Applying the International Classification of Functioning,Disability and Health (ICF) to measure childhood disability

The International Classification of Functioning, Disability and Health-ICF addresses the broad need for a common language and classification of functioning and disability. A parallel need is appropriate measures compatible with the content of the ICF to document the nature and impact of limitations of function, activities and participation. The interaction of developmental characteristics and disability among children represent special challenges for classification as well as measurement. Demographic trends emphasize the need for universal measures that encompass the components of the ICF and can be used in surveillance, screening and evaluation. This paper identifies issues related to application of the ICF to measure disability in childhood; reviews approaches and tools to assess childhood disability and identifies priorities for the development of measures of functioning and disability in children based on the ICF. The development of measures should be framed within a framework of children's rights and application of the biopsychosocial model to document profiles of functioning and disability of children.     

Applying the International Classification of Functioning, Disability and Health (ICF) to measure childhood disability

The International Classification of Functioning, Disability and Health-ICF addresses the broad need for a common language and classification of functioning and disability. A parallel need is appropriate measures compatible with the content of the ICF to document the nature and impact of limitations of function, activities and participation. The interaction of developmental characteristics and disability among children represent special challenges for classification as well as measurement. Demographic trends emphasize the need for universal measures that encompass the components of the ICF and can be used in surveillance, screening and evaluation. This paper identifies issues related to application of the ICF to measure disability in childhood; reviews approaches and tools to assess childhood disability and identifies priorities for the development of measures of functioning and disability in children based on the ICF. The development of measures should be framed within a framework of children's rights and application of the biopsychosocial model to document profiles of functioning and disability of children.     

Use of the International Classification of Functioning, Disability and Health (ICF) to identify preliminary comprehensive and brief core sets for multiple sclerosis

PURPOSE: To identify the preliminary comprehensive and brief core sets for multiple sclerosis (MS), in a Delphi process using the International Classification of Functioning, Disability and Health (ICF). METHOD: Focus groups and a consensus process were used to identify ICF core sets for MS. This included: preliminary ICF studies; empirical patient data collection for 101 MS participants; review of the evidence base and treatment in MS literature followed by a Delphi exercise with 23 physicians and allied health professionals in Melbourne, Australia. RESULTS: One hundred and forty-four (40%) second level ICF categories were selected by 23 participants in three rounds. The comprehensive MS ICF core set includes 34 (24%) categories from the component 'body function', six (4%) categories from 'body structures', 68 (47%) from 'activities and participation' and 36 (25%) from the component 'environmental' factors. Ten categories in 'personal factors' in MS were also suggested by the participants after intensive discussions. The brief set comprises 30 categories, 21% of categories in the comprehensive core set. CONCLUSION: Consensus expert opinion can use ICF categories to identify the core set for MS which reflects disease complexity and care burden for persons' with MS. Further research is needed to identify ICF categories of relevant personal factors to improve our understanding of the large social and cultural variance associated with them.     

Use of the International Classification of Functioning,Disability and Health (ICF) to identify preliminary comprehensive and brief core sets for multiple sclerosis

Purpose. To identify the preliminary comprehensive and brief core sets for multiple sclerosis (MS), in a Delphi process using the International Classification of Functioning, Disability and Health (ICF).

Method. Focus groups and a consensus process were used to identify ICF core sets for MS. This included: preliminary ICF studies; empirical patient data collection for 101 MS participants; review of the evidence base and treatment in MS literature followed by a Delphi exercise with 23 physicians and allied health professionals in Melbourne, Australia.

Results. One hundred and forty-four (40%) second level ICF categories were selected by 23 participants in three rounds. The comprehensive MS ICF core set includes 34 (24%) categories from the component ‘body function’, six (4%) categories from ‘body structures’, 68 (47%) from ‘activities and participation’ and 36 (25%) from the component ‘environmental’ factors. Ten categories in ‘personal factors’ in MS were also suggested by the participants after intensive discussions. The brief set comprises 30 categories, 21% of categories in the comprehensive core set.

Conclusion. Consensus expert opinion can use ICF categories to identify the core set for MS which reflects disease complexity and care burden for persons' with MS. Further research is needed to identify ICF categories of relevant personal factors to improve our understanding of the large social and cultural variance associated with them.     

