1,721,209 research outputs found
New approaches to understanding the impact of muskuloskeletal conditions
No full textThe approval of the new international classification of functioning, disability and health (ICF; formerly ICIDH) (WHO, 2001a) by the World Health Assembly (WHA) in May 2001 is a landmark event for medicine and society. With the ICF, patients' functioning, with its components body functions and structures, activities and participation, became a central perspective in medicine. The objective of this paper is to outline how the ICF can serve as a new global language of functioning and health and hence become a new approach for our understanding of the impact of musculoskeletal conditions.<br/
Applying the ICF and ICF Core Sets in rheumatoid arthritis
No full textThe new International Classification of Functioning, Disability, and Health (ICF) created by the World Health Organization provides both a framework and a classification that comprehensively represents the experience of patients with rheumatoid arthritis (RA), and also provides a universal language understood by health professionals, researchers, policy makers, patients, and patient organizations alike. To aid the implementation of the ICF in rheumatology and in medicine in general, practical tools such as the ICF Core Sets for RA have been developed using a rigorous scientific approach
Content comparison of Health Related Quality of Life (HRQOL) instruments based on the International Classification of Functioning, Disability and Health (ICF)
No full textThe increasing recognition of the patient perspective and, more specifically, functioning and health, has led to an impressive effort in research to develop concepts and instruments to measure them. Health-Related Quality of Life (HRQOL) and the International Classification of Functioning Disability and Health (ICF) represent two different perspectives from which to look at functioning and health. Therefore, it is expected that both will often be used concurrently in clinical practice, research and health reporting. The objective of our study was to examine the relationship between six HRQOL instruments (the SF-36, the NHP, the QL-I, the WHOQOL-BREF, the WHODASII and the EQ-5D) and the ICF. All six HRQOL instruments were linked to the ICF separately by two trained health professionals according to ten linking rules developed specifically for this purpose. The degree of agreement between health professionals was calculated by means of the kappa statistic. Bootstrapped confidence intervals were calculated. In the 148 items of the 6 instruments a total of 226 concepts were identified and linked to the ICF. The estimated kappa coefficients range between 0.82 and 0.98. The concepts contained in the items of the HRQOL instruments were linked to 91 different ICF categories, 17 categories of the component body functions, 60 categories of the component activities and participation, and 14 categories of the component environmental factors. Twelve concepts could not be linked to the ICF at all. In the component body functions, only emotional functions are covered by all examined instruments. In the component activities and participation, all instruments cover aspects of work, but the half of them scarcely cover aspects of mobility. Only four of the six instruments address environmental factors. The ICF proved highly useful for the comparison of HRQOL instruments. The comparison of selected HRQOL instruments may provide clinicians and researchers with new insights when selecting health-status measures for clinical studies
Understanding functioning, disability, and health in rheumatoid arthritis : the basis for rehabilitation care
No full textPurpose of review: To examine the recent literature on rheumatoid arthritis in relation to functioning and disability, highlighting it from the perspective of the biopsychosocial model of functioning, disability, and health of the World Health Organization. This review focuses on longitudinal studies because they clarify associations found in cross-sectional studies and are useful in shedding light on the mechanisms that explain functioning and disability.Recent findings: The studies that contribute best to understanding of functioning and disability in patients with rheumatoid arthritis are studies that (1) incorporate a comprehensive model to integrate different variables of interest, (2) use a longitudinal design to examine the potential casual relationships among the variables, and (3) use hierarchical regression analyses or path analysis to study the relation among variables.Summary: It is time to rethink and redefine what should be measured when addressing functioning and disability of patients with rheumatoid arthritis. The use of a universally agreed framework and classification, such as the International Classification of Functioning, Disability and Health, a universally agreed-on comprehensive list of variables potentially relevant to functioning and disability in rheumatoid arthritis, and a greater focus on functioning-oriented versus disability-oriented perspectives constitute a solid foundation for such a rethinking process
Psychometric properties of the WHODASII in rehabilitation patients
No full textBackground: To evaluate function and disability, the WHO has developed the WHO Disability Assessment Schedule II (WHODASII), an instrument arising from the same conceptual basis as the International Classification of Functioning, Disability, and Health (ICF).Objectives: The general objective of this study was to investigate whether the WHODASII––German version—is a valid instrument to measure functioning and disability across various conditions. Specific aims were (1) to assess its psychometric properties (reliability, validity, and sensitivity to change) based on the traditional test theory and (2) to compare its sensitivity to change after a rehabilitative intervention to the Short Form 36 (SF-36). Research design: This was a multi-center study with convenience samples of patients with different chronic conditions undergoing rehabilitation. Patients completed the WHODASII and the SF-36 before and after a rehabilitation treatment. Health professionals rated in cooperation with the patients the pain of the patients based on the ICF category “sensation of pain.” Results: 904 patients were included in the study. The Cronbach’s range from 0.70 to 0.97 for the different subscales of WHODASII. With exception of the subscale Activities, the exploratory-factor structure of the WHODASII corresponds highly with the original structure. The effect size (ES) of the WHODASII total score ranged from 0.16 to 0.69 depending on the subgroup. The ES of the SF-36 summary scores ranged from 0.03 to 1.40.Conclusions: The WHODAS II (German version) is a useful instrument for measuring functioning and disability in patients with musculoskeletal diseases, internal diseases, stroke, breast cancer, and depressive disorder. The results of this study support the reliability, validity, dimensionality, and responsiveness of the German version of the WHODASII. However, the reproducibility in test–retest samples of stable patients, as well as the question to what extent a summary score can be constructed, requires further investigation
