용하면사용자들은도움을받은상태의능력과도움을 통계청 255

264 한국표준건강분류 받지않은상태의수행을분류할수있다. 수행평가값 ( 제1평가값 ) 도움을받지않은상태의능력평가값 ( 제2평가값 ) 도움을받은상태의능력평가값 ( 제3평가값 ) 도움을받지않은상태의수행평가값 ( 제4평가값 ) d4500. 정보 매트릭스 선택적 ( 기본 ) 추가평가값 점 (.) 이하다섯째자리는향후개발될평가값, 예를들면관여주관적인만족도관련평가값을 위한자리이다. 수행평가값 ( 제 1 평가값 ) 도움을받지않은상태의능력평가값 ( 제 2 평가값 ) 도움을받은상태의능력평가값 ( 제 3 평가값 ) 도움을받지않은상태의수행평가값 ( 제 4 평가값 ) 추가평가값 ( 제 5 평가값 ) d4500. _ 정보 매트릭스 선택적추가적 ( 개발중 ) ( 기본 ) 256

265 부 록 능력평가값과수행평가값은보조기구나인적지원여부에관계없이사용할수있으며, 다음척도에 따른다.( 여기서 XXX 는 2 단계영역의숫자를나타낸다 ) xxx.0 어려움없음 (No difficulty) xxx.1 경도어려움 (Mild difficulty) xxx.2 중등도어려움 (Moderate difficulty) xxx.3 고도어려움 (Severe difficulty) xxx.4 완전어려움 (Complete difficulty) xxx.8 명시되지않음 (Not specified) xxx.9 해당없음 (Not applicable) 수행평가값과능력평가값을사용 어느평가값이든나열된각범주에사용할수있다. 하지만각경우마다전달되는정보는다르다. 두개의평가값을모두사용할경우결과는두가지구성개념의집합이다. 하나의평가값만사용할경우, 사용하지않은평가값의자리는.8 이나.9 로채우지말고빈공간 으로남겨두어야한다. 왜냐면.8 이나.9 는모두실제평가수치로해당평가값이분류되고있음을 의미하기때문이다. 두개의평가값적용사례 d4500 단거리보행 수행평가값에서이영역은개인이여러형태의지면과상태의실제환경에서지팡이, 보행기또는기타보조장비를이용해 1킬로미터미만의거리를걸어다니는것을의미한다. 예를들면산업재해로다리를잃은사람이지팡이를이용하여근처의매우가파르고미끄러운길을걸을때중등도의어려움을느낀다면다음과같은수행평가값을갖는다. d4500.2_ 단거리보행영역에서중등도수행제약 통계청 257

266 한국표준건강분류 능력평가값에서이영역은도움없이보행하는능력을의미한다. 상이한환경이미칠다양한영향을배제하기위해표준화된환경에서능력을측정해야한다. 표준화된환경은 (a) 테스트환경속에서능력평가를위해통상적으로사용되는실제환경일수도있고, (b) (a) 가불가능할경우동일한효과가있을것이라고생각되는가상의환경이다. 예를들면앞에서언급한사람이표준화된환경 ( 평평하고미끄럽지않은표면과같은 ) 에서지팡이없이보행하는실제능력은매우제한적이다. 따라서이사람의능력은다음과같이분류될수있다. d4500._3 단거리보행에있어고도능력제한 수행또는능력평가값을사용하면서, 실제환경또는표준환경을구체적으로명시하고자하는사 용자는환경요인분류를이용해야한다.[3. 환경요인 구성요소의분류규칙 3 참조 ] 4.4 환경요인분류 정의 환경요인은사람들이생활하는곳이자, 삶을영위하는신체적 사회적 태도적환경을구성한다. 환경요인이용환경요인은분류의 제2부배경요인 의구성요소이다. 기능수행의각구성요소마다환경요인을고려해야한다. 그리고 3. 환경요인구성요소의분류규칙 에서설명한세가지원칙중하나의원칙에따라환경요인을분류해야한다. 환경요인은개인이처한상황을표현하는사람의관점에서분류한다. 예를들면점자블록이없는 도로는휠체어사용자에게는촉진요인으로분류될수있지만, 시각장애인에게는저해요인이될수 있다. 평가값은한요소가저해요인또는촉진요인으로어느정도의작용을하는지알려준다. 환경요인이왜촉진요인또는저해요인으로작용하고어느정도로작용하는지에대해몇가지이유가있다. 촉진요인을분류할경우, 코드를분류하는사람은양질의자원또는저급품질의자원의접근성, 그접근이의존적인지가변적인지등과같은문제에유념해야한다. 저해요인의경우, 얼마나자주방해하는지, 그영향이큰지작은지, 또는피할수있는지없는지가의미가있을수도있다. 환경요인의존재 ( 예 : 장애인에대한부정적인태도 ) 또는부재 ( 예 : 필요한서비스의이용불가능 ) 가저해요인이 258

