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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. .
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
Validation of the International Classification of Functioning, Disability and Health Core Set for chronic widespread pain from the perspective of fibromyalgia patients
Robin Hieblinger, Michaela Coenen, Gerold Stucki, Andreas Winkelmann, Alarcos Cieza
Arthritis Research & Therapy , 2009, DOI: 10.1186/ar2696
Abstract: The sampling of patients followed the maximum variation strategy. Sample size was determined by saturation. The focus groups were digitally recorded and transcribed verbatim. The meaning condensation procedure was used for qualitative data analysis. After qualitative data analysis, the identified concepts were linked to ICF categories.Thirty-three patients participated in six focus groups. Fifty-four ICF categories out of 67 categories of the Comprehensive ICF Core Set for CWP were reported by the patients. Forty-eight additional categories that are not covered in the Comprehensive ICF Core Set for CWP were raised.Most ICF categories of the existing version of the Comprehensive ICF Core Set for CWP could be confirmed from the patient perspective. However, several categories not included in the Core Set emerged and should be considered for inclusion.The perspective of functioning, disability and health of the World Health Organization [1] establishes the basis for a comprehensive description of the experience of patients suffering from a determined disease. This perspective recognizes different aspects of health from a biological, individual and social perspective, providing for a coherent view of illness [2]. This holistic approach guided the development of the International Classification of Functioning, Disability and Health (ICF), which was approved by the World Health Assembly in May 2001. Since the ICF has been developed in a worldwide, comprehensive process and was endorsed by the World Health Assembly as a member of the World Health Organization Family of International Classifications, it is likely to become the generally accepted framework to describe functioning, disability and health from a bio-psycho-social perspective.Based on the bio-psycho-social perspective, the ICF classification contains the so-called ICF components Body Functions, Body Structures and Activities and Participation as well as the contextual factors Environmental and Personal Factors (
Uncovering Indicators of the International Classification of Functioning, Disability, and Health from the 39-Item Parkinson's Disease Questionnaire  [PDF]
Maria H. Nilsson,Albert Westergren,Gunilla Carlsson,Peter Hagell
Parkinson's Disease , 2010, DOI: 10.4061/2010/984673
Abstract: The 39-item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient-reported rating scale in Parkinson's disease (PD). However, recent studies have questioned its validity and it is unclear what scores represent. This study explored the possibility of regrouping PDQ-39 items into scales representing the International Classification of Functioning, Disability, and Health (ICF) components of Body Functions and Structures (BF), Activities and Participation (AP), and Environmental (E) factors. An iterative process using Rasch analysis produced five new items sets, two each for the BF and AP components and one representing E. Four of these were found to represent clinically meaningful variables: Emotional Impairment (BF), Gross Motor Disability (AP), Fine Motor Disability (AP), and Socioattitudinal Environment (E) with acceptable reliability (0.73–0.96) and fit to the Rasch model (total item-trait chi-square, 8.28–33.2; ). These new ICF-based scales offer a means to reanalyze PDQ-39 data from an ICF perspective and to study its health components using a widely available health status questionnaire for people with PD. 1. Introduction The International Classification of Functioning, Disability, and Health (ICF) provides a conceptualisation and classification of different components of health including biological, individual, and social perspectives [1]. The ICF contains two parts. The first part defines functioning and disability, which in turn consists of two components, Body Functions and Structures, and Activities and Participation. Body functions include physiological and psychological functions, and body structures refer to the anatomical integrity of the body. Activities are the execution of tasks or actions, whereas participation refers to the involvement in life situations. The second part conceptualizes contextual factors, which include environmental and personal factors. The environmental component is the facilitating or hindering impact of the physical, social, and attitudinal environment. Similarly, personal factors are recognized as having a facilitating or hindering impact but they are not further specified because of their vast social and cultural variation [1]. In addition to its use for clinical, educational, and research purposes, the ICF can be used to understand the content of different health outcome measures [2]. Linking such scales to the ICF can be valuable to allow clinical studies to relate to the ICF and for gaining a conceptual understanding of scale contents [3, 4], thereby serving as a base for their further
A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision  [cached]
Bornbaum CC,Doyle PC,Skarakis-Doyle E,Theurer JA
Journal of Multidisciplinary Healthcare , 2013,
Abstract: Catherine C Bornbaum,1 Philip C Doyle,1–3 Elizabeth Skarakis-Doyle,1,2 Julie A Theurer2,3 1Graduate Program in Health and Rehabilitation Sciences, 2School of Communication Sciences and Disorders, 3Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada Background: In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. Discussion: Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term “health condition” with the more inclusive and dynamic term “health state;” (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). Summary: It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of concerns that arise throughout the continuum of care in oncology. Keywords: ICF, International Classification of Functioning, Disability, and Health, cancer, quality of life, personal factors, health condition
A critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision
Bornbaum CC, Doyle PC, Skarakis-Doyle E, Theurer JA
Journal of Multidisciplinary Healthcare , 2013, DOI: http://dx.doi.org/10.2147/JMDH.S40020
Abstract: critical exploration of the International Classification of Functioning, Disability, and Health (ICF) framework from the perspective of oncology: recommendations for revision Review (198) Total Article Views Authors: Bornbaum CC, Doyle PC, Skarakis-Doyle E, Theurer JA Published Date March 2013 Volume 2013:6 Pages 75 - 86 DOI: http://dx.doi.org/10.2147/JMDH.S40020 Received: 07 November 2012 Accepted: 12 January 2013 Published: 08 March 2013 Catherine C Bornbaum,1 Philip C Doyle,1–3 Elizabeth Skarakis-Doyle,1,2 Julie A Theurer2,3 1Graduate Program in Health and Rehabilitation Sciences, 2School of Communication Sciences and Disorders, 3Department of Otolaryngology – Head and Neck Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada Background: In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients. Discussion: Examination of the ICF through the lens of cancer care highlights the fact that this framework can be a valuable tool to facilitate comprehensive care in oncology, but it currently possesses some areas of limitation that require conceptual revision; to this end, several recommendations have been proposed. Specifically, these proposed recommendations center on the following three areas of the ICF framework: (1) the replacement of the term “health condition” with the more inclusive and dynamic term “health state;” (2) the continuing development and refinement of the personal factors component to ensure issues such as comorbidities can be accounted for appropriately; and (3) the inclusion of a mechanism to account for the subjective dimension of health and functioning (eg, quality of life). Summary: It is through the expansion of these conceptual parameters that the ICF may become more relevant and applicable to the field of oncology. With these important revisions, the ICF has the potential to provide a broader biopsychosocial perspective of care that captures the diverse range of concerns that arise throughout the continuum of care in oncology.
Retaining the patient perspective in the International Classification of Functioning, Disability and Health Core Set for low back pain
Cecilie R e, Unni Sveen, Erik Bautz-Holter
Patient Preference and Adherence , 2008, DOI: http://dx.doi.org/10.2147/PPA.S4419
Abstract: aining the patient perspective in the International Classification of Functioning, Disability and Health Core Set for low back pain Original Research (5428) Total Article Views Authors: Cecilie R e, Unni Sveen, Erik Bautz-Holter Published Date November 2008 Volume 2008:2 Pages 337 - 347 DOI: http://dx.doi.org/10.2147/PPA.S4419 Cecilie R e1,2, Unni Sveen1, Erik Bautz-Holter1,2 1Department of Physical Medicine and Rehabilitation, Ulleval University Hospital, Oslo, Norway; 2Faculty of Medicine, University of Oslo, Norway Objective: To examine the relationship between health problems as rated by the health professionals in the Norwegian form of the Core Set for low back pain and the patients’ self-reported health problems in Oswestry Disability Index (ODI) and World Health Organization Disability Assessment Schedule II (WHODAS II). Methods: This was part of an international multicenter study where a convenience sample of 118 Norwegian patients with low back pain (LBP) participated. The ICF Core Set for LBP was filled in by the health professionals. The patients reported their health problems in the WHODAS II and ODI. The items in WHODAS II and ODI were linked to the ICF. The problems reported in WHODAS II and ODI were compared to the problems scored by the health professionals in the linked ICF categories in the Comprehensive ICF Core Set for LBP. Results: All items in ODI could be linked the ICF. Four items in WHODAS II could not be linked to the ICF and additionally two items could not be linked to specific ICF categories. All ICF categories linked to the ODI were included in the Comprehensive Core Set for LBP, whereas six items in WHODAS II could not be linked, and additionally 11 of the items were not represented in the Core Set. With the exception of sexual function, above three quarter of the patients’ reported problems within body functions was captured by the health professionals. Within several of the activities and participation categories the health professionals scores in the ICF reflected the patients’ reported problems well. Surprisingly some of the problems in activities of daily living were poorly reflected. Conclusion: The Comprehensive ICF Core Set for LBP covers most of the items in ODI and WHODAS II in areas where patients report significant problems, with some exceptions. The subjective dimension related to the impact of the health condition as well as the feeling of being a burden to their family appeared to be important to these patients and not covered in the ICF. Problems with sexual functions and relationship were poorly reflected in the health professionals’ scores in the Comprehensive ICF Core Set for LBP. In clinical practice it is a challenge to assess the individual patients’ broad spectrum of problems precisely.
Can the International Classification of Functioning, Disability and Health (ICF) be used to understand risk factors for falls in older Australian women?  [PDF]
Afsoon Hassani Mehraban, Lynette Mackenzie, Julie Byles, Richard Gibson, Cassie Curryer
Health (Health) , 2013, DOI: 10.4236/health.2013.512A006
Abstract:

