ICF Core Sets E-Book

• Herausgeber: Hogrefe Publishing
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2022

Seitenzahl: 164

Beschreibung

New fully revised edition: - Updated information on 8 new Core Sets and the Generic Sets - Includes ICD-11 codes - New details on the Core Set development process - New section on ICF-based tools - Five detailed case examples More about the book WHO's International Classification of Functioning, Disability and Health (ICF) is the internationally accepted standard for assessing, documenting, and reporting functioning and disability. The ICF Core Sets highlighted in this second edition of the book have been developed to facilitate the standardized use of the ICF in real-life clinical practice. Consequently, they can guide clinical quality management efforts. This edition has been updated to reflect developments in the ICF Core Sets, including updated information on eight new Core Sets and the Generic Sets, the new ICD-11 codes, more details on the Core Set development process, and a new section on ICF-based tools. This manual: - Introduces the concepts of functioning and the biopsychosocial model of the ICF - Describes how and why the ICF Core Sets have been developed - Explains step-by-step an approach for applying the ICF Core Sets in clinical practice - Provides practical tips for clinicians to apply the easy-to-use, comprehensive documentation form - Includes case examples illustrating the assessment of people with different health conditions and in different healthcare contextsThis manual is inherently multi-professional and will be of benefit not only for practitioners working in various healthcare contexts but also for students and teachers.

Leseprobe

ICF Core Sets

Manual for Clinical Practice

2nd edition

Editors

Jerome Bickenbach

Alarcos Cieza

Melissa Selb

Gerold Stucki

About the Authors

Jerome Bickenbach, PhD, LLB, is a steering committee member of the ICF Research Branch. He was involved in the development of the International Classification of Functioning, Disability and Health (ICF) at the World Health Organization (WHO) and regularly consults with WHO on ICF implementation and international disability social policy. Instrumental in establishing the Center for Rehabilitation in Global Health Systems, a WHO Collaborating Centre, at the University of Luzern, he became its first codirector.

Alarcos Cieza, PhD, MPH, was one of the architects of the established and internationally implemented ICF Core Set development process. Subsequently, she took on a leadership role in many ICF Core Set projects and was instrumental in developing ICF Core Set–based data collection and documentation tools.

Todd E. Davenport, DPT, MPH, OCS, has applied the ICF and ICF Core Sets in physical therapy of individuals with musculoskeletal conditions, and teaches ICF-oriented clinical practice guidelines.

Reuben Escorpizo, DPT, MSc, led the development of the ICF Core Set for Vocational rehabilitation (VR) and the corresponding Work Rehabilitation Questionnaire (WORQ). He also collaborated on the validation of various ICF Core Sets.

Monika Finger, PhD, MSc, was involved in developing the ICF Core Set for VR and co-led the development of the WORQ. She has been coordinating its validation and cultural adaptation internationally.

Andrea Glässel, PhD, MSc, MPH, participated in the development and validation of several ICF Core Sets. She has provided ICF training in different health professional degree programs.

Miriam Lückenkemper, MA, was involved in the development and validation of ICF-based measurements, manuals and ICF Core Set for VR.

Alexandra Rauch, Dr. rer. biol. hum., MPH, participated in the development and validation of several ICF Core Sets. She was instrumental in developing ICF Core Set–based documentation tools, including the website https://www.icf-core-sets.org/, and ICF training materials. She also edited the first edition of this book.

Sean D. Rundell, DPT, PhD, MS, has applied the ICF and ICF Core Sets in physical therapy. He conducts epidemiological and health services research into musculoskeletal health conditions.

Melissa Selb, MSc, is the coordinator of the ICF Research Branch. She has been involved in developing several ICF Core Sets and consults on ICF-related projects worldwide, including development of ICF-based tools, conducting ICF training, and supporting ICF implementation worldwide.