267 부 록 될수있음을역시유념해야한다. 건강상태에따라환경요인이생활에미치는영향은다양하고복잡 하다. 향후지속적인연구로이상호작용에대한이해가확대되고이러한요인을설명하기위해제 2 평가값이필요하다는공감대가형성되기바란다. 몇몇경우에다양한환경요인의집합체는빈곤, 개발, 농촌환경또는도시환경, 사회자본과같은하나의용어로요약된다. 하지만이러한요약된용어자체가 KCF 분류에포함되어있지않다. 이경우코드를분류하는사람은구성요인을분리하여코드를부여해야한다. 이러한약어를구성하는명확하고일관성있는환경요인집합체가있는지를판단하기위해추가연구가필요하다. 제1평가값다음은환경요인의저해요인또는촉진요인영향정도를나타내는양 (+) 과음 (-) 의척도다. 아래와같이점 (.) 만을사용할경우에는저해요인을의미하고, 덧셈표시 (+) 를사용할경우에는촉진요인을의미한다. xxx.0 저해요인없음 (No barrier) xxx.1 경도저해요인 (Mild barrier) xxx.2 중등도저해요인 (Moderate barrier) xxx.3 고도저해요인 (Severe barrier) xxx.4 완전저해요인 (Complete barrier) xxx.8 명시되지않은저해요인 (Barrier, not specified) xxx.9 해당없음 (Not applicable) xxx+0 촉진요인없음 (No facilitator) xxx+1 경도촉진요인 (Mild facilitator) xxx+2 중등도촉진요인 (Moderate facilitator) xxx+3 고도촉진요인 (Substantial facilitator) xxx+4 완전촉진요인 (Complete facilitator) xxx+8 명시되지않은촉진요인 (Facilitator, notspecified) xxx+9 해당없음 (Not applicable) 통계청 259

268 한국표준건강분류 부록 3 활동과참여목록활용 활동과참여의구성요소는다양한행위와생활영역을나타내는중립적영역에대한항목이다. 각영역은단계별로일반적인범주에서세부적인범주순으로정리된범주를포함하고있다.( 예를들면 4장 움직임 영역은 d450 보행 범주, d4500 단거리보행 같은세부적인하위항목을포함하고있다.) 활동과참여영역은기능수행전반을다루며, 사회적 개인적수준에서모두에서분류할수있다. 서론에서지적했듯이, 이목록은여러가지방법으로 KCF가정의한 활동 과 참여 의특정개념을나타내는데사용할수있다. KCF 정의는다음과같다. 건강차원에서 활동 은개인에의한행위또는과제수행을의미한다. 참여 는일상생활상황에의관여를의미한다. 이영역의목록에서활동 (a) 과참여 (p) 간의관계를체계화하는데사용하는방법은다음네가지다. (1) 활동영역과참여영역간의완전분리 ( 두영역간중복이없다 ) 일련의특정범주들은활동 ( 개인이하는행위또는과제 ) 으로만분류되고, 어떤범주는참여 ( 실질 적인생활환경의관여 ) 로만분류된다. 따라서이일련의두범주는상호배타적이다. 이방법에서는일련의활동범주과참여범주는사용자에의해정해진다. 각범주는활동또는 참여항목중어느하나에해당되며, 두가지항목을다포함할수는없다. 예를들면활동과참여 영역은다음과같이구분될수있다. a1 학습과지식의적용 a2 일반적과제와요구 a3 의사소통 a4 움직임 p5 자기관리 p6 가정생활 p7 대인상호작용과관계 p8 주요생활영역 260

