Training on the International Classification of Functioning, Disability and Health (ICF): the ICF-DIN Basic and the ICF-DIN Advanced Course developed by the Disability Italian Network

The development of the International Classification of Functioning, Disability and Health Core Sets for deafblindness: A study protocol

BACKGROUND

Individuals with deafblindness experience a combination of hearing and vision impairments. The World Health Organization has developed a global framework referred to as the International Classification of Functioning, Disability and Health (ICF) to describe health and functioning. From the full ICF classification, a selection of categories, referred to as ICF Core Sets, provide users with a tool to describe functioning and disability in specific health conditions. There has been no ICF Core Set created for deafblindness. Given that core sets are instrumental in improving clinical practice, research, and service delivery, the aim of this study is to develop an ICF Core Set for deafblindness.

METHODS

As part of the preparatory phase in the ICF Core Set development, there are four studies that will be conducted. This includes the [1] systematic literature review that examines the researcher's perspective, [2] qualitative study focusing on the individuals with deafblindness experience, [3] experts survey that looks at health professional's perspective, and [4] empirical study that examines the clinical perspective. The studies will be conducted using the principles outlined by the ICF Research Branch for the development of ICF Core Sets. The systematic literature review protocol was submitted for registration on PROSPERO CRD42021247952.

DISCUSSION

An ICF Core Set created for deafblindness will benefit individuals living with deafblindness who are often excluded from social participation, policies, and services. An ICF Core Set for deafblindness will have a significant impact on healthcare professionals, policymakers, researchers, service providers and individuals with deafblindness by facilitating communication among all stakeholder to support the functioning of those with deafblindness.

Development of a Short Version of ICF Core Set for Stroke Adapted for Rehabilitation in Korea: a Preliminary Study

This study aimed to develop a short version of the International Classification of Functioning, Disability, and Health (ICF) core set and verify functioning levels of patients for stroke rehabilitation in Korea. Using the Delphi technique, a 3-round consensus process was conducted. Thirty multidisciplinary rehabilitation experts from different hospitals completed the consensus study. The questionnaire for this study adopted the comprehensive ICF core set for stroke developed by the Geyh group. A 7-point Likert-type scale was used by participants to weigh the impact of each category on activities of daily living or rehabilitation after a stroke. The consensus of ratings was assessed with Spearman's rho and inter-quartile range indices. A core set to assess functioning levels of patients with stroke was developed from those categories. A short version of ICF core set to assess and verify functioning levels of patients with stroke was developed for 12 categories, including 3 categories (consciousness, muscle power, and attention) from body functions, 1 (structure of brain) from body structures, 5 (eating, walking, moving around, changing basic body position, and carrying out daily routine) from activities and participation, and 3 (individual attitudes of immediate family members, immediate family, and personal care providers/personal assistants) from environmental factors. This preliminary study developed a Delphi consensus process, gathering statistical evidence and expert commands based on the short version of ICF core set for rehabilitation of stroke patients in Korea.

Training needs of Portuguese practitioners working with children and young people with complex and intense support needs

Upon the publication in Portugal of Decree-Law No. 3/2008, inclusive education for all children in regular schools became compulsory. In a short period of time, the educational community (special education teachers, regular education teachers, administrators, and technicians) were required to include and teach all students in regular schools. This article characterizes Portuguese teachers' perceptions (TPs; N = 105) about the training needs of practitioners working with children and young people with complex and intense support needs (CISNs). In this work, we use data collected using the questionnaire for practitioners working with children and young people with CISN-TPs, which was drawn up under the auspices of project ENABLIN+. The results of content analysis showed that the most frequently mentioned themes were special education, intervention strategies, international classification of functioning, disability and health, educational legislation, and family support/intervention. In conclusion, training should focus on specific contents, should be for everyone (practitioners and nonpractitioners), and should aim to improve practices, while being sufficiently flexible and differentiated to meaningfully inform each professional.

"No policy is an island": how the ICF international classification system may support local education planning in England

Background: A crucial issue in special educational needs and disability policy and provision is the documentation of children's functioning, for which many countries have a statutory document. In England this is the education health and care plan. Recent research challenges the quality of these plans. Purpose: To provide evidence on the usefulness of the international classification of functioning, disability and health as a system with potential to support the development of higher quality plans in England. Methods: Twenty-five professionals participated in a one-day training session on the international classification of functioning disability and health, with a focus on designing higher quality SMART targets to be included in children's plans. Results: Overall, participants regarded the system as useful. Comparison of targets written before and after the training show improvements in relevance, specificity and on the extent to which they were action-oriented and measurable. Conclusions: Results are discussed in light of international lessons learned around the potential of the international classification of functioning disability and health to support policy change. A "no policy is an island" approach is proposed, suggesting local policy-makers should open horizons beyond geographical boundaries in evidence-based decision-making for supporting children with disabilities.Implications for rehabilitationThe ICF can be regarded as a useful framework for supporting professionals developing targets for children with Education Health and Care (EHC) plans in England.For developing SMART targets with the ICF, professionals can use the taxonomy to look for detailed aspects of functioning, relevant to a certain developmental stage.Using the ICF can support in making more measurable targets in EHC plans if the universal qualifier scale is applied when describing detailed aspects of functioning.Professionals trained on the ICF recognise its usefulness for writing EHC targets.More in-depth training is recommended for supporting the development of more holistic biopsychosocial EHC plans in England.

