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Zhang M, Gao Y, Xue J, Li K, Zhang L, Yu J, Yan T, Hou X. Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method. BMC Geriatr 2024; 24:239. [PMID: 38454354 PMCID: PMC10921752 DOI: 10.1186/s12877-024-04816-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults. OBJECTIVE The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults. METHODS A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion. RESULTS Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision. CONCLUSIONS Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.
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Affiliation(s)
- Malan Zhang
- Department of Exercise Rehabilitation, College of Exercise and Health, Guangzhou Sport University, Guangzhou, China
| | - Yan Gao
- Department of Rehabilitation Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jingjing Xue
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lifang Zhang
- School of Nursing, Youjiang medical university for nationalities, Baise, China
| | - Jiani Yu
- Department of Rehabilitation, GuangDong Province Hospital of Chinese Medicine, Guangzhou, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Xiaohui Hou
- Department of Exercise Rehabilitation, College of Exercise and Health, Guangzhou Sport University, Guangzhou, China.
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Ponomarenko GN, Petrishcheva KN. [International Classification of Health Interventions of World Health Organization as the basis for a new nomenclature of medical rehabilitation services]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2024; 101:5-11. [PMID: 38639145 DOI: 10.17116/kurort20241010215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
The development of health care system, including medical rehabilitation, in the Russian Federation is required updating nomenclature of simple and complex medical services and establishing its detailed list. The latter should integrate international experience and features of domestic health care system. OBJECTIVE To analyze the structure of International Classification of Health Interventions (ICHI) of World Health Organization (WHO) and the possibilities of its practical application in domestic medical rehabilitation system. MATERIAL AND METHODS The role of ICHI and its structural logical correlations with other classifications of the WHO international classifications section has been determined. Analysis of ICHI application areas, comparison of ICHI codes and new nomenclature of medical services were performed. RESULTS Analysis of ICHI and new nomenclature project of medical services in the Russian Federation showed, that ICHI formed the basis for the development of a new medical services nomenclature, including a section on medical rehabilitation. The basic principles of ICHI (structure by axes: aim, action, means; codes uniqueness; hierarchical method of classification formation) and ICHI fragment associated with purposes for systems and organism functions are presented in the new nomenclature of medical services. It has been established that ICHI can be a basis for developing domestic list of rehabilitation services, the formation of which is planned in the near future. CONCLUSION The development of medical services nomenclature in the Russian Federation will significantly increase the availability, funding and effectiveness of medical rehabilitation assistance.
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Affiliation(s)
- G N Ponomarenko
- Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - K N Petrishcheva
- Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, St. Petersburg, Russia
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van Velzen M, de Graaf-Waar HI, Ubert T, van der Willigen RF, Muilwijk L, Schmitt MA, Scheper MC, van Meeteren NLU. 21st century (clinical) decision support in nursing and allied healthcare. Developing a learning health system: a reasoned design of a theoretical framework. BMC Med Inform Decis Mak 2023; 23:279. [PMID: 38053104 PMCID: PMC10699040 DOI: 10.1186/s12911-023-02372-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023] Open
Abstract
In this paper, we present a framework for developing a Learning Health System (LHS) to provide means to a computerized clinical decision support system for allied healthcare and/or nursing professionals. LHSs are well suited to transform healthcare systems in a mission-oriented approach, and is being adopted by an increasing number of countries. Our theoretical framework provides a blueprint for organizing such a transformation with help of evidence based state of the art methodologies and techniques to eventually optimize personalized health and healthcare. Learning via health information technologies using LHS enables users to learn both individually and collectively, and independent of their location. These developments demand healthcare innovations beyond a disease focused orientation since clinical decision making in allied healthcare and nursing is mainly based on aspects of individuals' functioning, wellbeing and (dis)abilities. Developing LHSs depends heavily on intertwined social and technological innovation, and research and development. Crucial factors may be the transformation of the Internet of Things into the Internet of FAIR data & services. However, Electronic Health Record (EHR) data is in up to 80% unstructured including free text narratives and stored in various inaccessible data warehouses. Enabling the use of data as a driver for learning is challenged by interoperability and reusability.To address technical needs, key enabling technologies are suitable to convert relevant health data into machine actionable data and to develop algorithms for computerized decision support. To enable data conversions, existing classification and terminology systems serve as definition providers for natural language processing through (un)supervised learning.To facilitate clinical reasoning and personalized healthcare using LHSs, the development of personomics and functionomics are useful in allied healthcare and nursing. Developing these omics will be determined via text and data mining. This will focus on the relationships between social, psychological, cultural, behavioral and economic determinants, and human functioning.Furthermore, multiparty collaboration is crucial to develop LHSs, and man-machine interaction studies are required to develop a functional design and prototype. During development, validation and maintenance of the LHS continuous attention for challenges like data-drift, ethical, technical and practical implementation difficulties is required.