269 부 록 p9 지역사회생활, 사회생활및시민으로서의생활 이러한구조의분류 a 범주코드. q p q c ( 활동항목으로간주되는범주 ) p 범주코드. q p q c ( 참여항목으로간주되는범주 ) 여기서 q p 는수행평가값이고, q c 는능력평가값이다. 만약수행평가값을사용할경우, 활동항 목또는참여항목을의미하는범주는수행구성개념측면에서해석되어야한다. 만약능력평가값을 사용할경우, 활동항목또는참여항목을의미하는범주는능력구성개념을사용하여해석한다. 이런방식으로방법 (1) 은어떤중복이나반복없이완전한정보매트릭스를제공한다. (2) 일련의활동영역과참여영역간의부분중복 이방법에서는일련의범주들을활동항목과참여항목모두로해석할수있다. 즉동일한범주에 대해개인적으로 ( 즉, 개인이하는행위나과제로 ) 해석될수도있고, 사회적으로 ( 즉, 실질적인생활 상황에의관여로 ) 해석될수도있다. 예를들면다음과같다. a1 학습과지식의적용 a2 일반적인과제와요구 a3 의사소통 a4 움직임 a5 자기관리 a6 가정생활 p3 의사소통 p4 움직임 p5 자기관리 p6 가정생활 p7 대인관계 p8 주요생활영역 p9 지역사회생활, 사회생활및시민으로서의생활 이러한구조의분류 이구조에서는범주를분류하는방법상제약이있다. 즉 중복 되는범주는동일한평가값 ( 수행의 제 1 평가값또는능력의제 2 평가값 ) 과관련해다른값을가질수없다. 예를들면다음과같다. 통계청 261

270 한국표준건강분류 a 범주.1 또는 a 범주. 1 p 범주.2 p 범주. 2 이방법을선택하는사용자는중복되는범주내의코드가활동항목으로분류되어있지만참여 항목으로분류되어있지않을때또는그반대의경우, 다른것을의미할수도있다고생각한다. 하지만 정보매트릭스속평가값의특정칸에는하나의단일코드가들어가야한다. (3) 중복에상관없이세부적인범주는활동으로, 포괄적인범주는참여로구분 활동과참여의정의를각영역에적용하는또한가지방법은 참여 를특정영역내에서보다일반적이거나보다포괄적인범주 ( 예를들면각장의제목같은 1단계 ) 로제한하고, 활동 은 보다세부적인 범주 ( 예를들면 3, 4단계범주 ) 로간주하는것이다. 이접근방식은일부또는모든영역의범주를 포괄적인범주대세부적인범주 차원에서나눈다. 사용자는일부영역을모두 ( 즉, 모든세부단계에서 ) 활동으로보거나모두참여로간주할수도있다. 예를들면 d4550 기어다니기 는활동으로해석할수있는반면, d455 이동 은참여로해석할 수있다. 이접근방식을이용하는두가지방법이있다. (a) 중복이있을수없다. 즉, 한항목이활동이면참여가될수없다. (b) 중복이있을수있다. 일부사용자는활동차원에서는전체리스트를사용하고참여에대해서는포괄적인표제어만사용할수도있기때문이다. 이러한구조의분류 방법 (1) 또는방법 (2) 와유사하다. (4) 활동과참여모두동일한영역이용, 즉두개의영역이완전중복 이방법에서는활동과참여목록에있는모든영역을활동과참여두가지로간주할수있다. 모든 범주를사회적기능수행 ( 참여 ) 과개인적기능수행 ( 활동 ) 으로해석할수있다. 예를들면 d330 말하기는활동및참여로간주할수있다. 성대에손상을입은사람은보조장치를 사용해말할수있다. 능력과수행평가값을이용하여이사람은다음과같은평가를받을수있다

