How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice.
Rauch A,Cieza A,Stucki G
European journal of physical and rehabilitation medicine
Rehabilitation aims to enable people experiencing or likely to experience disability to achieve and maintain optimal functioning. Consequently, the assessment of functioning is the starting point of a patient and goal oriented rehabilitation process. Within the International Classification of Functioning, Disability and Health (ICF) rehabilitation practitioners can rely for the first on a worldwide accepted model providing a universal language for the description and classification of functioning. To take advantage of the ICF in rehabilitation management there is a need to develop appropriate ICF Tools for clinical practice. Such ICF Tools, integrating the model and the classification of the ICF, have to be integrated in a problem solving approach provided by the Rehab-Cycle. ICF Tools have been developed for the use in the different steps of the Rehab-Cycle. Existing ICF Core Sets in combination with the use of ICF Qualifiers were the basis for this development. In clinical practice, these ICF Tools allow the description of a functioning state, the illustration of the patient's experience of functioning and the relation between rehabilitation goals and appropriate intervention targets, an overview over required resources to improve specific aspects of human functioning and finally, the changes in functioning states following rehabilitative interventions. The ICF Tools support a common understanding of functioning and the communication among team members when used in multidisciplinary rehabilitation. The development of electronic documentation systems, the assignment of standardized instruments to ICF categories and the operationalization of the ICF Qualifiers can contribute to further improvements of ICF based rehabilitation management in the future.
Towards ICF implementation in menopause healthcare: a systematic review of ICF application in Switzerland.
Zangger Martina,Poethig Dagmar,Meissner Florian,von Wolff Michael,Stute Petra
Swiss medical weekly
AIMS OF THE STUDY:To present a systematic literature review on the application and degree of implementation of the International Classification of Functioning, Disability and Health (ICF) across different health conditions and regions in Switzerland in order to develop an ICF classification of the climacteric syndrome in the medium term. METHODS:A systematic literature search was conducted through Embase and Medline covering the period between 2011 and August 2016. Inclusion criteria were the term ICF in title or abstract and Switzerland as the workplace of the first author. Identified publications were analysed as descriptive statistics. RESULTS:A total of 83 articles were included in the analysis. Forty-seven different first authors from 24 different institutions were identified. The majority of publications were from Swiss Paraplegic Research (68.7%) and focused on neurology (31.3%). Forty-six cohort studies were identified. In most of them, the ICF was used to set up a general language for comparing patients' information (82.9%). Only one paper from the medical specialty gynaecology was identified; this was on breast cancer. No paper on the menopause was found. CONCLUSION:In Switzerland, the ICF is actively used in various areas of healthcare, especially in the field of neurology and rehabilitation. There is a need for ICF core sets in other medical fields, such as menopause healthcare, in order to accomplish the goal of the European Menopause and Andropause Society, which is a healthcare model for healthy menopause and aging.
10.4414/smw.2017.14574
ICF Core Sets development for the acute hospital and early post-acute rehabilitation facilities.
Grill Eva,Ewert Thomas,Chatterji Somnath,Kostanjsek Nenad,Stucki Gerold
Disability and rehabilitation
The goal of this paper is to report on the background and the methods used in the ICF Core Set development for patients in the acute hospital and early post-acute rehabilitation facilities. ICF Core Sets are sets of categories out of the International Classification of Functioning, Disability and Health (ICF) which can serve as minimal standards for the assessment, communication and reporting of functioning and health for clinical studies, clinical encounters and multi-professional comprehensive assessment and management. The ICF Core Sets were developed in a formal decision-making and consensus process, integrating evidence gathered from preliminary studies and expert opinion. The Acute ICF Core Sets for patients with neurological, musculoskeletal and cardiopulmonary conditions are intended for use by physicians, nurses, therapists and other health professionals working in the acute hospital on medical, surgical or other units not specialised in rehabilitation. The Post-acute ICF Core Sets for geriatric patients and patients with neurological, musculoskeletal or cardiopulmonary conditions are intended for use by physicians, nurses, therapists and other health professionals involved in early post-acute rehabilitation. The Acute and Post-acute ICF Core Sets are first versions and need to be tested and validated in the patient and professional perspective and in different countries, regions, health care and provider settings.
10.1080/09638280400013974
ICF components of corresponding outcome measures in flexor tendon rehabilitation - a systematic review.