Gerold Stucki, MD, MS, as director of the ICF Research Branch, was one of the architects of the ICF Core Set development process. He has worked with WHO and various organisations and professional societies to promote the practical implementation of the ICF and ICF Core Sets in medicine, rehabilitation and the health sector at large, including in clinical routine and clinical quality management. He has led the development of methods for the standardised assessment and reporting of functioning information using the ICF and/or ICF Core Sets.

Library of Congress of Congress Cataloging in Publicationinformation for the print version of this book is available via the Library of Congress Marc Database under the Library of Congress Control Number 2020946492

Library and Archives Canada Cataloguing in Publication

Title: ICF core sets : manual for clinical practice / editors, Jerome Bickenbach, Alarcos Cieza,

Melissa Selb, Gerold Stucki.

Other titles: ICF core sets (2020)

Names: Bickenbach, Jerome Edmund, editor. | Cieza, Alarcos, editor. | Selb, Melissa, editor. |

Stucki, Gerold, editor.

Description: 2nd edition. | Includes bibliographical references and index.

Identifiers: Canadiana (print) 20200340271 | Canadiana (ebook) 20200340433 | ISBN 9780889375727

(softcover) | ISBN 9781616765729 (PDF) | ISBN 9781613345726 (EPUB)

Subjects: LCSH: Human physiology—Classification—Handbooks, manuals, etc. | LCSH: Human anatomy—

Classification—Handbooks, manuals, etc. | LCSH: Disability evaluation—Classification—Handbooks,

manuals, etc. | LCGFT: Handbooks and manuals.

Classification: LCC R123 .I34 2020 | DDC 612.001/2—dc23

©2021byHogrefe Publishing

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|v|Preface

Gerold Stucki

The diagnosis of health conditions and the assessment of an individual’s functioning are at the core of clinical practice. For more than 100 years, health professionals have relied on the World Health Organization (WHO) International Classification of Diseases (ICD) for the diagnosis and classification of health conditions (https://www.who.int/classifications/icd/en/). Since 2001 health professionals have been able to turn to the ICD companion reference classification, the International Classification of Functioning, Disability and Health (ICF) for the assessment and description of functioning.1 The ICD and the ICF are used for health statistics so that mortality, morbidity and functioning (and disability) data can be collected in a uniform and internationally comparable fashion. There are a variety of other uses for these classifications, such as program eligibility and reimbursement. Most importantly, however, the ICF has great potential for enhancing clinical practice by providing a standardised description of functioning by means of ICF-based tools, such as the one described here. Functioning information is central for key aspects of clinical practice: to structure the clinical assessment of functioning, the assignment to health services and health interventions and the management of services and interventions, including outcome evaluation. In this manual, we focus on the description of functioning for which standardisation is of crucial importance, both for consistent practice and for comparable health outcomes.

When the ICF was endorsed by the World Health Assembly in 2001, it represented the outcome of a unique international collaborative exercise that produced not only a paradigm shift in our understanding of functioning and disability, but also a complete reference system that, for the first time, made health and disability information comparable around the globe. Yet, as an exhaustive classification, it was clear that the ICF is not directly usable as a practical tool in daily practice, since clinicians need only a fraction of the categories found in the ICF. Responding to the need for practical ICF-based tools for clinical practice, the ICF Core Set project was initiated soon after its launch.2,3

ICF Core Sets provide health professionals with invaluable tools tailored for specific healthcare areas. In this manual, health professionals will find practical guidance on how to apply ICF Core Sets in their clinical practice in structuring clinical descriptions, and the assessment and reporting of functioning. Although ICF Core Sets are intended for all health practitioners, the emphasis in this manual is on the needs of health professionals who apply the ICF Core Sets in the context of rehabilitation. The manual is inherently multiprofessional and may be used not only by practitioners working in different settings but also by students in the health professions, their teachers and their mentors.

|vi|To facilitate the use of the manual, each chapter can be read on its own. The manual starts with an introduction to the concept of functioning as the lived experience of health. It then provides an introduction to the ICF and the process of developing ICF Core Sets. A chapter outlining the principles that govern an approach for using ICF Core Sets in practice is followed by a series of case examples illustrating this approach in different contexts. To further promote the use of ICF Core Sets in clinical practice, the manual is accompanied by an open access interactive web-based tool (https://www.icf-core-sets.org/). Please see Chapter 9 in this book for more information.

