Using the ICF in transition research and practice? Lessons from a scoping review

Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review

PURPOSE

We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs.

METHODS

We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM.

RESULTS

We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity.

CONCLUSION

Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.

Feasibility of Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Framework for Aquatic Activities: A Scoping Review

(1) Background: In recent years, reviewing studies of aquatic activities for children with developmental delays has been a complex task due to the multitude of indices and professional languages. (2) Aim: To determine if the ICF-CY framework can be used as the unifying language in AA studies of children with DD. (3) Methods: Part One-A systematic review of selected studies focusing on goals that were found to be positive. These goals were linked to the ICF-CY categories. Part Two-Review of all studies using the ICF-CY's functioning components. (4) Results: Most of the positive goals were properly linked to ICF-CY and made it possible to review the 71 articles in a uniform language. (5) Conclusions: It is feasible to use the ICF framework as a universal structure and language.

Identification of the needs of children with neurodisability and their families at different stages of development: A qualitative study protocol

BACKGROUND

Within the field of childhood neurodisability, the tendency in the study of needs has been to categorize them based on ability (motor, verbal, cognitive). However, current perspectives such as F-words, family-centered practices, or the principles of family empowerment, lead the researcher to ask: What are these needs according to the stage of development?

METHODS AND ANALYSIS

A descriptive qualitative study will be carried out. Several methods will be followed to ensure the reliability and validity of the results, and the Standards for Reporting Qualitative Research and the Consolidated criteria for reporting qualitative research checklists will also be used to guide the project. Data collection is sought from three main sources: Focus groups (detection of needs), a survey to collect sociodemographic and clinical data necessary to obtain an overview of the context of the participants, and a survey to find out the level of satisfaction with this initiative.

DISCUSSION

The results expected to be obtained after this study will respond to the main needs of families with childhood neurodisability, based on age groups and covering the whole territory of the Spanish population. Thanks to these detected needs, it will be possible to design future lines of work to improve the design of family-centered practices and increase the empowerment of families. The intention is to detect needs by stage of development, which can be categorized within the F-words framework, showing families and professionals a clear picture of the needs of this population.

The International Classification of Functioning, Disability and Health: Accuracy in Aquatic Activities Reports among Children with Developmental Delay

Functioning, as described in the International Classification of Functioning, Disability and Health (ICF), increasingly raises interest in the world of child rehabilitation, especially because its application empowers patients and parents by not putting the emphasis on disability in terms of the medical diagnosis but on the person's lived experience and the level of functioning that might be achieved. However, this requires the correct understanding and application of the ICF framework to overcome differences in the often locally used models or the understanding of disability, including mental aspects. To evaluate the level of accurate use and understanding of the ICF, a survey was performed on studies of aquatic activities in children aged 6-12 with developmental delay published between the years 2010 and 2020. In the evaluation, 92 articles were found that matched the initial keywords (aquatic activities and children with developmental delay). Surprisingly, 81 articles were excluded for not referring to the ICF model at all. The evaluation was performed by methodological critical reading according to the ICF reporting criteria. The conclusion of this review is that despite the rising awareness in the field of AA, the ICF is used inaccurately and often not according to the model's biopsychosocial principles. For the ICF to become a guiding tool in evaluations and goal-setting for aquatic activity, the level of knowledge and understanding of the framework and language needs to be increased via curricula and studies on the effect of interventions on children with developmental delay. Even more so, the level of understanding on how to apply functioning among instructors and researchers working in the aquatic environment needs to be increased.

Body Function and Structure, Activity, and Participation Limitations of Lung Transplant Recipients Within the Scope of the International Classification of Functioning, Disability, and Health

OBJECTIVES

There is no study in the literature that specifically evaluates lung transplant recipients in the long-term under the framework of the International Classification of Functioning, Disability, and Health. The aim of this study was to evaluate the relationships between lung transplant recipient age, age at transplant, and comorbidity levels and the body structure and functions and the activity and participation levels of patients within the scope of the International Classification of Functioning, Disability, and Health.

MATERIALS AND METHODS

We evaluated 27 lung transplant recipients according to the International Classification of Functioning, Disability, and Health items in domain b (body functions), domain s (body structures), and domain d (activities and participation). For domain b, sleep functions, psychosocial status, respiratory functions, and upper and lower extremity exercise capacity were evaluated. Posture was evaluated for the s domain. Balance, arm functional capacity, health-related quality of life, and physical activity were evaluated for domain d.

RESULTS

As the age of lung transplant recipients and the age at transplant increase, their sleep quality and respiratory functions decreased, and postural impairment increased. There was a negative correlation between age at transplant and functional exercise capacity (P < .05). As the comorbidity level of the recipient increases, the upper and lower extremity exercise capacity, physical activity level, and quality of life declined. There was a moderately positive correlation between the level of comorbidity and balance disorder (P < .05).

CONCLUSIONS

We found the International Classification of Functioning, Disability, and Health framework to be useful for the evaluation and for planning pulmonary rehabilitation for lung transplant recipients; it can bring a new perspective to physiotherapists specialized in cardiopulmonary rehabilitation.

Personal factors understood through the Ecological-Enactive Model of Disability and implications for rehabilitation research

The International Classification of Functioning, Disability and Health (ICF) recognizes that disability arises from the interaction between an individual with a medical condition and the context in which they are embedded. Context in the ICF is comprised of environmental and personal factors. Personal factors, the background life and lifestyle of an individual, are poorly understood in rehabilitation. There is limited knowledge about how personal and environmental factors interact to shape the contextual conditions critical for explaining functioning and disability. In this paper, we explore how a newly proposed model of disability, the Ecological-Enactive Model of Disability, can enhance understanding of personal factors across multiple rehabilitation disciplines. We draw from a review of evidence and phenomenological interviews of individuals with Friedreich's Ataxia. We consider the practical impact of this understanding on disability and rehabilitation research and pathways for the future focusing on representative design.

