1、September 2015 Translation by DIN-Sprachendienst.English price group 16No part of this translation may be reproduced without prior permission ofDIN Deutsches Institut fr Normung e. V., Berlin. Beuth Verlag GmbH, 10772 Berlin, Germany,has the exclusive right of sale for German Standards (DIN-Normen).
2、ICS 11.020!%F0“2351325www.din.deDDIN EN 16686Osteopathic healthcare provision;English version EN 16686:2015,English translation of DIN EN 16686:2015-09Osteopathische Gesundheitsversorgung;Englische Fassung EN 16686:2015,Englische bersetzung von DIN EN 16686:2015-09Prestations de soins dostopathie;Ve
3、rsion anglaise EN 16686:2015,Traduction anglaise de DIN EN 16686:2015-09See start of applicationwww.beuth.deDocument comprises 37 pagesIn case of doubt, the German-language original shall be considered authoritative.08.15DIN EN 16686:2015-09 2 A comma is used as the decimal marker. National foreword
4、 This document (EN 16686:2015) has been prepared by Technical Committee CEN/TC 414 “Project Committee Services in osteopathy” (Secretariat: ASI, Austria), The responsible German body involved in its preparation was the DIN-Normenausschuss Dienstleistungen (DIN Standards Committee Services), Working
5、Committee NA 159-03-04 AA Qualittskriterien in der Osteopathie. In the German version, the masculine form of the term “osteopath” is solely used for simplicity,s sake and for easy reading. EUROPEAN STANDARD NORME EUROPENNE EUROPISCHE NORM EN 16686 July 2015 ICS 11.020 English Version Osteopathic hea
6、lthcare provision Prestations de soins dostopathie Osteopathische Gesundheitsversorgung This European Standard was approved by CEN on 30 April 2015. CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European Standard the status o
7、f a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN member. This European Standard exists in three official versions (English, French, German
8、). A version in any other language made by translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management Centre has the same status as the official versions. CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia,
9、Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and United
10、 Kingdom. EUROPEAN COMMITTEE FOR STANDARDIZATION COMIT EUROPEN DE NORMALISATION EUROPISCHES KOMITEE FR NORMUNG CEN-CENELEC Management Centre: Avenue Marnix 17, B-1000 Brussels 2015 CEN All rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. EN 16
11、686:2015 EEN 16686:2015 (E) 2 Contents Page European foreword . 4 Introduction . 5 1 Scope 6 2 Terms and definitions . 6 3 Description of Osteopathy 8 4 Clinical practice . 9 4.1 General 9 4.2 Essential competencies for osteopathic practice 9 4.3 Case History, examination and interpretation of the f
12、indings 10 4.4 Osteopathic treatment . 10 4.5 The osteopathic profession 11 4.5.1 General 11 4.5.2 Continuing professional development 11 4.5.3 Quality management . 11 5 Ethics 12 6 Education and Training . 12 6.1 General 12 6.2 Forms and/or categories of education 12 6.2.1 General 12 6.2.2 Common f
13、eatures of both Type I and Type II programmes . 12 6.2.3 Type I programmes 13 6.2.4 Type II programmes . 13 6.3 Core competencies: the context of osteopathic education 14 6.4 Osteopathic teaching, learning and assessment . 15 6.4.1 Teaching and learning . 15 6.4.2 Practical skills 15 6.4.3 Clinical
14、education 16 6.4.4 Assessment 17 6.5 General management requirements 18 Annex A (informative) Osteopathic models 19 A.1 General 19 A.2 Biomechanical Model 19 A.3 The respiratory/circulatory model . 19 A.4 The neurological model 19 A.5 The biopsychosocial model 20 A.6 The bioenergetic model 20 Annex
15、B (normative) Ethics for osteopaths 21 B.1 General 21 B.2 Acting in the patient interest 21 B.3 Working in partnership with the patient 21 DIN EN 16686:2015-09 EN 16686:2015 (E) 3 B.4 Maintaining public trust and confidence in the osteopathic profession . 22 B.5 Maintaining, respecting and protectin
16、g patient information 22 B.6 Working in partnership with healthcare providers 23 Annex C (informative) Types of techniques used in osteopathic treatment . 24 C.1 General . 24 C.2 Direct techniques 24 C.3 Indirect techniques 24 C.4 Balancing techniques . 24 C.5 Combined techniques . 24 C.6 Reflex-bas
17、ed techniques 24 C.7 Fluid techniques 24 Annex D (informative) A-deviations 25 Bibliography 35 DIN EN 16686:2015-09 EN 16686:2015 (E) 4 European foreword This document (EN 16686:2015) has been prepared by Technical Committee CEN/TC 414 “Project Committee - Services in osteopathy”, the secretariat of
18、 which is held by ASI. This European Standard shall be given the status of a national standard, either by publication of an identical text or by endorsement, at the latest by January 2016, and conflicting national standards shall be withdrawn at the latest by January 2016. Attention is drawn to the