The editors and authors of this manual are enthusiastic about the enormous potential the implementation of the ICF and ICF Core Sets has for improving the understanding of patients’ problems and addressing their needs accordingly. We recognise that this manual would not have been possible without the outstanding effort of health professionals around the world and the indispensable support provided by the Classifications and Terminologies (previously Classification, Terminology and Data Standards) Team at WHO. We wish to commend everyone who has contributed to bringing this manual, now in its 2nd edition, to fruition.

Although the value of the ICF and ICF Core Sets for clinical practice are increasingly being recognised, system-wide implementation continues to be challenging. We would therefore like to encourage users of this manual to support the implementation of the ICF and ICF Core Sets by sharing with the ICF Research Branch their experience with applying the approach outlined in this manual and ICF implementation in general (see https://www.icf-research-branch.org/). Let’s learn from each other!

Contents

Preface

1 What Is Functioning and Why Is It Important?

2 Introduction to the International Classification of Functioning, Disability and Health

2.1 Integrative Model of Functioning, Disability and Health

2.2 Structure and Codes of the ICF Classification

2.3 ICF Qualifiers

3 ICF Core Sets

3.1 ICF Core Set Development Process

3.2 Available ICF Core Sets

4 Use of ICF Core Sets in Clinical Practice

4.1 Selection of ICF Core Sets (“What to Describe”)

4.2 Description of Level of Functioning (“How to Describe”)

4.3 Documentation Form

4.4 Creating a Functioning Profile

5 Case Examples

5.1 Case Example 1: Applying the ICF Core Set for Musculoskeletal Conditions in Acute Care

5.2 Case Example 2: Applying the Comprehensive ICF Core Set for Spinal Cord Injury in Post-Acute Care

5.3 Case Example 3: Applying the ICF Core Set for Multiple Sclerosis in Long-Term Care

5.4 Case Example 4: Applying the ICF Core Set for Vocational Rehabilitation in Long-Term Care

5.5 Case Example 5: Applying the ICF Core Set for Low Back Pain in Long-Term Care

6 References

7 Acknowledgements

8 Key Terms

9 Documentation Online

Peer Commentaries

|1|1What Is Functioning and Why Is It Important?

Jerome Bickenbach

Everyone knows what health is, although we are all a bit vague about it. A researcher who had spent years defining health gave up saying that “it seems to be impossible to devise a concept of health which is rich enough to be nutritious and yet not so rich as to be indigestible”.4 Although the World Health Organization (WHO) definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” is famous (https://www.who.int/about/who-we-are/constitution), when it comes to collecting information about people’s health, assessing patients, planning health interventions and describing the outcomes we want, no one actually uses this definition. To be practical about health information, we need a more concrete notion of “health”. We need to focus on what matters about one’s health. Longevity certainly matters, but for most of us, our health is more about what we can or can not do in our lives. Health, in short, is about how we function in our day-to-day lives. To denote this positive and practical aspect of health, WHO used the term “functioning”, which was the foundation for the International Classification of Functioning, Disability and Health (ICF).

What does WHO mean by functioning? Functioning is the third indicator of health along with mortality and morbidity and the key indicator for rehabilitation.5 The WHO notion of functioning is both narrower and broader than the ordinary English term “functioning”. It is narrower because it only applies to humans, but far broader because it captures all body functions and body structures and everything that people do (actions, tasks, skills) as well as all of the things they are or aspire to be (parents, workers, voters). Functioning can be considered the lived experience of health. In the following chapters, the specific details of how the WHO concept of functioning operates in the ICF will be carefully set out, since these details are crucial for understanding the ICF Core Sets and their application. Here we look only at how WHO intends the concept of functioning to be used.

