Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health

Background and Aim:  Because occupational therapy focuses on occupations and activities of daily living in the context of the environment, conceptual occupational therapy models might be closely related to the International Classification of Functioning, Disability and Health (ICF). The purpose of this paper is to explore the link of conceptual occupational therapy models to the ICF.
Methods and Results:  A structured literature search was performed. The concepts on which the models are built were linked to the ICF categories and components according to 10 established linking rules. Three conceptual occupational therapy models were identified in the literature: the Model of Human Occupation, the Canadian Model of Occupational Performance and the Occupational Performance Model (Australia). The majority of the concepts from the three models could be linked to the ICF.
Conclusion:  By applying the conceptual models, occupational therapists might add an additional perspective to multidisciplinary teams that use the ICF.     

A Systematic Review of Functioning in Vocational Rehabilitation Using the International Classification of Functioning,Disability and Health

Background: Vocational rehabilitation (VR) is aimed at engaging or re-engaging individuals with work participation and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization can be operationalized in the context of VR. The objective of this study is to review the literature to identify outcomes or measures being used in VR using a systematic review methodology and link those measures to the ICF. Methods: We applied a structured search strategy using multiple databases. Items or constructs of the measures or outcomes identified were linked to the ICF by two trained individuals. Results: We have identified 648 measures which contained 10,582 concepts that were linked to the ICF which resulted in 87 second-level ICF categories. Out of the 87 categories, 31 (35.6%) were related to body functions, 43 (49.4%) were related to activities and participation, and 13 (14.9%) were related to environmental factors. No category was related to body structures. Conclusions: Our review found great diversity in the ICF contents of the measures used in different VR settings and study populations, which indicates the complexity of VR. This systematic review has provided a list of ICF categories which could be considered towards a successful VR.     

An International Expert Survey on Functioning in Vocational Rehabilitation Using the International Classification of Functioning,Disability and Health

Background Vocational rehabilitation (VR) is a key process in work disability (WD) management which aims to engage or re-engage individuals to work and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO) can be interfaced with VR but there is a lack of evidence of what ICF contents experts in the field consider. The objective of this study is to survey the experts in the VR field with regard to what factors are considered important to patients participating in VR using the ICF as the language to summarize the results. Methods An internet-based survey was conducted with experts from six WHO Regions (Africa, the Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). Experts were asked six open-ended questions on factors that are important in VR. Each question was related to a component of the ICF (body functions, body structures, activities and, environmental factors, and personal factors). Responses were linked to the ICF. Results Using a modified stratified randomized sampling, 201 experts were sent the survey and 151 experts responded (75% response rate). We identified 101 ICF categories: 22 (21.8%) for body functions, 13 (12.9%) for body structures, 36 (35.6%) for activities and participation, and 30 (29.7%) for environmental factors. Conclusions There was a multitude of ICF functioning domains according to the respondents which indicates the complexity of VR. This expert survey has provided a list of ICF categories which could be considered in VR.     

Demystifying disability: a review of the International Classification of Functioning, Disability and Health

The paper describes and evaluates the theoretical underpinnings of the International Classification of Functioning, Disability and Health (ICF), and develops the proposition that its conceptual framework provides a coherent, if uneven, guide through the competing conceptions of disability. To date, however, there has been little evaluation of the theoretical efficacy of the ICF. In seeking to redress this, the paper develops the argument that the ICF fails to specify, in any detail, the content of some of its main claims about the nature of impairment and disability. This has the potential to limit its capacity to educate and influence users about the relational nature of disability. The paper develops the contention that three parts of the ICF require further conceptual clarification and development: (a) (re)defining the nature of impairment; (b) specifying the content of biopsychosocial theory; and (c) clarifying the meaning and implications of universalisation as a principle for guiding the development of disability policies.     

中国听力残疾老年人生活自理能力影响因素分析

  目的  了解中国听力残疾老年人的社会参与功能障碍现状及其影响因素,为提高听力残疾老年人的生活质量提供参考依据。  方法  收集2006年第二次全国残疾人抽样调查数据中39 166例 ≥ 60岁听力残疾老年人相关数据,分析不同程度听力残疾老年人的社会参与功能障碍现状及其影响因素。  结果  中国39 166例听力残疾老年人中,有社会参与功能障碍老年人33 524例,社会参与功能障碍率为85.59 %;13 156例中度和26 010例重度听力残疾老年人中,有社会参与功能障碍老年人分别为10 092和23 432例,中度和重度听力残疾老年人社会参与功能障碍率分别为76.71 %和90.09 %。多因素非条件logistic回归分析结果显示,年龄 ≥ 80岁是中国中度听力残疾老年人社会参与功能障碍的危险因素,文化程度小学及以上、有配偶、家庭人均年收入 ≥ 1 401元、居住在城镇、所在地区经济水平为中等和较高人类发展指数（HDI）是中国中度听力残疾老年人社会参与功能障碍的保护因素;年龄 ≥ 70岁是中国重度听力残疾老年人社会参与功能障碍的危险因素,文化程度小学及以上、有配偶、家庭人均年收入 ≥ 1 401元、居住在城镇、所在地区经济水平为中等和较高HDI是中国重度听力残疾老年人社会参与功能障碍的保护因素。  结论  中国听力残疾老年人普遍存在社会参与功能障碍,严重程度越重,社会参与功能障碍越广泛;年龄、文化程度、配偶情况、家庭人均年收入、居住地和所在地区社会经济水平是影响其参与社会生活的主要因素。     