Perceived usefulness of the International Classification of Functioning, Disability and Health (ICF) increases after a short training: A randomized controlled trial in master of advanced nursing practice students

The Master program of Advanced Nursing Practice (MANP) educates nurses to become a nurse practitioner. Nurse practitioners are health care professionals focusing on the intersection of cure and care. However, a clear model covering that area is lacking. The use of the International Classification of Functioning, Disability and Health (ICF) may be considered for incorporation in curricula due to its focus on the integration of cure and care. The purpose of this study is to test the effects of a short (= 4-h instructor-led) ICF training on perceived usefulness of the ICF. In a randomized controlled trial, 76 MANP students were randomly allocated to intervention or control group. Data were collected using an 'ICF survey and learning assessment tool'. Data of 56 students were included for analysis. Perceived usefulness of the ICF increased significantly in the intervention group immediately after training (p = 0.001) but no longer at 3-months follow-up (p = 0.388). Attitude and knowledge related to the ICF were significantly increased in the intervention group at both post-training assessments (p < 0.001 and 0.02). The positive influence of the ICF training on perceived usefulness of the ICF is relevant for including ICF in MANP curriculum.

The ICF has made a difference to functioning and disability measurement and statistics

AIMS

Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics.

METHODS

In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge.

RESULTS

The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation.

CONCLUSION

The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.

A Survey of Occupational Therapists in Canada about Their Knowledge and Use of the ICF

Background. The current impact of the International Classification of Functioning, Disability and Health (ICF) on the field of occupational therapy within Canada is unknown. Purpose. To survey occupational therapists in Canada about their knowledge, use of, and suggestions for education about the ICF. Method. Mixed methods design included (i) an online survey, with data analyzed using quantitative methods; and (ii) semi-structured interviews with a purposeful sample of 10 therapists, using content analysis. Results. The online survey was completed by 587 occupational therapists (17.6% return). Four hundred and ten respondents (70.0%) indicated some ICF knowledge, and 121 of those individuals (29.5%) reported using it in practice. Interview participants suggested resources, perceived meaning and investment factors impact ICF knowledge. Suggested uses include frameworks and interprofessional collaboration, while ideas for education involve meaningful and accessible formats. Practice Implications. The ICF may be useful to occupational therapists in different settings if it fulfills a meaningful purpose and fits with practice models.

Evolution of system for disability assessment based on the International Classification of Functioning, Disability, and Health: A Taiwanese study

BACKGROUND/PURPOSE

The criteria for disability were mainly based on the medical model, and the candidates for disability benefits were identified by physicians mainly depending on their degree of bodily impairment, but without sufficient evaluation of their activity, participation, and environment in Taiwan. According to the People with Disabilities Rights Protection Act, the assessment of a person's eligibility for disability benefits was required to be based on the International Classification of Functioning, Disability, and Health (ICF) framework since July 11, 2012. This study investigated a proposed system to assess patients' eligibility for disability in Taiwan, based on the ICF.

METHODS

We have initiated a national decision-making process involving members of Taiwan's ICF Team. We facilitated 16 group discussions on the ICF coding system, in which 199 professionals participated. In each group, one member led the group discussion until a consensus was reached.

RESULTS

We have developed a process to determine the eligibility of people with disabilities. This study set up the standards, tools, and practice manuals for each category. We have also developed a core set for disability assessment.

CONCLUSION

We implemented a new system to assess patients' eligibility for disability. The proposed assessment protocol and tools require further validation.

Multidisciplinary perspective for cerebral palsy assessment after an international, classification of functioning, disability and health training

OBJECTIVE

To assess knowledge related to the ICF before and after an ICF training and to identify items to compose a monocentric rehabilitation ICF code set for cerebral palsy (CP).

METHODS

(a)

DESIGN

A cross-sectional study with a descriptive-explorative design. (b)

PARTICIPANTS

Professionals from the fields of physiotherapy, nutrition, dentistry, occupational therapy, psychology, social work, speech therapy and medicine. (c)

INSTRUMENT

A questionnaire to assess ICF's knowledge (total score = 17).