The International Classification of Functioning, Disability and Health (ICF): a unifying model for the conceptual description of the rehabilitation strategy
Full text linkAn important basis for the successful development of rehabilitation practice and research is a conceptually sound description of rehabilitation understood as a health strategy based on a universally accepted conceptual model and taxonomy of human functioning. With the approval of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in 2001 and the reference to the ICF in the World Health Assembly’s resolution on “Disability, including prevention, management and rehabilitation” in 2005, we can now rely on a universally accepted conceptual model. It is thus time to initiate the process of evolving an ICF-based conceptual description that can serve as a basis for similar conceptual descriptions and according definitions of the professions applying the rehabilitation strategy and of distinct scientific fields of human functioning and rehabilitation research. In co-operation with the Physical and Rehabilitation Medicine (PRM) section of the European Union of Medical Specialists (UEMS) and its professional practice committee, we present a first tentative version of an ICF-based conceptual description in this paper. A brief definition describes rehabilitation as the health strategy applied by PRM and professionals in the health sector and across other sectors that aims to enable people with health conditions experiencing or likely to experience disability to achieve and maintain optimal functioning in interaction with the environment
Evaluation of the German translation of the Stroke Impact Scale using Rasch analysis
No full textTo assess the complex and heterogeneous consequences of stroke, currently comprehensive patient-centered measures, like the Stroke Impact Scale (SIS), are increasingly being developed. The purpose of this study was to evaluate the psychometric properties of the German translation of the SIS using Rasch analyses. A total of 196 patients with stroke from 16 study centers participated in the study. In tests for item fit, 7 of the 64 items displayed model misfit. Response categories of 25 items showed threshold disordering. Person separation reliability lay above.80 in six domains. No differential item functioning was detected with respect to age, gender, disability severity, and setting. The results provide support for validity and reliability of the SIS, and also point out issues for further improvement and adaptation of the SIS
Content comparison of health-related quality of life instruments for obstructive sleep apnea
No full textBackground and purpose: Due to the increasing importance of quality of life assessments in obstructive sleep apnea (OSA) patients and due to an increased use of the International Classification of Functioning, Disability and Health (ICF), for comparative purposes it is essential to understand the relationship between health-related quality of life (HRQOL) instruments and the ICF. The purpose of this study was to compare the content covered by OSA-specific instruments using the ICF.Patients and methods: OSA-specific instruments were identified, including the Calgary Sleep Apnea Quality of Life Index, the Functional Outcomes of Sleep Questionnaire, the Obstructive Sleep Apnea Patient-Oriented Severity Index, and the Quebec Sleep Questionnaire, and linked to the ICF by six health professionals according to standardized guidelines. The degree of agreement between health professionals was calculated by means of the kappa statistic.Results: A total of 308 concepts were identified and linked to 78 different ICF categories; 35 categories of the component body function, one category of the component body structure, 38 categories of the component activities and participation, and four categories of the component environmental factors. Only contents within the chapters mental functions, mobility and social life were addressed by all instruments. Forty-seven categories were covered by only one instrument.Conclusion: The ICF proved highly useful for the comparison of HRQOL instruments. This analysis may help researchers and clinicians to choose the most appropriate HRQOL instrument for a specific purpose as well as help to compare study outcomes of studies using different instruments for HRQOL assessment
Validation of the Comprehensive International Classification of Functioning, Disability and Health core set for rheumatoid arthritis: the perspective of physical therapists
No full textBackground and Purpose: The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Rheumatoid Arthritis (RA) represents the typical spectrum of problems in the functioning of patients with RA. The objective of this study was to validate this ICF Core Set from the perspective of physical therapists. Methods: Physical therapists were asked about their intervention goals in a 3-round Delphi survey. Intervention goals were compiled, and the physical therapists were asked whether they considered the goal classes to be relevant. The goal classes then were linked to the ICF. Results: A total of 82 physical therapists in 12 countries named 562 intervention goals. A total of 45 goal classes covering all ICF components were identified. The goal classes addressing muscle tone, balance and coordination, and psychological distress were not represented in the ICF Core Set for RA. Discussion and Conclusion: The validity of the ICF Core Set for RA was largely supported. However, some categories currently not covered by the ICF Core Set for RA will need to be investigated further
How to apply the ICF and ICF core sets for low back pain
No full textObjective: To introduce the International Classification of Functioning, Disability and Health (ICF) as conceptual model and classification and the ICF Core Sets as a way to specify functioning for a specific health condition such as Low Back Pain, and to illustrate the application of the ICF and ICF Core Sets in the context of clinical practice, the planning and reporting of studies and the comparison of health status measures.Methods: A decision-making and consensus process was performed to develop the ICF Core Sets for Low Back Pain, the linking procedure was applied as basis for the content comparison of health-status measures and the Rehab-Cycle was used to exemplify the application of the ICE and ICF Core Sets in clinical practice.Results: Two different ICF Core Sets, namely, a comprehensive and a brief, are presented, three different health-status measures were linked to the ICF and compared and a case example of a patient with Low back Pain was described based on the Rehab-Cycle.Discussion: The ICF is a promising new framework and classification to assess the impact of Low Back Pain. The ICF and practical tools, such as the ICF Core Sets for Low Back Pain, are useful for clinical practice, outcome and rehabilitation research, education, health statistics, and regulation
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