Comments on the Portuguese translation of the International Classification of Functioning, Disability and Health

An analysis of the World Health Organization terminology for disability indicates the influence of the social model of disability in the International Classification of Functioning, Disability, and Health. This theoretical framework should guide any translations of the document. In Brazil, the document was translated as Classifica??o Internacional de Funcionalidade, Incapacidade e Saúde. We argue that more appropriate than translating disability as "incapacidade" and impairments as "deficiências" would be to use the term "deficiência" for disability and "les?o" for impairment. Considering the normative impact of a WHO document for social policy and international research, the translation should accurately reflect the concepts and their theoretical basis.     

Content identification of the IWQOL-Lite with the International Classification of Functioning,Disability and Health

Introduction  

The identification of the content of a measure could ensure that the most appropriate measure is chosen to meet a particular objective. Mapping the Impact of Weight on Quality Of Life (IWQOL-Lite) to the International Classification of Functioning, Disability and Health (ICF) will improve the understanding of its structure and aid in the interpretation of the results.     

Comparing the content of participation instruments using the International Classification of Functioning, Disability and Health

Background  

The concept of participation is recognized as an important rehabilitation outcome and instruments have been developed to measure participation using the International Classification of Functioning, Disability and Health (ICF). To date, few studies have examined the content of these instruments to determine how participation has been operationalized. The purpose of this study was to compare the content of participation instruments using the ICF classification.     

Comparing the content of participation instruments using the International Classification of Functioning, Disability and Health

Background

The 'Perception of Anti-Coagulant Treatment Questionnaire' (PACT-Q) was developed to assess patients' expectations of, and satisfaction with their anticoagulant treatment. This questionnaire needs to be finalised and psychometrically validated.

Methods

The PACT-Q was included in the United States, the Netherlands and France into three phase III multinational clinical trials conducted to evaluate efficacy and safety of a new long-acting anticoagulant drug (idraparinux) compared to vitamin K antagonist (VKA). PACT-Q was administered to patients with deep venous thrombosis (DVT), atrial fibrillation (AF) or pulmonary embolism (PE) at Day 1, to assess patients' expectations, and at 3 and 6 months to assess patients' satisfaction and treatment convenience and burden. The final structure of the PACT-Q (Principal Component Analysis - PCA - with Varimax Rotation) was first determined and its psychometric properties were then measured with validity of the structure (Multitrait analysis), internal consistency reliability (Cronbach's alpha coefficients) and known-group validity.

Results

PCA and multitrait analyses showed the multidimensionality of the "Treatment Expectations" dimension, comprising 7 items that had to be scored independently. The "Convenience" and "Burden of Disease and Treatment" dimensions of the hypothesised original structure of the questionnaire were combined, thus resulting in 13 items grouped into the single dimension "Convenience". The "Anticoagulant Treatment Satisfaction" dimension remained unchanged and included 7 items. All items of the "Convenience" and "Anticoagulant Treatment Satisfaction" dimensions displayed good convergent and discriminant validity. The internal consistency reliability was good, with a Cronbach's alpha of 0.84 for the "Convenience" dimension, and 0.76 for the "Anticoagulant Treatment Satisfaction" dimension. Known-group validity was good, especially with regard to occurrence of thromboembolic events within 3 months from randomisation.

Conclusion

The PACT-Q is a valid and reliable instrument that allows the assessment of patients' expectations and satisfaction regarding anticoagulant treatment, as well as their opinion about treatment convenience of use. Its two-part structure - assessment of expectations at baseline in the first part, and of convenience, burden and treatment satisfaction in the second - was validated and displays good and stable psychometric properties. These results are not sufficient to recommend the use of satisfaction as primary endpoint in clinical trials; further validation work is needed to support the interpretation of PACT-Q dimension scores. However, this first validation makes the PACT-Q an appropriate measure for use in clinical and pharmacoepidemiological research, as well as in real-life studies.

Trial Registration

(ClinicalTrials.gov numbers, NCT00067093, NCT00062803 and NCT00070655).     

A tool for enhancing strategic health planning: a modeled use of the International Classification of Functioning,Disability and Health

This article describes use of the International Classification of Functioning, Disability and Health (ICF) as a tool for strategic planning. The ICF is the international classification system for factors that influence health, including Body Structures, Body Functions, Activities and Participation and Environmental Factors. An overview of strategic planning and the ICF are provided. Selected ICF concepts and nomenclature are used to demonstrate its utility in helping develop a classic planning framework, objectives, measures and actions. Some issues and resolutions for applying the ICF are described. Applying the ICF for strategic health planning is an innovative approach that fosters the inclusion of social ecological health determinants and broad populations. If employed from the onset of planning, the ICF can help public health organizations systematically conceptualize, organize and communicate a strategic health plan. This article is a US Government work and is in the public domain in the USA.