Rehabilitation and Health Assessment: Applying ICF Guidelines


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Didactics — Learning and Teaching. Network Sociologies of Education Network Reserach on Arts Education. Research on Environmental und Sustainability Education Network Research on Language and Education LEd. Organizational Education.

The importance of assessing disability for successful neurological rehabilitation

Gender and Education Additional Events. Emerging Researchers' Conference. Breadcrumb Navigation. Main Content. Inclusive Education. Contribution Contemporary approaches within the special education field contend that outlining assessment and intervention processes for children with additional needs requires a functional perspective on their needs rather than a developmental point of view about their delays Florian et al.

Method teachers attended to a 50 hours in-service training program divided in 25 hours of contact hours — structured in six sessions — and 25 hours of practical assignments related to training contents.

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The training program covered: 1 Conceptual models of disability and intervention issues within the realms of a human rights agenda; 2 the ICF structure and its interactive model 3 the use of a problem solving method as a strategy to generate holistic FPs consistent with the person-environment fit approach. In order to evaluate the impact of the program, a student's IEP was provided by each trainee before and after the training two IEPs generated by each teacher for the same student.

Expected Outcomes Results showed that the training program promoted more holistic and accurate descriptions of students' functioning profiles. It was also observed that post-program IEPs reduced their focus on the body functions component in relation to the activity and participation component, which is in line with the ICF framework. These results are discussed in terms of the contribution of the training program for the development of teachers' skills in the ICF use to elaborate educationally relevant functional profiles of students with additional needs.

The results are also discussed in terms of the ICF framework as a classification system more compatible with the human rights agenda and of how such framework may contribute to improve European educational policies. References Decreto-Lei n. Author Information Manuela Sanches-Ferreira submitting.

Thus, an interview format informed by the ICF structure enabled the professionals to highlight the needs for assessment information [ 35 ]. Except in 10 papers all the ICF components were described. Two papers commented on personal factors, despite the fact they are part of the ICF there are no categorizations [ 29 , 35 ].

Only two papers described the component participation [ 44 , 66 ]. One paper described all components but environmental factors [ 58 ]. Six papers evaluated the body functions component only [ 42 , 47 , 49 , 56 , 57 , 59 ], and three papers reported on all components except body functions or participation components [ 45 , 60 , 75 ].

Seven papers used the ICF core set [ 27 , 29 , 30 , 38 , 46 , 51 , 55 ], among which four studies reported on the core set for VR [ 30 , 38 , 46 , 72 ]. The ICF used as a framework was the most prevalent operationalizing of ICF 18 papers , whereas linking, analysing and developing appeared in 8, 12 and 12 papers respectively. As 32 of the 50 included papers were reviews the predominant profession involved in ICF were researchers.

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Among the original papers no single profession stood out as particularly ICF users. In general the ICF enabled the various professions involved in VR in a structured way to obtain relevant need assessments and communicate this across professions. The majority 40 of papers described all factors, which support the bio-psycho-social approach. However, it was not clear if the ICF was suitable as an instrument for goal setting and evaluation as merely single papers mentioned these properties.

Moreover, the ICF was criticised for being time consuming.

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Unexpectedly four papers described the ICF components body and acidity only, despite participation and environmental factors seem inseparable from VR. The VR core set was not the primary tool when functioning was evaluated within VR. Compared to the findings in another review where qualitative papers only constituted a tenth [ 10 ], and despite some papers with a mixed study designs were defined as qualitative in this review, the number of qualitative and quantitative papers was more balanced in this review.

The ICF is seen as a useful tool for describing, comparing and contrasting information from outcome measures and clinical patient reports across diagnoses, settings, languages and countries [ 77 ]. A review showed that linking health and health-related information to the ICF is a useful way to apply the ICF in research [ 77 ]. Evaluation of functioning is relevant early in VR [ 8 ], and this review found several presentations of the applicability for VR and use of the ICF to examine and measure VR processes and outcomes. The findings show that the ICF was useful in providing a clear description of the consequences of diseases, and of the factors that can be described using the ICF coding, which may potentially support the VR professionals, e.

Thus, the ICF might contribute to a more informative description in multi-professional assessments, because healthcare professionals have different perspectives on the health-care process [ 57 ]. However, a paper concluded that in primary care there seem to be a lack of knowledge about the ICF, and that increased cooperation between GPs and other health-care professions may require learning as well as a change of attitudes [ 57 ].

