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New international classification of functioning, disability and health  [PDF]
Stucki Gerold,Maksimovi? Milo?,Davidovi? Dragana,Jorga Jagoda
Srpski Arhiv za Celokupno Lekarstvo , 2007, DOI: 10.2298/sarh0706371s
Abstract: The WHO International Classification of Functioning, Disability and Health (ICF) provides a coherent view of health from a biological, individual and social perspective. This view may be defined both as multi- and interdisciplinary management of one’s functioning and health. This new classification is currently being assessed in multiple centers in 32 countries, on 12 health conditions. The Institute of Hygiene and Medical Ecology, School of Medicine, University of Belgrade, is one of them, serving as the centre where the classification is being tested in obese population. The objective of this paper is to provide information needed for further development and practical application of this classification in various health conditions. The new language of ICF is an exciting landmark event for preventive medicine and rehabilitation. It may lead to a stronger position of rehabilitation within the medical community, change multiprofessional communication and improve communication between patients and health professionals. .
Defining disability, functioning, autonomy and dependency in person-centered medicine and integrated care
Luis Salvador-Carulla,Vladimir I Gasca
International Journal of Integrated Care , 2010,
Stroke after Hospitalization: Assessment of Functional Prognosis through Disability and Dependency in CNHU-HKM, Cotonou, Benin  [PDF]
Dieu Donné Gnonlonfoun, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Constant Adjien, Isaac Avlessi, Octave Houannou, Gérald Goudjinou, Jocelyn Acakpo, Dismand Houinato, Dossou Gilbert Avode
Neuroscience & Medicine (NM) , 2014, DOI: 10.4236/nm.2014.53017

Introduction: Stroke results in severe disability, with impacts that are sometimes socially, emotionally or professionally dramatic and also dramatic for the cost involved in care and treatment. Objective: Assessing the functional prognosis after hospitalization and identifying associated factors. Method: It consisted in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved 100 patients who have known stroke for at least 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Disability and dependency were then measured respectively with the Rankin score and Barthel index. The STATA/IC11.0 statistical software was used as the basis for data analysis. Unvaried and multi-varied analyzes helped to identify associated factors. Results: The overall disability and dependency rates were respectively 69% and 57.7%. And the highest rate of disability (38.8%) was observed between 50 and 60 years old. However, dependency prevalence was higher in subjects above 70 years old (37.3%). Regarding gender, the prevalence of disability was 59.2% in men and rather 41.5% in women. Predictors of disability and dependency were paralysis on admission (IC95% = 0.26 [0.77 - 0.92]; p = 0.036), obesity (IC95% = 0.26 [0.77 - 0.92]; p = 0.012) and monthly income lower than 70$US (IC95% = 0.05 [0.01 - 0.56]; p = 0.015). Conclusion: This study enabled us to assess the functional outcome of patients once discharged. The significance of motor deficit on stroke occurrence, obesity and the low monthly income were factors of poor functional prognosis.

