Manual for Clinical Practice
E-Book, Englisch, 136 Seiten
ISBN: 978-1-61334-572-6
Verlag: Hogrefe Verlag
Format: EPUB
Kopierschutz: Wasserzeichen (»Systemvoraussetzungen)
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 contexts
This 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.
Zielgruppe
Health care professionals as well as students and teachers.
Autoren/Hrsg.
Fachgebiete
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Physiotherapie, Physikalische Therapie Rehabilitation
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Public Health, Gesundheitsmanagement, Gesundheitsökonomie, Gesundheitspolitik
Weitere Infos & Material
|5|2
Introduction 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 refers to impairments in body functions and body structures, limitations in activities and restrictions in participation. The definitions of these components are presented in Table 1. Although functioning is associated with a health condition (which includes diseases, disorders and injuries), it is not conceptualised as the direct consequence of a health condition but rather as the result of the interaction between a health condition and contextual factors (environmental and personal factors). The interaction among these components is dynamic and bidirectional; changes in one component may influence one or more of the other |6|components. This interaction is depicted in the integrative biopsychosocial model of the ICF as shown in Figure 2.1 Positive Negative Body functions are the physiological functions of body systems (including psychological functions) Impairments are problems in body functions or structures, such as significant deviation or loss Body structures are anatomical parts of the body, such as organs, limbs and their components Activity is the execution of a task or action by an individual Activity limitations are difficulties an individual may have in executing activities Participation is involvement in a life situation Participation restrictions are problems an individual may experience in involvement in life situations Facilitators Barriers Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives and can act as either facilitators or barriers Personal factors are the particular background of an individual’s life and living and comprise features of the individual that are not part of a health condition or health state As depicted in the ICF model, environmental factors play a modifying role in a person’s functioning and disability. Environmental factors can act as barriers (producing or increasing the severity of a disability) or as facilitators (improving or even eliminating a disability).1 Considering |7|this, it is important that environmental factors are taken into account when describing a person’s level of functioning.8,9 With this biopsychosocial model, the ICF contributes to a better understanding of functioning and disability, and offers a comprehensive approach for describing the lived experience of health. This model also serves as the basis for the ICF as a classification. Like all reference classifications in the WHO Family of International Classifications (WHOFIC),10 the ICF provides a standard language, specifically for the description, assessment and reporting of functioning, by classifying all relevant components of functioning and environmental factors. Health conditions (disorders or diseases) are a component of the integrative model of functioning, disability and health, and can be classified using the International Classification of Diseases (ICD) (https://www.who.int/classifications/icd/en/). Since the ICD and the ICF are complementary, users are advised to use them together to describe both the health condition and its impact on a person’s functioning. 2.2 Structure and Codes of the ICF Classification
The ICF classification is arranged hierarchically. See Figure 3. Overall, the classification consists of two parts: (1) functioning and disability and (2) contextual factors, each with two components. Part 1 consists of the components body functions and body structures and activities |8|and participation, and Part 2 consists of environmental factors and personal factors. Although personal factors are included in the integrative model of functioning, disability and health, they are not yet classified in the ICF. Users may assess and describe them in a manner that is suitable for their use. In all of the classified components, chapters represent the first level of the classification. Each chapter is subdivided into the basic elements of the classification, called categories, which are organised in hierarchically arranged second, third and fourth levels. Currently, only body functions and body structures contain fourth-level categories. The codes of chapters and categories constitute the common classificatory language that can be applied across countries, languages, cultures and professions for data collection and comparison. ICF codes are composed of a prefix (“b” for body functions, “s” for body structures, “d” for activities and participation and “e” for environmental factors) followed by a numeric code that consists of one digit for the first or chapter level, two digits for the second level, then one digit for the third and one digit for the fourth level. Consider this example: The hierarchical organisation of the classification allows users to choose either a broader description (e.g., by using a...