Adjusting the family's life: A grounded theory of caring for children with special healthcare needs in rural areas, Thailand

This study aims to understand the experiences of families of children with special healthcare needs in rural areas in Thailand. Grounded theory (GT) was employed to understand families' experiences when caring for children with special healthcare needs (CSHCN) in rural areas. Forty-three family members from thirty-four families with CSHCN participated in in-depth interviews. Interviews were recorded and transcribed. The constant comparative method was used for data analysis and coding analysis. Adjusting family's life was the emergent theory which included experiencing negative effects, managing in home environment, integrating care into a community health system, and maintaining family normalization. This study describes the process that families undergo in trying to care for CSHCN while managing their lives to maintain a sense of normalcy. This theory provides some intervention opportunities for health care professionals when dealing with the complexities in their homes, communities and other ambulatory settings throughout the disease trajectory, and also indicates the importance of taking into consideration the family's cultural background.

ICF Personal Factors Strengthen Commitment to Person-Centered Rehabilitation – A Scoping Review

Background: The International Classification of Functioning, Disability and Health (ICF) classification is a biopsychosocial frame of reference that contributes to a holistic understanding of the functioning of a client and the factors involved. Personal factors (PFs) are not currently classified in the ICF due to large societal and cultural diversity and lack of clarity in the scope of such factors.

Aims: To ascertain which factors in the ICF classification have been defined as PFs in different studies and what conclusions have been drawn on their role in the ICF classification.

Methods: The study was a scoping review. A systematic search for articles published in 2010–2020 was performed on the Cinahl, Pubmed, ScienceDirect, and Sport Discus databases. The PFs specified in the articles were classified according to the seven categories proposed by Geyh et al. socio-demographic factors; position in the immediate social and physical context; personal history and biography; feelings; thoughts and beliefs; motives; and general patterns of experience and behavior.

Results: The search yielded 1,988 studies, of which 226 met the inclusion criteria. The studies had addressed a wide variety of PFs that were linked to all seven categories defined by Geyh et al. Some studies had also defined PFs that were linkable to other components of the ICF or that did not describe functioning. Approximately 22% (51) of the studies discussed the role of PFs in rehabilitation.

Conclusions: The range of PFs in the ICF classification addressed in the reviewed studies is wide. PFs play an important role in rehabilitation. However, according to the reviewed studies, a more precise coding of PFs is not yet warranted.

Functional activities habits in chronic stroke patients: A perspective based on ICF framework

BACKGROUND

Functional autonomy and social inclusion are of key importance for stroke patient's rehabilitation.

OBJECTIVE

To evaluate activity and participation of chronic stroke patients by means of basic (BADL), instrumental (IADL) and social (SADL) activities of daily living.

METHODS

Forty individuals, 24 patients and 16 healthy individuals fill in a functional activities habits questionnaire.

RESULTS

Regarding BADL, 25% of the patients did not get out of bed and 70.8% did not use toilet by themselves. Considering IADL, 29.2% of the patients did not dial the telephone, 70.8% did not wash dishes and clothes, 58.3% did not cook, 100% did not sew, 87.5% did not carry out repairs, 41.7% did not go to the bank, 54.2% did not shop and 45.8% did not write (all p < 0.05). Regarding SADL, 87.5% of the patients were not working professionally, 41.7% did not visit friends or relatives, 75% did not travel and go to the beach and 95.8% did not dance (all p < 0.05).

CONCLUSIONS

Chronic stroke patients have limitations in activity and restrictions to participation, even after few years of stroke onset, particularly regarding applying knowledge, use of communication devices, domestic life, major life areas and community, social and civic life.

Exploring the international uptake of the "F-words in childhood disability": A citation analysis

BACKGROUND

The "F-words in childhood disability" (function, family, fitness, fun, friends, and future) were introduced in a concept paper in 2012 entitled, "The F-words in childhood disability: I swear this is how we should think!". The "F-words" are grounded in, and aim to operationalize, the World Health Organization's (World Health Organization, 2001) International Classification of Functioning, Disability and Health (ICF) framework. A citation analysis was conducted to explore the extent of research uptake of the "F-words" concepts.

METHODS

Three databases-Google Scholar, Wiley Online, and Web of Science-were searched from July 2012 to December 2018 for sources that cited the original F-words paper. Dates of publication and countries of first authors were extracted from all cited articles, and a taxonomy was developed to categorize the type of usage.

RESULTS

The search yielded 157 sources from 26 countries, and the number of citations has continued to increase since the paper's publication. Sources were placed into three categories: cited/referenced (n = 109; i.e., the paper was simply cited), integrated/informed (n = 36; i.e., the F-words were stated within the text), and non-English (n = 12). Of the 36 integrated/informed sources, 34 (94.4%) applied the F-words to the ICF framework and five themes emerged with respect to the use of the F-words: (a) support of a holistic approach to childhood disability, (b) association of the F-words to physical activity and rehabilitation, (c) application and measurement of quality of life, (d) F-words research team-related papers, and (e) "other" category.

CONCLUSION

This citation analysis shows that the F-words are mainly being used to operationalize the ICF, support a holistic approach to childhood disability, and inform physical activity and rehabilitation-based interventions. These perspectives will play an important role in informing the next steps with respect to moving the F-words into research and practice.