For WHO, functioning is a set of specific domains of human functioning – once again, body functions and body structures and the things people do and the things people are or aspire to be. These domains of functioning are the items in the ICF classification. Secondly, WHO understands functioning to be a continuous concept – that is, a concept of “more or less”, measurable along a continuum from complete (or total) functioning to complete absence of (or no) |2|functioning. In other words, when people experience difficulties in functioning, the result is “disability”, in the WHO sense of that word. The word “disability” has suffered the plight of being defined in countless different ways, by people concerned about theory as well as practice. Even within the health professions, there is really no consensus about what disability means. It was for that reason that WHO outlined its notion of disability, defining it in terms of functioning – in particular, as the level of functioning that is below a determined threshold along a continuum, for each domain, between completely present and completely absent.

Where that threshold is placed is not the WHO’s decision; it is a matter for science and practice, epidemiology and population-based norms. It is also, it must be said, an economic and political judgment. It is clear, though, that where the threshold for disability lies is left to each country to determine and justify to the community of health professionals and practitioners. Obviously, the complete absence of functioning is disability, so drawing no threshold at all would be impossible to justify. Putting the threshold close to complete functioning, would also be impossible to justify. Thus, the threshold is somewhere in the middle of the continuum, most likely closer to the “complete” absence end. Figure 1 is a graphical depiction, along a continuum, of the relationship between the WHO’s conception of functioning and disability.

Figure 1. Functioning and disability in the International Classification of Functioning, Disability and Health (ICF)

Why should the notion of functioning matter to health professionals? First and foremost, functioning is what matters to the health professionals’ patients. Patients are not so much concerned about knowing medical facts; they want to know if they will be able to walk or see their friends across the street or get a job. All of us think health is important because of how our health affects everything that we do in our lives. Secondly, there is no better description of outcomes of health interventions than improvements in functioning. Finally, we know that problems in functioning can predict both the objective need for health services and the subjective desire for these services. Administratively, therefore, health system planning depends on good information about functioning.

In actual clinical and public health, uses of the WHO notion of functioning meet the challenges of descriptive data collection and analysis. At both the individual and the population levels, functioning describes the outcome of the five main public health strategies: prevention, promotion, cure, rehabilitation and support. We seek to improve functioning, either as a primary outcome (cure and rehabilitation) or as a related outcome (prevention, promotion and palliative care).6 Functioning is also valuable for the clinical assessment of individuals. As we shall show in the following chapters, the ICF functioning framework offers a common terminology |3|and conceptual model for the improvement of clinical and patient-oriented assessment instruments. Thus, for example, the international network Outcome Measures in Rheumatology (OMERACT) has adopted the ICF as the reference model for understanding what to measure when thinking about the lived experience of rheumatoid arthritis.7 The ICF is also the basis for the ICF Core Sets for which this manual provides guidance for use in practice.

|5|2Introduction to the International Classification of Functioning, Disability and Health

Melissa Selb and Alarcos Cieza

In May 2001, the International Classification of Functioning, Disability and Health (ICF) was endorsed by the World Health Assembly. A reference classification of the World Health Organization (WHO), the ICF provides a comprehensive and standardised framework and language for the description, assessment and reporting of functioning and disability.1 As introduced in Chapter 1, functioning is the lived experience of health. To better understand functioning, the ICF offers a multidimensional approach based on the interaction between the components of the person’s intrinsic health capacity (body functions and body structures, activities and participation) and the person’s environment. As a classification, the ICF systematically groups components of functioning and environmental factors, each of which is composed of domains (chapters and blocks) and categories. The classification also provides a system of ICF qualifiers to describe the extent of the problems in functioning – that is, the extent of disability in relevant domains or categories. This chapter introduces the basic concepts of the ICF.

2.1 Integrative Model of Functioning, Disability and Health

Functioning is the umbrella term for the components of body functions, body structures, and activities and participation. Disability