271 부 록 제1평가값 수행 상에보통정도의어려움 ( 개인적스트레스또는다른사람에의한스트레스같은배경요인때문 ) 제2평가값보조기구의도움없이는 능력 상에심각한어려움제3평가값보조기구의도움을받아 능력 상에경미한어려움 KCF 정보매트릭스에따르면이사람의상황은다음과같이분류해야한다. d 방법 (4) 에따르면이사람은다음과같이분류할수있다. a p330.2 방법 (4) 에서수행평가값과능력평가값을모두사용할경우, KCF 정보매트릭스의동일한칸에두개의값이존재하게된다. 즉, 하나는활동을대표하는값이고또하나는참여를대표하는값이다. 이들값이동일하다면충돌은일어나지않고, 단지 중복 (redundancy) 만존재한다. 하지만값이다를경우사용자는정보매트릭스를위한분류결정규칙을개발해야한다. 왜냐하면 WHO의공식적인분류형식은다음과같기때문이다. d 범주 q p q c 이런 중복 문제를극복하기위한한가지방법은능력평가값을활동으로, 수행평가값을참여로 간주하는것이다. 또한가지방법은 삶의상황에관여 를분명하게표현하는추가참여평가값을개발하는것이다. KCF의지속적인사용과경험적자료가일반화되면, KCF 분류사용자들이상기방법중어느것을선호하는지판단할수있는객관적증거를통해알게될것이다. 또한경험론적연구를통해활동과참여개념을보다명확하게운용하게될것이다. 이러한개념들이다양한상황과여러국가에서, 그리고상이한목적을위해어떻게이용되고있는지에관한자료가쌓이면, 그때는상기방법에보다적절한개정이이루어질것이다. 통계청 263

272 한국표준건강분류 부록 4 사례예제 다음은 KCF 개념을적용한다양한사례를설명하고있다. 사례를통해사용자가 KCF 의기본 분류개념과구조의취지및적용을이해하는데도움이되기바란다. 보다자세한내용을원한다면 WHO 의교육매뉴얼과교육과정을참조하기바란다. 능력제한과수행문제가없는장해 손톱하나가없이태어난아이가있다. 이기형은신체구조의장해에속하지만손의기능이나아이가손으로할수있는것에지장을주지않으므로아이는능력에아무런제한도받지않는다. 마찬가지로이기형때문에수행문제가생기지않는다. 따라서놀림을받거나놀이에서제외되지않고다른아이들과어울릴수있으므로장해로인한능력제한이나수행상문제가없다. 능력제한은없으나수행문제가있는장해 당뇨병에걸린아이는췌장이인슐린을적절하게생산하지못하는기능적인장해가있다. 당뇨병은약물즉인슐린으로조절될수있다. 신체기능 ( 인슐린수치 ) 이조절되면췌장의기능수행장해와관련하여능력의제한을받지않는다. 그렇지만당뇨병에걸린아이는당분섭취제한이필요하기때문에음식을먹는경우친구나또래와어울리는과정에서수행문제를경험할가능성이크다. 적절한음식이부족하면장해요인이발생할수있다. 따라서아이는능력에제한이없음에도불구하고적절한음식이제공되도록하는대책이마련되지않는다면, 현재환경하에서사회화에대한참여 ( 수행 ) 에어려움을겪을것이다. 또한예로다른신체적이상은없지만, 안면에백반증이있는사람을들수있다. 미용문제는능력에제한을초래하지는않는다. 하지만불행하게도백반증을나병이라오해하고전염되는것으로생각하는환경에서는이사람이생활할수도있다. 따라서현재환경에서의이런부정적인태도는대인관계에서심각한수행문제를야기하는환경적장해요인이될수있다. 환경에따라수행문제의여부가달라지는능력제한이있는장해 지능발달에있어중요한편차는정신적장해이다. 이것은개인의다양한능력에몇가지제한을 초래할수있다. 반면환경요인은서로다른삶의영역에서개인의수행정도에영향을줄수있다. 예를들면정신장애를가진아이에게일반인에비해기대치가높지않은환경에서단순하고반복적 264