Purpose: To evaluate the relevance and accuracy of determining and predicting risk factors for falls in older women using the International Classification of Functioning, Disability and Health (ICF). Methods: We tested the accuracy of the ICF against risk of falls amongst 568 community dwelling participants of the Australian Longitudinal Survey on Women’s Health (ALSWH). We linked health-related variables to the ICF using ten linking rules. The logistic regression analysis evaluated the relationship between the variables and the outcome of falls. Self-report surveys measured daily functioning, health service use, medications, housing and social support. Results: Variables aligned with the ICF components of body function, health conditions, environment, activity and participation (ADL/IADL), and general health were significantly associated with falls. Discussion and conclusion: Mapping ALSWH health-related data to ICF components identified significant risk factors for falls are related to health conditions, functional limitations and home hazards. Biopsycho-social approaches guided by the ICF framework are crucial for fall prevention.

 

Using the International Classification of Functioning, Disability and Health (ICF) to Describe Children Referred to Special Care or Paediatric Dental Services  [PDF]
Denise Faulks, Johanna Norderyd, Gustavo Molina, Caoimhin Macgiolla Phadraig, Gabriela Scagnet, Caroline Eschevins, Martine Hennequin
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0061993
Abstract: Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child’s capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child’s real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ±3.6yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were ‘Intellectual functions’, ‘High-level cognitive functions’, and ‘Attention functions’. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including ‘Handling stress’, ‘Caring for body parts’, ‘Looking after one’s health’ and ‘Speaking’. In the Environment domain, facilitating items included ‘Support of friends’, ‘Attitude of friends’ and ‘Support of immediate family’. One item was reported as an environmental barrier – ‘Societal attitudes’. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might be used to develop an ICF-CY Core Set for Oral Health - a holistic but practical tool for clinical and epidemiological use.
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