Physical Functioning, Perceived Disability, and Depressive Symptoms in Adults with Arthritis  [PDF]
Katie Becofsky,Meghan Baruth,Sara Wilcox
Arthritis , 2013, DOI: 10.1155/2013/525761
Abstract: This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis ( ). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models ( ). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models ( ). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy. 1. Introduction For public health purposes, the term arthritis refers to over 100 musculoskeletal conditions of varying etiologies that cause pain, aching, or stiffness in or around a joint [1]. During 2007–2009, an estimated 50 million adults in the United States reported doctor-diagnosed arthritis [2]. As the US population grows in number and the baby boomers continue to enter older adulthood, arthritis is projected to affect 67 million Americans by 2030 [3]. When rising obesity rates are also considered, an even larger public health burden can be expected, as obesity has been associated with both the development and progression of arthritis [4]. A recent study estimates that 18% of adults with arthritis also have comorbid depression [5], compared with 7% of the general US population [6]. This high prevalence may be due, in part, to the functional limitations associated with arthritis symptoms. Depression may also be linked to perceived disability, a construct closely related to functional limitation, but with an important distinction: functional limitations alone, defined as alterations in the performance of a functional task, are not the equivalent
Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health
Martin Mueller, Edith Schuster, Ralf Strobl, Eva Grill
Health and Quality of Life Outcomes , 2012, DOI: 10.1186/1477-7525-10-75
Abstract: We conducted a series of qualitative semi-structured face-to-face interviews using a descriptive approach. Data was analyzed using the meaning condensation procedure and then linked to categories of the International Classification of Functioning, Disability and Health (ICF).From May to July 2010 12 interviews were carried out until saturation was reached. Four hundred and seventy-one single concepts were extracted which were linked to 142 different ICF categories. 40 of those belonged to the component body functions, 62 to the component activity and participation, and 40 to the component environmental factors. Besides the most prominent aspect “dizziness” most participants reported problems within “Emotional functions (b152), problems related to mobility and carrying out the daily routine. Almost all participants reported “Immediate family (e310)” as a relevant modifying environmental factor.From the patients’ perspective, vertigo has impact on multifaceted aspects of functioning and disability, mainly body functions and activities and participation. Modifying contextual factors have to be taken into account to cover the complex interaction between the health condition of vertigo on the individuals’ daily life. The results of this study will contribute to developing standards for the measurement of functioning, disability and health relevant for patients suffering from vertigo.
Graduate Courses in Occupational Therapy and International Classification of Functioning, Disability and Health  [PDF]
Ana Rita Costa de Souza Lobo Braga, Leonardo Petrus da Silva Paz, Vera Regina Fernandes da Silva Mar?es
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.617197
Abstract: The formation of Occupational Therapists has become the subject of analysis and debate in recent decades after several changes in health policies in Brazil, among them the implementation of the National Curriculum Guidelines (NCGs) directing teaching practices in line with the Health Unic System and International Classification of Functioning, Disability and Health (ICF). Given these paradigms, the Occupational Therapy courses passed with several adjustments in their course of pedagogical political projects (PPPs) and their teaching practices. The study’s goal was to characterize the Occupational Therapy courses and analyze their PPPs focusing on changes in the health care model and the inclusion of ICF. The research was exploratory and was conducted through documentary analysis. By 2013 there were 63 occupational therapy courses working in the country, 44 in private institutions and 19 in public, demonstrating a lack of supply in public. The Occupational Therapy courses are still guided by the biomedical model, and the applicability of the ICF as well as the insertion of the biopsychosocial model are incipient in teaching practice.
Comparing the content of participation instruments using the International Classification of Functioning, Disability and Health
Vanessa K Noonan, Jacek A Kopec, Luc Noreau, Joel Singer, Anna Chan, Louise C Masse, Marcel F Dvorak
Health and Quality of Life Outcomes , 2009, DOI: 10.1186/1477-7525-7-93