273 부 록 이지만해야할과제가주어진다면그아이는불이익을거의받지않는다. 이런환경에서아이는 다른삶의상황에서도과제를잘수행할것이다. 반면비슷한지적장애를가진아이가경쟁적이고학업에대한기대가높은환경에서성장하게되면 앞의아이와비교해서다양한삶의상황에서과제수행에더많은문제를경험할것이다. 이들사례는두가지문제를강조한다. 첫째는실제개인의기능수행을비교하는인구집단표준이나 기준이현실적으로지금의상황과맞아야한다는것이다. 둘째는환경요인의존재여부가특정기능 수행을촉진할수도저해할수도있다는것이다. 능력제한은없지만수행문제를일으키는과거장해 급성정신병적에피소드로부터회복된사람은 정신병환자 라는오명을견디었으나, 그사람이 속한환경에있는사람들의부정적태도때문에취업이나대인관계에서수행에문제를경험할수 있다. 따라서그사람은취업과사회생활관여에있어제약을받게된다. 유사한수행문제를일으키는상이한장해와능력제한 특정직무가요구하는필요조건 ( 예를들면키보드를통한컴퓨터조작 ) 을충족시킬수없을정도의 장해 ( 사지마비 ) 때문에취직이되지않는사람이있다. 그직장에는그의업무수행을돕는편의시설 ( 예를들면수동키보드를대신하는음성인식소프트웨어 ) 이갖추어져있지않다. 덜심한사지마비를가진다른한사람은필요한직무를수행할능력을갖고있을수있지만, 장애인을채용하는비율이이미채워졌기때문에취직할수없다. 세번째사람은해당업무를수행할능력은있지만휠체어같은보조기구를이용해야만경감되는 활동제약을갖고있기때문에휠체어를이용할수없는직장환경에서는취직이되지않는다. 마지막으로휠체어를사용하는사람이취직되어, 업무를수행할능력을갖고실질적으로업무를수행하고있다. 그럼에도불구하고이사람은직장내휴게실이용이어렵기때문에다른근로자들과의대인관계에서여전히어려움을겪고있다. 직장에서사교적측면에서의수행문제는승진에걸림돌이될수있다. 네명의사람모두자신의건강상태또는장해와상호작용하는다른환경요인때문에고용영역에서 수행상의문제를경험한다. 첫번째사람의경우, 환경적장애물은직장내편의시설부족과부정적인 통계청 265

274 한국표준건강분류 인식이포함된다. 두번째사람은장애인고용에대한부정적인태도에직면하고있다. 세번째사람은 접근성이어려운건물환경문제에직면해있고, 네번째사람은장애에대한부정적인인식에직면 하고있다. 능력제한은없지만, 수행에명백한문제를일으키는의심되는장해 AIDS 환자들과일하는사람이있다. 이사람은건강하지만정기적으로 HIV검사를받아야한다. 그는능력상아무런제한이없다. 그럼에도불구하고사회적으로그를아는사람들은그가 AIDS 바이러스에감염되었을지도모른다는생각에서그를회피한다. 이로인해그는대인관계영역그리고지역사회생활, 사회생활및시민으로서의생활영역에서중대한수행문제를야기한다. 그는주변사람들의부정적인인식때문에참여제약을받는다. 수행문제를일으키지만, 현재 KCF 에분류되어있지않은장해 어머니가유방암으로사망한 45세여성이최근자발적으로암검사를받았고유방암을유발하는유전자를갖고있다는사실이밝혀졌다. 그녀는신체기능또는신체구조상아무런이상도없다. 또한능력상제한도받고있지않다. 하지만보험회사는그녀가유방암에걸릴위험이높기때문에건강보험가입을거부한다. 그녀는건강보험회사의정책때문에건강관리영역의참여에서제약을받고있다. 추가사례 말더듬 진단을받은 10세소년이언어장애치료전문의에게갔다. 검사과정에서언어 (speech) 불연속성, 언어가속능력상의문제, 언어타이밍상의문제, 부적절한언어리듬등의문제가발견되었다.( 장해 ) 학교에서큰소리로책을읽거나대화를나누는데문제가있었다.( 능력제한 ) 그룹토론시간에그는토론에참여하고싶었지만자발적으로토론에참여하지못했다.( 다른사람과대화영역에서수행상의문제 ) 이소년은여러사람과함께대화할때질서정연한대화전개에대한사회적표준과관례때문에대화참여에제한을받는다. 4개월전채찍질 (whiplash) 손상을입은 40세여성이목의통증, 심한두통, 어지럼증, 근력약화그리고불안을호소했다.( 장해 ) 보행, 요리, 청소, 컴퓨터사용, 운전등의능력에제한을받고있다. ( 능력제한 ) 의사와의상담에서이들증상이어느정도해결될때까지정시출퇴근하는정규직일자리로돌아가는것을미루기로동의하였다.( 고용영역에서수행상의문제 ) 만약현재환경에서회사정책이근무시간자유선택을허용하여, 증상이특히심할때쉬거나집에서일할수있다면고용영역에서참여제약을덜받게될것이다