19、possibility that some of the elements of this document may be the subject of patent rights. CEN and/or CENELEC shall not be held responsible for identifying any or all such patent rights. Attention is drawn to the fact that in certain countries specific national regulations apply and take precedence
20、 over this European Standard. Users of this European Standard are advised to inform themselves of the applicability or non-applicability for this European Standard by their national responsible authorities. According to the CEN/CENELEC Internal Regulations, the national standards organisations of th
21、e following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherl
22、ands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and the United Kingdom. DIN EN 16686:2015-09 EN 16686:2015 (E) 5 Introduction Osteopathy is a primary contact and patient-centred healthcare discipline, that emphasizes the interrelationship of structure
23、and function of the body, facilitates the bodys innate ability to heal itself, and supports a whole-person approach to all aspects of health and healthy development, principally by the practice of manual treatment. Patients who choose osteopathic treatment have to be assured of the quality and the s
24、tandard of care that they will receive. This standard is concerned with the provision of osteopathic diagnosis, treatment and care. It aspires to set a standard that provides for high quality clinical practice, education, safety and ethics for the benefit of patients. This European Standard does not
25、 supersede national legislation. DIN EN 16686:2015-09 EN 16686:2015 (E) 6 1 Scope This European Standard specifies the requirements and recommendations regarding the healthcare provision, facilities and equipment, education, and ethical framework for the good practice of osteopathy. 2 Terms and defi
26、nitions For the purposes of this document, the following terms and definitions apply. 2.1 care interventions that are designed to maintain and improve health 2.2 case history detailed account of a patients health and disease status and other information provided by them 2.3 clinical record document
27、which relates to the case history, examination, assessment, evaluation, diagnosis, treatment or care provided to a patient, and any necessary administrative information 2.4 co-morbidities concomitant but unrelated pathological or disease processes 2.5 consent acceptance by a patient of a proposed co
28、urse of action to be taken by an osteopath after having been informed of relevant factors relating to it 2.6 continuing professional development CPD means by which members of a profession maintain, improve and broaden their knowledge and skills relating to that profession 2.7 diagnosis the developme
29、nt by an osteopath of working hypotheses of dysfunction(s), and recognition of signs and symptoms of illness or disease using diagnostic processes of examination, assessment and evaluation Note 1 to entry: This definition is being used in this European Standard, whether or not the legislation of an
30、individual state prevents such a term being used by an osteopath. 2.8 dysfunction area of the body with impeded biomechanical, neuroelectrical, vascular, biophysical, biochemical or cellular function which is causing a decrease in health 2.9 health state of complete physical, mental and social wellb
31、eing and not merely the absence of disease or infirmity DIN EN 16686:2015-09 EN 16686:2015 (E) 7 2.10 healthcare activity carried out by a professional in the field of the health and/or well-being of the person Note 1 to entry: This definition is being used in this European Standard, whether or not
32、the legislation of an individual state prevents such a term being used by an osteopath. 2.11 osteopath osteopath (in some circumstances and some countries referred to as an osteopathic physician or osteopathic practitioner) is an individual who has completed an appropriate education in osteopathy an
33、d continues to demonstrate the required standards 2.12 osteopathy primary contact and patient-centred healthcare discipline, that emphasizes the interrelationship of structure and function of the body, facilitates the bodys innate ability to heal itself, and supports a whole-person approach to all a
34、spects of health and healthy development, principally by the practice of manual treatment Note 1 to entry: The terms osteopathy and osteopathic medicine are sometimes, and in some countries, used interchangeably. 2.13 patient confidentiality right of an individual to have information about them kept