Abstract: A systematic literature search was conducted to identify instruments that assess participation according to the ICF. Instruments were considered to assess participation and were included if the domains contain content from a minimum of three ICF chapters ranging from Chapter 3 Communication to Chapter 9 Community, social and civic life in the activities and participation component. The instrument content was examined by first identifying the meaningful concepts in each question and then linking these concepts to ICF categories. The content analysis included reporting the 1) ICF chapters (domains) covered in the activities and participation component, 2) relevance of the meaningful concepts to the activities and participation component and 3) context in which the activities and participation component categories are evaluated.Eight instruments were included: Impact on Participation and Autonomy, Keele Assessment of Participation, Participation Survey/Mobility, Participation Measure-Post Acute Care, Participation Objective Participation Subjective, Participation Scale (P-Scale), Rating of Perceived Participation and World Health Organization Disability Assessment Schedule II (WHODAS II). 1351 meaningful concepts were identified in the eight instruments. There are differences among the instruments regarding how participation is operationalized. All the instruments cover six to eight of the nine chapters in the activities and participation component. The P-Scale and WHODAS II have questions which do not contain any meaningful concepts related to the activities and participation component. Differences were also observed in how other ICF components (body functions, environmental factors) and health are operationalized in the instruments.Linking the meaningful concepts in the participation instruments to the ICF classification provided an objective and comprehensive method for analyzing the content. The content analysis revealed differences in how the concept of participat
Interpersonal Dependency Inventory: Its Construct Validity and Prediction of Dysphoric Mood and Life Functioning via Negative Life Events  [PDF]
Masayo Uji, Yukihiro Takagishi, Keiichiro Adachi, Toshinori Kitamura
Psychology (PSYCH) , 2013, DOI: 10.4236/psych.2013.412134

Previous Dependency Inventory (JIDI) as well demonstrates how the interpersonal attitudes assessed by the JIDI generate interpersonal negative life events (NLEs) and therefore results in dysphoric moods and poor life functioning. The subjects of this study were 467 Japanese university students. The JIDI was administered at Time 1, and the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was administered at Time 2 for the purpose of assessing dysphoric mood and life functioning. NLEs occurring between Times 1 and 2 were evaluated. The three-factor structure of the JIDI was confirmed by confirmatory factor analysis. The structural equation modeling demonstrated that of the three factors, only one, “emotional reliance”, predisposed individuals to dysphoric mood and poor life functioning, both directly and indirectly, via interpersonal NLEs. Although the other two factors did not increase vulnerability to interpersonal NLEs or dysphoric mood, “lack of social self-confidence” worsened general functioning, and “assertion of autonomy” led to poor functioning in close relationships, both directly. Furthermore, “assertion of autonomy” decreased anxiety levels. As to gender differences, simultaneous analysis of multi-groups showed that female subjects were more likely to become anxious following interpersonal NLEs.

Distribution and determinants of functioning and disability in aged adults - results from the German KORA-Age study
Ralf Strobl, Martin Müller, Rebecca Emeny, Annette Peters, Eva Grill
BMC Public Health , 2013, DOI: 10.1186/1471-2458-13-137
Abstract: The objective of our study is to examine the frequency, distribution and determinants of functioning and disability in aged persons and to assess the contribution of diseases to the prevalence of disability.Data originate from the MONICA/KORA study, a population-based epidemiological cohort. Survivors of the original cohorts who were 65 and older were examined by telephone interview in 2009. Disability was assessed with the Health Assessment Questionnaire Disability Index (HAQ-DI). Minimal disability was defined as HAQ-DI > 0. Logistic regression was used to adjust for potential confounders and additive regression to estimate the contribution of diseases to disability prevalence.We analyzed a total of 4117 persons (51.2% female) with a mean age of 73.6 years (SD = 6.1). Minimal disability was present in 44.7% of all participants. Adjusted for age and diseases, disability was positively associated with female sex, BMI, low income, marital status, physical inactivity and poor nutritional status, but not with smoking and education. Problems with joint functions and eye diseases contributed most to disability prevalence in all age groups.In conclusion, this study could show that there are vulnerable subgroups of aged adults who should receive increased attention, specifically women, those with low income, those over 80, and persons with joint or eye diseases. Physical activity, obesity and malnutrition were identified as modifiable factors for future targeted interventions.
Second-order Mental State Attribution in Children with Intellectual Disability: Cognitive Functioning and Some Educational Planning Challenges  [cached]
Anastasia Alevriadou,Stergiani Giaouri
Journal of Educational and Developmental Psychology , 2011, DOI: 10.5539/jedp.v1n1p146
Abstract: Second-order mental state attribution in two groups of children with non-specific intellectual disability and Down syndrome was investigated. The children were compared to overall mental age-matched group of typically developing children. The aim of the present study was to determine the specificity of the theory of mind deficit to different groups of children with intellectual disability. The results clearly showed that children with Down syndrome performed more poorly than the children with non-specific intellectual disability, and that typically developing children perform significantly better than do other groups. The findings are discussed in terms of the specificity of the etiology-related profiles of intellectually disabled groups. Several critical issues related to intervention strategies in the field of intellectual disability are also discussed, considering the educational practices.
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