275 부 록 부록 5 한국표준건강분류사용에대한윤리적지침 모든과학적도구는오용이나남용의가능성을갖고있다. KCF 같은분류시스템이악용되지않으리라믿는것은지나친낙관이다. ICIDH 개정과정에처음부터장애인과장애인옹호기관이참여했다. 그들이제공한정보로인해 KCF 용어, 내용, 그리고구조상에상당한변화가있었다. 이부록은 KCF를윤리적으로사용하기위한몇가지기본적인지침을제시하고있다. 어떤지침도분류나기타과학적수단이어떻게오용될지완전히예측할수는없다. 그리고지침만으로오용을막을수는없다. 이지침역시예외는아니다. 따라서이지침을주의깊게읽음으로써사용자들이 KCF 분류를장애인에게해를끼친다거나불쾌감을주는방식으로사용하지않기를희망한다. 존중과비밀보장 (1) KCF 는항상개인의고유한가치와자율권존중을위해이용해야한다. (2) 사람에게낙인을찍는데 KCF 를사용해서는안된다. 즉한두개장애범주차원에서만사람을 파악하는데 KCF 를이용해서는안된다. (3) 임상환경에서항상기능수행수준분류대상자의숙지, 협력, 동의하에 KCF 를이용해야한다. 대상자의인식능력제한으로관여하기힘들면대리인이적극적인참여자역할을해야한다. (4) KCF 를사용해분류된정보는개인정보로간주되며, 비밀보장원칙에따라합법적으로사용해야 한다. KCF 의임상적이용 (5) 임상학자는개인, 또는개인의대리인에게 KCF 사용의목적을설명하고, 그개인의기능수준 분류를위한 KCF 사용의적합성에대해질문할수있는기회를제공해야한다. (6) 기능수준분류대상자또는그대리인은참여할기회를갖게하며, 특히사용하는범주와제공 된평가의적합성을확인할기회를가져야한다. (7) 결함은개인의건강상태와 ( 그가살고있는 ) 물리적 사회적배경의결과이기때문에 KCF 는 전체론적관점에서이용해야한다. 통계청 267

276 한국표준건강분류 KCF 정보의사회적이용 (8) KCF 정보는삶에대한자신의선택과통제력을강화하기위해최대한개인의협력아래이용 해야한다. (9) KCF 정보는사회정책개발과개인의참여를강화 지원하는정치적변화를위해이용해야한다. (10) KCF 나 KCF 를이용해도출한모든정보는확립된권리를인정하지않거나개인또는단체의 법적권리를제한하는데이용되어선안된다. (11) KCF 분류에의해같은부류로분류된개인이라고해도여러가지측면에서다를수있다. KCF 분류에기초한법규와규정은개인을 KCF 의도이상으로동일시해서는안되며, 기능수행 수준을분류한것은개인적인것으로여겨져야한다

277 부 록 부록 6 최소한의이상적인데이터수집을위한한국표준건강분류권고사항 신체기능과구조장 (chapter) 및코드분류범주 시각 2 b210-b220 시각과관련기능 청각 2 b230-b240 청각과전정기능 말하기 3 b310-b340 음성과말하기의기능 소화 5 b510-b535 소화계통과관련된기능 배설 6 b610-b630 비뇨기능 수정 6 b640-b670 생식기능 성생활 6 b640 성기능 피부와외관손상 8 b810-b830 피부와관련구조의기능 호흡 4 b440-b460 호흡계통의기능 통증 2 b280 통증 감정 1 b152-b180 특정정신기능 수면 1 b134 전반적정신기능 에너지와욕동 1 b130 전반적정신기능 인지 1 b140,b144,b164 주의력, 기억과고위인지기능 활동과참여 의사소통 3 d310-d345 의사소통 - 수용 이동 4 d450-d465 보행과이동 민첩성 4 d430-d445 물건나르기, 옮기기, 다루기 자기관리 5 d510-d570 자기관리 일상활동 6,8 d6, d8 가정생활, 주요생활영역 대인관계 7 d730-d770 특정대인상호작용 사회활동 9 d910-d930 지역사회생활, 사회생활및시민으로서의 생활 통계청 269