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Affiliation(s)
- Mark van Velzen
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Helen I de Graaf-Waar
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Tanja Ubert
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Robert F van der Willigen
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Lotte Muilwijk
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Institute for Communication, media and information Technology, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Maarten A Schmitt
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Mark C Scheper
- Data Supported Healthcare: Data-Science unit, Research Center Innovations in care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Allied Health professions, faculty of medicine and science, Macquarrie University, Sydney, Australia
| | - Nico L U van Meeteren
- Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Top Sector Life Sciences and Health (Health~Holland), The Hague, the Netherlands
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Zampolini M, Selb M, Boldrini P, Branco CA, Golyk V, Hu X, Kiekens C, Negrini S, Nulle A, Oral A, Sgantzos M, Shmonin A, Treger I, Stucki G. The Individual Rehabilitation Project as the core of person-centered rehabilitation: the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists Framework for Rehabilitation in Europe. Eur J Phys Rehabil Med 2022; 58:503-510. [PMID: 35148044 PMCID: PMC9980560 DOI: 10.23736/s1973-9087.22.07402-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.e. to optimize a person's functioning across the continuum of care. An IRP is a multi-element, person-centered rehabilitation management scheme, in which rehabilitation is generally provided by a multiprofessional team under the leadership of a physical and rehabilitation medicine (PRM) physician, working in an interdisciplinary manner and together with the patient (or proxy). A reference system for operationalizing functioning and standardizing the process is the International Classification of Functioning, Disability and Health (ICF) - for assessing functioning needs, defining rehabilitation goals and outcomes. The objective of this paper is to present the IRP as a framework for rehabilitation in Europe (EUR-IRP). The specific aims are: 1) to introduce the IRP; and 2) to describe the framework components, elements and variables of the IRP. Demonstration projects (case studies) using the EUR-IRP will be conducted. The present paper presents the efforts to date for developing the EUR-IRP, a key part of the action plan of the PRM Section and Board of the European Union of Medical Specialists to implement the ICF systemwide across the care continuum. This paper serves as another step to bring together practice, science and governance in calling for contribution from rehabilitation clinicians and researchers and professional societies in PRM and beyond.
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Affiliation(s)
| | - Melissa Selb
- ICF Research Branch, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Treviso, Italy
| | - Catarina A Branco
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Volodymyr Golyk
- Department of Physical and Rehabilitation Medicine and Sports Medicine, Shupyk National University of Healthcare of Ukraine, Kyiv, Ukraine.,Department of Physical and Rehabilitation Medicine, City Municipal Teaching Hospital N.4, Dnipro, Ukraine
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, Università "La Statale, " Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Anda Nulle
- National Rehabilitation Center "Vaivari, " Jurmala, Latvia
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Markos Sgantzos
- School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Aleksei Shmonin
- First Saint-Petersburg I.P. Pavlov State Medical University, Saint-Petersburg, Russia
| | - Iuly Treger
- Department of Rehabilitation, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gerold Stucki
- ICF Research Branch, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
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Tomaschek R, Gemperli A, Rupp R, Geng V, Scheel-Sailer A. A systematic review of outcome measures in initial rehabilitation of individuals with newly acquired spinal cord injury: providing evidence for clinical practice guidelines. Eur J Phys Rehabil Med 2019; 55:605-617. [DOI: 10.23736/s1973-9087.19.05676-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Maritz R, Baptiste S, Darzins SW, Magasi S, Weleschuk C, Prodinger B. Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning. The Canadian Journal of Occupational Therapy 2018; 85:330-341. [PMID: 30442023 DOI: 10.1177/0008417418797146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND. The International Classification of Functioning, Disability and Health (ICF) can serve as reference for standardized documentation of health in clinical practice. PURPOSE. This study aims to bridge the gap between the ICF and occupational therapy specific concepts, represented by occupational therapy models and their derived assessments. METHOD. Occupational therapy assessments in relation to their models were systematically linked to the ICF, and a compatibility analysis was conducted. To strengthen reliability of the linkings, feedback from the respective assessment hosts was obtained. FINDINGS. Linking tables were developed for the Assessment of Motor and Process Skills, the Canadian Occupational Performance Measure, and the Model of Human Occupation Screening Tool. Similarities and differences between the ICF and the three assessments and their associated models show how they differ from and complement each other. IMPLICATIONS. The findings of this study lay the foundation for standardized documentation in occupational therapy and enhance the practicability of the ICF.