Oltman Renée,Neises Gudrun,Scheible Daniel,Mehrtens Gerhard,Grüneberg Christian
BMC musculoskeletal disorders
BACKGROUND:The International Classification of Functioning, Disability and Health (ICF) delivers a holistic approach to health conditions. The objective of the present study is to provide an overview of flexor tendon rehabilitation outcome measures with respect to ICF components. Furthermore, it aims to investigate to which extent current assessments measure aspects of health according to these components primarily focussing on activity and participation. METHODS:A systematic literature review was conducted to identify all studies meeting the inclusion criteria. Studies were only included if they assessed more than body function and body structure and referred to the ICF components activity and participation. The outcome measures were analysed and their linkage to the ICF components were investigated to examine to which degree aspects of health outcome as defined by the ICF were considered. RESULTS:As anticipated, the application of outcome measures after flexor tendon repair is non conform. In many studies the emphasis still lies on physical impairment neglecting activity limitations and participation restrictions.Aspects of health after flexor tendon repair could be assessed more adequately and cover patients' needs more sufficiently by choosing outcome measures which refer to all aspects of functioning. CONCLUSION:The ICF can help to identify aspects of health which are not being considered. The ICF can help promote further development of adequate outcome measures including activity limitation and participation restrictions by targeting patient centred goals and respecting patients' needs.
10.1186/1471-2474-9-139
Remodeling of the ICF: A commentary.
Sykes Catherine R,Maribo Thomas,Stallinga Hillegonda A,Heerkens Yvonne
Disability and health journal
Since its publication in 2001 the International Classification of Functioning, Disability and Health (ICF) has attracted debate about the content and the model presented. After almost 20 years use, regular updating since 2008 and with the prospect of a new edition in 2020 there is increasing interest in the ICF as a tool to meet contemporary information requirements. Information on functioning is important across not only health systems, but all areas where change in functioning is important: education, employment, and social welfare for example. This commentary responds to the issues raised in a commentary by Mitra & Shakespeare in 2019 and supports review of the ICF in the current context by informing users and providers of data on human functioning how they might engage in the maintenance, updating, and modernisation of the ICF.
10.1016/j.dhjo.2020.100978
ICF Linking and Cognitive Interviewing Are Complementary Methods for Optimizing Content Validity of Outcome Measures: An Integrated Methods Review.
Frontiers in rehabilitation sciences
Content validity is a fundamental requirement of outcome measures. After reviewing operational needs and existing definitions, content validity we as defined as: the extent to which a measure provides a comprehensive and true assessment of the key relevant elements of a specified construct or attribute across a defined range, clearly and equitably for a stated target audience and context. ICF linkage rules from 2002, 2005, and 2019 have provide increasingly clear processes for describing and evaluating content of outcome measures. ICF Core Sets provide international reference standards of the core constructs of importance for different health conditions. Both are important as reference standards during content validation. To summarize their use as reference standards, the following summary indicators were proposed: (1) Measure to ICF linkage, (2) Measure to (Brief or Comprehensive) Core Set Absolute Linkage, (3) Measure to (Brief or Comprehensive) Core Set Unique Linkage, (4) Core Set Representation, and (5) Core Set Unique Disability Representation. Methods to assess how respondents engage with content are needed to complement ICF-linking. Cognitive interviewing is an ideal method since it used to explore how respondents interpret and calibrate response to individual items on an outcome measure. We proposed a framework for classifying these responses: Clarity/Comprehension, Relevance, Inadequate response definition, Reference Point, Perspective modification, and Calibration Across Items. Our analysis of 24 manuscripts that used ICF linking for content validation since updated linking rules were published found that authors typically used linking to validate existing measures, involved multiple raters, used 2005 linking rules, summarized content at a concept level (e.g., impairment, activity, participation) and/or use core sets as a reference standard. Infrequently, ICF linking was used to create item pools/conceptual frameworks for new measures, applied the full scope of the 2019 linking rules, used summary indicators, or integrated ICF-linking with qualitative methods like cognitive interviews. We conclude that ICF linkage is a powerful tool for content validity during development or validation of PROM. Best practices include use of updated ICF linking rules, triangulation of ICF linking with participant assessments of clarity and relevance preferably obtained using cognitive interview methods, and application of defined summary indicators.
10.3389/fresc.2021.702596