RESULTS

A high effect size of the ICF training was found (Cohen's d = 4.10). Ninety-one and 43 ICF categories were selected for a comprehensive evaluation and triage, respectively, for CP.

CONCLUSION

ICF categories were identified to compose a comprehensive evaluation and for triage through an ICF code sets for CP. Studies are needed to validate the instrument on the knowledge of the ICF and to test the impact of ICF's training for clinical rehabilitation of CP.

The International Classification of Functioning, Disability and Health: development of capacity and performance scales

OBJECTIVE

There has been no attempt to obtain a continuous summary measure of disability from the checklist of the International Classification of Functioning, Disability and Health (ICF). Our objective was to assess whether valid scales of Capacity and Performance could be developed from the "Activities and Participation" domain of the ICF checklist.

STUDY DESIGN AND SETTING

A multicenter, observational study of 1,092 patients with 12 different chronic conditions from five European countries was conducted. Exploratory and confirmatory factor analyses were performed to assess the underlying factor structure. Reliability and validity of the Capacity and Performance scales were evaluated. Construct validity was assessed calculating effect size coefficients between extreme severity groups (discriminant ability).

RESULTS

The good fit of the confirmatory factor model supported the global scales of Capacity and Performance and their "Psychosocial" and "Physical" subscales. Reliability was excellent (coefficients=0.79-0.92). Effect sizes of most conditions were large for the Capacity global scale (0.50-3.05), and slightly lower for the Performance global scale (0.45-2.57).

CONCLUSIONS

Our findings support the measurement model, reliability, and validity of the Capacity and Performance scales. Summary measures of functioning based on the ICF can be obtained using these scales, which should facilitate their incorporation in clinical and epidemiological studies.

Use of The International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems

A common framework for describing functional status information is needed in order to make this information comparable and of value. The World Health Organization's International Classification of Functioning, Disability and Health (ICF), which has been approved by all its member states, provides this common language and framework. The article provides an overview of ICF taxonomy, introduces the conceptual model which underpins ICF and elaborates on how ICF is used at population and clinical level. Furthermore, the article presents key features of the ICF tooling environment and outlines current and future developments of the classification.

Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation

PURPOSE

To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001.

METHOD

The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application.

RESULTS

A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009.

CONCLUSIONS

The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.

The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention--feasibility and usefulness as a common language and frame of reference for practice

Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

Disseminating the WHO International Classification of Functioning Health and Disability (ICF) in the Veneto region of Italy

PURPOSE

To show the feasibility and effect of a large formation effort focused on the International Classification of Functioning, Disability and Health (ICF), which may introduce a revolutionary new conceptual framework for people involved in rehabilitation services.

METHODS

We here describe the large information/formation project launched by the Regional Direction for Social Services of the Veneto region (Italy). Here we describe the first of the two steps of the project, aimed to reach 900 health professionals throughout the whole region. They were exposed to a structured modular course consisting of a mix of frontal lectures and workshop sessions. During the workshop sessions the participants were confronted with questions referring to the actual application of ICF in their services.

RESULTS

The results show that the attendance (90%) was very high. The workshop sessions provided interesting indications on the possible applications of ICF in the clinical settings, as well as points of strength and potential problems that the implementation of ICF may have in the Regional Health Service.

CONCLUSIONS

To our knowledge this is the largest alphabetization effort on ICF attempted in a public health system, and it indicates a possible effective approach to its controlled diffusion and future implementation.

Three model curricula for teaching clinicians to use the ICF

PURPOSE

Three systematic programmes to train health professionals to use the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) are described, along with efforts to evaluate their effectiveness.

METHODS

The first programme was a randomized study comparing the effects of a 2-hour instructor-led programme and a self-directed learning module on ICF-related knowledge, attitudes, and coding skills among occupational therapy graduate students. The second programme was a series of intensive 3.5-day workshops for public sector rehabilitation professionals in South Africa. The third programme involved a series of internet-based teaching modules regarding the ICF for graduate students in rehabilitation counselling.

RESULTS

The first project found that both instructor-led and self-guided training formats were effective in improving basic ICF-related knowledge, but only instructor-led training led to a significant improvement in coding skill. It also had more positive effects on ICF-related attitudes. This approach to learning assessment was generalizable to multidisciplinary health professionals in South Africa, who achieved a relatively high degree of coding accuracy after the 3.5-day workshop. Participant evaluations supported the structure, content, and length of the training. Students in the third programme also reported a very positive learning experience and positive views of the ICF.

CONCLUSIONS

An empirical basis is important for identifying the best and most efficient training methods for particular audiences and specific purposes. The length and format of training can be differentially related to specific training goals (i.e., knowledge, attitudes, and coding skills). Interactive distance learning methods may help to overcome the weaknesses of self-directed training in comparison to face-to-face training.