35、 private 2.14 primary contact profession profession that a patient may consult directly but does not imply managing the multidisciplinary care of the patient Note 1 to entry: This definition is being used in this European Standard, whether or not the legislation of an individual state prevents such
36、a term being used by an osteopath. 2.15 referral transfer of responsibility for care to a third-party for a particular purpose, such as additional investigation, care or treatment that is outside the referring practitioners competence 2.16 treatment interventions that are designed to improve, mainta
37、in and support health, relieve symptoms, or reduce dysfunction and disease DIN EN 16686:2015-09 EN 16686:2015 (E) 8 3 Description of Osteopathy The practice of osteopathy uses osteopathic, medical and scientific knowledge to apply the principles of osteopathy to patient diagnosis and treatment. The
38、aim of osteopathy is to improve and support all aspects of health and healthy development. Osteopathic treatment may be preventive, curative, palliative or adjuvant. Osteopaths analyse and evaluate the structural and functional integrity of the body using critical reasoning of osteopathic principles
39、 to inform individual diagnosis and treatment of the patient. These principles are: the human being is a dynamic functional unit, whose state of health is influenced by the body, mind and spirit; if one part is changed in the system, the balance of the whole pattern will be affected; the body posses
40、ses self-regulatory mechanisms and is naturally self healing; the human being always tries to regain its own dynamic balance and establish homeostasis; and structure and function are interrelated at all levels of the human being. The osteopathic approach to healthcare is patient-centred and focused
41、on the patients health rather than disease-centred. Scientific rigour and evidence-informed practice are an important part of patient treatment and case management. Osteopaths use manual contact to identify and evaluate movement in all structural and functional aspects of the patient, identifying al
42、terations of function and movement that impede health and addressing these. The highly developed sense of touch and attention to complex systems as a unit is typical of an osteopathic approach. Osteopathy is an independent healthcare discipline. Osteopaths should also cooperate with practitioners of
43、 other disciplines. Osteopathy is based on principles drawn from human physiology, anatomy, embryology and other bio-medical sciences. In consequence of the complexity of the human organism there are a number of different models that are used in osteopathy. The models set out in Annex A articulate h
44、ow an osteopath seeks to influence a patients physiological responses. These models influence the gathering of diagnostic information and the interpretation of the significance of structural findings in the overall health of the patient. Typically a combination of models will be appropriate for an i
45、ndividual patient and adapted to the patients diagnosis, co-morbidities, other therapeutic regimens, and response to treatment. The terms osteopathy and osteopathic medicine are sometimes, and in some countries, used interchangeably. DIN EN 16686:2015-09 EN 16686:2015 (E) 9 4 Clinical practice 4.1 G
46、eneral Osteopathy is focused on the patients health rather than being disease-centred. Osteopaths shall have an understanding of osteopathic and non-osteopathic models of health and disease and how these inform a critical consideration of practical patient care and management. They shall have a crit
47、ical awareness of relevant research and of principles and practice of relevant healthcare approaches for adequate referral, cooperation and adjuvant treatment. 4.2 Essential competencies for osteopathic practice Osteopaths share a set of core competencies that guide them in the diagnosis, management
48、 and treatment of their patients and form the foundation for the osteopathic approach to healthcare. The following are essential competencies for osteopathic practice which sould be included in all training programmes (see 6.3 below): a) osteopathic history, principles, and approach to healthcare; b
49、) basic sciences relevant to osteopathic practice; c) diagnosis and treatment planning; d) knowledge of the mechanisms of action of manual therapeutic interventions and the biochemical, cellular and gross anatomical response to treatment; e) ability to appraise medical and scientific literature critically and incorporate relevant and contemporary information into practice; f) competency in the palpatory and clinical skills necessary to diagnose dysfunctions of the body, with an emphasis on osteopathic diagnosis (see Annex A); g) competency in a broad range of
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