278 한국표준건강분류 부록 7 WHO 의장애가있는사람에관한고찰 ICF 개정작업은처음부터장애인과장애기관이제공한정보로부터많은도움을받았다. 특히 국제장애인연맹 (DPI:Disabled People's International) 은개정작업에많은시간과노력을투자 했으며 ICF 는이들이제공한중요한조언을반영하고있다. WHO는기능수행과장애분류개정작업에장애인과장애인복지기관이전적으로참여하는것이중요하다는사실을잘알고있다. ICF 분류는다양한과학적 임상적 행정적 사회정책적차원에서장애의평가와측정을위한기초를제공할것이다. 따라서 ICF가잘못사용되어장애인에게불이익을초래하지않도록노력하고있다.([ 부록 5] 윤리적지침참조 ) 특히 WHO는최선의노력에도불구하고 ICF 분류에사용된바로그용어가장애인에게오히려오명을씌우고낙인을찍는역효과를일으킬수도있다는사실을알고있다. 이점을염려하여개정과정에서경멸적인뉘앙스를갖고있는영어의 핸디캡 (handicap)' 이라는용어를삭제하고, 장애 (disability)' 라는용어를구성요소의명칭으로는사용하지않고종합적 포괄적 용어로사용하도록하였다. 하지만어느정도기능적인제한이나제약을가진사람을어떻게언급하는것이최상인가하는어려운문제가여전히남아있다. ICF는사람과그들을둘러싼물리적 사회적환경간의상호작용으로부터비롯된다차원적인현상을나타내기위해장애라는용어를사용한다. 개인을언급할때여러가지이유에서 장애를가진사람 (people with disabilities) 이라는표현을선호하는사람이있는가하면, 어떤사람은 장애입은사람 (disabled people) 이라는표현을선호한다. WHO가이러한차이에관해채택하고있는일반적인관행은없다. 따라서 ICF가엄격히어떤한가지접근법만택하고, 다른접근법을외면하는것은바람직하지않다. 오히려사람은자신이원하는대로불릴권리가있다는중요한원칙을 WHO는인정하고있다. 더욱이 ICF는사람을분류하는것이아니라는것을강조하는것이중요하다. ICF는삶의상태와환경적영향측면에서개인의건강특성을분류하고있다. 그것은건강상특징과환경요인이어떻게상호작용하여장애를만드는가에대한것이다. 그러므로개인을오로지장해, 활동제한또는참여제약측면에서만조명하도록축소하거나특징되어서는안된다. 예를들면 ICF분류는 정신적핸디캡을지닌사람 으로언급하는대신학습문제를지닌사람이라는표현을사용하고있다. ICF는건강상태또는장애용어로사람을거론하는것을피하고, 중립적이고구체적인표현을사용함으로써이러한원칙을지키고있다

279 부 록 사람에대한체계적인낙인찍기는합법성문제를야기할수있으므로, ICF의범주는폄하, 비난, 부적절한암시적표현을피해중립적으로표현되고있다. 하지만이러한접근방식은소위 용어의정화 라는문제를야기한다. 개인이가진부정적인건강상태와그에대한타인의반응은그건강상태를정의하는데사용된용어와는무관하다. 장애가어떤식으로불리든장애는낙인과상관없이존재한다. 이것은언어적문제일뿐만아니라장애에대한개인적 사회적태도의문제다. 따라서정확한내용과용어의사용및분류가필요하다. WHO 는분류와평가가장애인의권리를박탈하거나차별을심화시키는것이아니라, 장애인의 권리강화에이바지하도록지속적인노력을기울일것이다. 장애인스스로모든부분에서 ICF의이용과발전을위해노력하길바란다. 연구원, 관리자또는정책입안자와같이장애인도 ICF 분류의근간이되는규약과도구개발을도울수있다. ICF는또한근거에기반한어떤주장을전개할때중요한증거로제시할수있다. ICF는변화를위한사례를만들기위해신뢰할수있고비교가능한자료를제공한다. 장애가건강상태또는장해의결과일뿐만아니라환경적저해요인의결과라는정책적개념을우선연구목록으로만들고, 이어서타당하고신뢰할수있는근거로발전시켜야한다. 왜냐하면이런증거야말로범세계적으로장애인을위한진정한사회적변화를이끌수있기때문이다. 또한 ICF의사용으로장애지원을증대시킬수있다. 주된장애지원목적은장애인의참여수준을향상시킬수있는중재방법을알아내는것이기때문에 ICF는장애의주요문제가어디에있는지즉그것이저해요인이라일컫는환경인지, 촉진요인의부재인지, 개인의제한된능력인지, 아니면여러가지복합적인요소인지파악하는데도움을줄수있다. 이과정에서적절한중재방법을정하고, 그중재노력이참여수준에미치는영향을모니터링하고측정할수있다. 이런식으로구체적인증거에근거하여목적을달성해나갈수있고, 장애지원이라는전반적목표에다가갈수있을것이다. 통계청 271

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