Furthermore, an ICF-based questionnaire regarding time to RTW, work difficulties, job satisfaction, and work relations was reportedly useful for occupational physicians assessing patients after transplant procedures [ 40 ].

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However, the procedure of for assessment of self-reported work ability was reported as complex and required specific training of the staff involved [ 40 ]. The present review illustrates how the ICF may support development of questionnaires [ 59 , 60 ], like e. Although the ICF is a reasonable starting point in efforts to harmonize terminologies [ 33 ], the framework is also criticised for limitations.

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This scoping review reported on the ICF components only. However, each of the components except for personal factors is further divided into domains and underlying categories providing more detail of a component. Qualifiers are built into the coding system to indicate the magnitude of the impairment, limitation or restriction for each category. A review on the use of ICF in outcome measures used within VR identified that a third of categories were related to body functions [ 10 ]. This review also identified some papers solely reporting on body functions, which is not representing a bio-psycho-social approach.

It should be recognized that the ICF is limited with respect to comprehensive descriptions of work disability, e. The ICF however, cannot describe causal relationship [ 26 ], and a solution may be to use the ICF combined with other instruments, which can reveal causal relations. It was pointed out that although the framework includes personal factors, they cannot be classified in the ICF [ 68 ].

This is a limitation of the framework, as e. Work participation relies on both personal and environmental factors, which in addition to the medical data, affect functioning and participation, e. Factors that are likely to be emphasized in a VR setting are within the components: activities, participation and environmental factors [ 35 ].

A Cochrane review found a lack of interventions targeting the ICF-domains: attitudinal and social environment [ 74 ]. However, this review found only a few papers lacking the environmental factors. These include environmental factors that may prove to be useful when disability evaluation and work capacity is being assessed. However, a validation study of the comprehensive VR core set concluded, that it was insufficient from a sole physiotherapist perspective, there was a need for additional ICF categories. Although the VR core set was considered useful to clarify responsibilities and for communication in a multidisciplinary setting, it was too comprehensive for mono-disciplinary use of physiotherapist [ 78 ].

The core sets in general were not recognized to provide an exhaustive list but rather the minimum number of categories to be assessed [ 8 ]. Therefore practice may supply the VR core set with other instruments in order to fully assess functioning. One strength was the inclusion of both qualitative and quantitative papers from multiple settings and countries.

Furthermore, the scoping review format offers an overview of study findings in a field where the knowledge is still limited. The reviewers experienced difficulties in study selection, despite the method by two reviewers and how to ensure eligibility criteria is a limitation. In a scoping review the extracted data is based on information provided in individual papers without critical assessment, which is a limitation despite no scope of synthesizing evidence. Furthermore, the categories of operationalization may not be mutual exclusive. This review confirm challenges with the use of the ICF: e.

The content of VR varies widely among countries because of differing insurance policies and disability attitudes; e. The ICF may be used to ensure comprehensiveness of evaluation in study populations with chronic diseases [ 46 ]. Furthermore, the framework may cover all relevant aspects of disability and may encourage the VR professionals to draw a holistic picture [ 26 ].

The ICF may be combined with existing measures and incorporated in daily practice [ 31 ]. Our findings revealed that the ICF has been applied in different settings and for different purposes, which has important implications for future research.


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In order to ensure comparability across studies and robust testing of hypotheses the use of the ICF needs to be clarified. Furthermore, how data are collected, assessed and classified based is lacking in the field of VR.


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Hence, research on the practical utility of the ICF across different assessment instruments is crucially needed to inform a feasible framework development in VR. Although the ICF provides a framework to evaluate contextual factors, this review finds there is a gap between the knowledge of the impact of personal factors and actual assessment within VR and more research is needed.

The scoping review revealed use of the ICF within the field VR in 50 papers, and in various settings; e. The operationalization of the ICF was described in four ways: for structuring information, linking of categories or content, analysis according to the ICF framework, or development of instruments or models based on the ICF.

The components of the ICF that depict functioning and disability were largely incorporated in the VR research. This observation points to the benefit of using a common set of ICF components to inform the selection of set of measurement instruments. We thank the research librarian Helene Sognstrup Aarhus University Library, for providing support in the search strategies for this review. Momsen, C. Stapelfeldt, R. Rosbjerg, M.

Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines
Rehabilitation and Health Assessment: Applying ICF Guidelines Rehabilitation and Health Assessment: Applying ICF Guidelines

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