The International Classification of Functioning, Disability and Health (ICF) and nursing

Background.  Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care.
Aim.  The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing.
Method.  The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing.
Conclusion.  The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses' thinking and practice by increasing awareness of the social, political and cultural dimensions of disability.     

Measuring participation according to the International Classification of Functioning,Disability and Health (ICF)

PURPOSE: To report which existing survey instruments assess participation according to the International Classification of Functioning, Disability and Health (ICF). METHOD: A literature search for relevant survey instruments was conducted. Subsequently, survey instruments were evaluated of which the complete questionnaire, published in the English language, was obtained. Items on participation were evaluated according to the ICF, defined as involvement in life situations, including being autonomous to some extent or being able to control your own life. RESULTS AND CONCLUSIONS: Eleven survey instruments were identified, of which nine were evaluated on participation. All of the nine instruments measure participation to some extent. The two instruments closest to solely involve items on participation level are the Perceived Handicap Questionnaire (PHQ) and the London Handicap Scale (LHS). The PHQ is measuring the perception of participation. In the LHS, the items are formulated in terms of participation, while the response categories include all components of the ICF, from problems in body function to participation. Much more discussion is needed to be able to get an unambiguous picture to distinguish between activity and participation.     

Application of the International Classification of Functioning,Disability and Health (ICF) in clinical practice

Purposes: We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics.

Subjects and methods: During one year consecutive patients (n?=?343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5?–?1?–?2?–?4 kHz in the better ear.

Results: Activity limitation and participation restriction were both higher for HA experienced than HA naïve subjects ( p?2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors.

Conclusions: As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.     

Use of the International Classification of Functioning,Disability and Health (ICF) in social services for elderly in Sweden

Purpose: To examine the content of health information in acts of social services of elderly people in relation to the International Classification of Functioning, Disability and Health (ICF) and to describe the health information in the different parts of the acts according to the ICF. Method: Health information of 25 acts from four municipalities was analysed and the concepts were linked to ICF codes, using the established coding rules. Results: The health information consisted of 372 concepts, which were linked to 122 specific ICF codes. The concepts in the acts were mostly linked to the ICF component Activities and Participation, except for the current functioning concepts where the ICF component Body functions was the most frequent. The 3rd level was most frequent in Activities and Participation and in Environmental factors, and the 2nd level was most frequent in Body functions. Conclusions: The ICF covers the concepts and terms contained in the acts to a large extent. Furthermore, the results show that the ICF codes differ in the different parts of the acts. The ICF provides a coherent and structured documentation, which contributes to a legally secure assessment of assistance. The selection of ICF codes can be used in development of “code sets” for social services for elderly.

Implications for Rehabilitation

• The ICF covers, to a large extent, the concepts of health information used in the acts of the social service management process in Sweden.

• The concepts in the acts were mostly linked to the ICF component Activities and Participation.

• The ICF seems to be useful in the Electronic Health Record of social service management process for elderly people in Sweden.

     

进一步拓展《国际功能、残疾和健康分类》的临床应用

1 背景:ICF问世已经20年了 《国际功能、残疾和健康分类(International Classification of Functioning, Disability and Health,ICF)》自2001年5月由世界卫生组织(WHO)正式发布以来,已经20年了[1].20年间,WHO一直致力于推动ICF在各...     

如何将国际功能、残疾和健康分类应用于临床康复管理

康复致力于使经历或可能经历残疾的人获得并维持最佳功能状态.因此,功能评定是以患者和目标导向的康复过程的起点.ICF作为世界范围内普遍接受的模式,首次为康复工作人员提供了一个功能描述和分类的通用语言.为了将ICF充分应用于康复管理,需要为临床实践开发相应的ICF工具.这些整合了ICF分类和模式的工具,必须被整合在康复周期的解决问题的方法中.已经开发了应用于康复周期不同阶段的ICF工具.现有的与ICF限定值联合使用的ICF核心分类集,也是基于该发展过程.在临床实践中,ICF工具描述了患者功能状态,说明了患者的功能体验,将康复目标和合适的干预措施目标相联系,需要全面的资源来改善人类功能的特定方面,并且最终通过康复干预改善患者功能状态.在应用多学科康复时,ICF工具支持对功能的通用理解,并在小组成员间进行交流.电子文档系统的发展,ICF类目标准工具的分配以及ICF限定值的操作化,在不远的将来进一步改善基于ICF的康复管理.