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Administration of assessment instruments during the first rehabilitation of patients with spinal cord injury: a retrospective chart analysis. Spinal Cord 2017; 56:322-331. [PMID: 29259347 DOI: 10.1038/s41393-017-0039-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/26/2017] [Accepted: 11/12/2017] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Retrospective chart analysis. OBJECTIVES To examine which professionals administered which assessment instruments in which patient in clinical practice during first rehabilitation after newly acquired spinal cord injury (SCI) and the differences in the frequencies of different assessments between patient groups. SETTING Specialized SCI acute care and rehabilitation clinic. METHODS Patients after SCI, aged 18 years and above, admitted for first rehabilitation between December 2014 and December 2015 were analyzed. Descriptive statistics of 54 selected assessments. p values based on the χ 2 test were calculated for assessments used in both paraplegic and tetraplegic patients. RESULTS One hundred and nineteen patients were screened. Forty-one assessments were administered, of which 10 on average more than once per patient. The most frequently used assessments were Spinal Cord Independence Measure III (7.7 times per patient), Skin Assessment (3.6 times), and Manual Muscle Test (3.2 times for Lower Extremities; 2.5 times for Upper Extremities). The American Spinal Injury Association Impairment Scale was administered on average 1.9 times per patient. More variation in the number of assessments per patient was observed in patients with complete and incomplete lesions compared to patients with paraplegia and tetraplegia. CONCLUSION Assessments covering neurological functioning, mobility, and self-care are used in clinical practice during first rehabilitation of patients with SCI, while others covering autonomic functioning, pain, participation, or quality of life are still missing. Based on these observations and national and international requirements, a meaningful standard for an assessment toolkit, applicable in general and in specific subgroups, needs to be defined and implemented.
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Lustenberger NA, Prodinger B, Dorjbal D, Rubinelli S, Schmitt K, Scheel-Sailer A. Compiling standardized information from clinical practice: using content analysis and ICF Linking Rules in a goal-oriented youth rehabilitation program. Disabil Rehabil 2017; 41:613-621. [PMID: 28944699 DOI: 10.1080/09638288.2017.1380718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To illustrate how routinely written narrative admission and discharge reports of a rehabilitation program for eight youths with chronic neurological health conditions can be transformed to the International Classification of Functioning, Disability and Health. METHODS First, a qualitative content analysis was conducted by building meaningful units with text segments assigned of the reports to the five elements of the Rehab-Cycle®: goal; assessment; assignment; intervention; evaluation. Second, the meaningful units were then linked to the ICF using the refined ICF Linking Rules. RESULTS With the first step of transformation, the emphasis of the narrative reports changed to a process oriented interdisciplinary layout, revealing three thematic blocks of goals: mobility, self-care, mental, and social functions. The linked 95 unique ICF codes could be grouped in clinically meaningful goal-centered ICF codes. Between the two independent linkers, the agreement rate was improved after complementing the rules with additional agreements. CONCLUSIONS The ICF Linking Rules can be used to compile standardized health information from narrative reports if prior structured. The process requires time and expertise. To implement the ICF into common practice, the findings provide the starting point for reporting rehabilitation that builds upon existing practice and adheres to international standards. Implications for Rehabilitation This study provides evidence that routinely collected health information from rehabilitation practice can be transformed to the International Classification of Functioning, Disability and Health by using the "ICF Linking Rules", however, this requires time and expertise. The Rehab-Cycle®, including assessments, assignments, goal setting, interventions and goal evaluation, serves as feasible framework for structuring this rehabilitation program and ensures that the complexity of local practice is appropriately reflected. The refined "ICF Linking Rules" lead to a standardized transformation process of narrative text and thus a higher quality with increased transparency. As a next step, the resulting format of goal codes supplemented by goal-clarifying codes could be validated to strengthen the implementation of the International Classification of Functioning, Disability and Health into rehabilitation routine by respecting the variety of clinical practice.
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Affiliation(s)
- Nadia A Lustenberger
- a Swiss Paraplegic Centre (SPC) , Nottwil , Switzerland.,b Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,c Department of Health Sciences and Health Policy , University of Lucerne , Switzerland
| | - Birgit Prodinger
- b Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,c Department of Health Sciences and Health Policy , University of Lucerne , Switzerland
| | - Delgerjargal Dorjbal
- b Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,c Department of Health Sciences and Health Policy , University of Lucerne , Switzerland
| | - Sara Rubinelli
- b Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,c Department of Health Sciences and Health Policy , University of Lucerne , Switzerland
| | - Klaus Schmitt
- a Swiss Paraplegic Centre (SPC) , Nottwil , Switzerland
| | - Anke Scheel-Sailer
- a Swiss Paraplegic Centre (SPC) , Nottwil , Switzerland.,c Department of Health Sciences and Health Policy , University of Lucerne , Switzerland
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