ICF Core Sets for the assessment of functioning of adults with cerebral palsy

Assessing the Adequacy of the Physical, Social, and Attitudinal Environment to the Specific Needs of Young Adults With Cerebral Palsy: The European Adult Environment Questionnaire

OBJECTIVES

To present the development of the European Adult Environment Questionnaire (EAEQ), to assess to what extent it covers the International Classification of Functioning, Disability and Health (ICF), and to describe the adequacy of the physical, social, and attitudinal environment to the specific needs of young adults with cerebral palsy (CP).

DESIGN

Cross-sectional.

SETTING

Administrative regions in France, Germany, Italy, Portugal, and Sweden.

PARTICIPANTS

Young adults with CP (N=357), with varying severity profiles, aged 19-28 years at time of interview (2018-20).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE(S)

Physical, social, and attitudinal environment unmet needs.

RESULTS

Relevant environmental factors (EFs) for young adults with CP were identified during focus groups in England and Portugal. EFs were mapped to the ICF environmental classification and the EAEQ analytical structure resulted from this linking procedure. It comprised 61 items, linked to 31 ICF environmental classification categories, and covered 4 of its 5 chapters. Content validity assessed with the bandwidth index (percentage coverage of ICF Core Sets for adults with CP) was satisfactory (79.3%). A descriptive analysis was carried out. Participants had a mean age of 24 years, 56% were men, 38% had severely limited mobility. Less than 16% reported unmet needs for EFs relating to home, college/work/day placement, and communication in the Products and technology chapter. Unmet needs were higher (>20%) for the other items in the Public use and Land development categories. Social support, attitudes, and understanding of relatives were often adequate to the participants' needs. The proportion of unmet needs varied by sex (women were more often concerned) and raised with increasing gross motor impairment.

CONCLUSION

The EAEQ describes in detail the adequacy of the environment to the specific needs of young adults with CP. Its ICF-based structure opens up possibilities for use in a universal conceptual framework.

Revision of the brief international classification of functioning, disability and health core set for multiple sclerosis: a study of the comprehensive icf core set for multiple sclerosis with participants referred for work ability assessment

OBJECTIVE

To evaluate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for multiple sclerosis with regard to the Brief ICF Core Set for multiple sclerosis.

DESIGN

Descriptive cross-sectional single-centre study.

SUBJECTS

A total of 151 participants (99 females/52 males, mean age 49 years) referred for work ability assessment.

METHODS

Data were collected from clinical recordings and by telephone interview.

RESULTS

Among 33 Body Functions, 14 were impaired in over 60% of the participants, and 6 in over 75%. These 6 most impaired functions were related to exercise tolerance (b455), urination (b620), muscle power (b730), motor reflex (b750), control of voluntary movement (b760) and gait pattern (b770). Among 54 Activities and Participation categories, 8 were impaired in over 60% of the participants, and 3 were impaired in over 75%. The latter activities were related to walking (d450), moving around (d455) and moving around using equipment (d465). Among the 36 Environmental categories, most were facilitators, except for temperature (e2250) and employment (e590). The latter category was both a facilitator and a barrier.

CONCLUSION

These results suggest additional categories that should be included into the Brief ICF Core Set, to improve its representation of the complex disability of multiple sclerosis.

A postpartum functional assessment tool for women based on the international classification of functioning, disability and health

BACKGROUND

Postpartum dysfunctions and complications can occur in women. However, functional assessment should be conducted to make treatment plans before any intervention is implemented. In this context, the International Classification of Functioning, Disability and Health (ICF) may be a useful tool for women postpartum to document functional data and set rehabilitation goals. The purpose of this study was to determine the corresponding domains that should be considered in the evaluation of women's postpartum functioning based on the International Classification of Functioning, Disability and Health (ICF) model using the Delphi method.

METHODS

Fifteen domestic experts were invited to conduct two rounds of expert consensus survey on the ICF-based postpartum functional assessment category pool obtained through literature retrieval, clinical investigation, and reference to relevant literature. The sample was medical staff with professional knowledge of women's health. The opinions of experts were summarized, and the positive coefficient, authority coefficient and coordination degree of experts were calculated.

RESULTS

A total of 15 domestic experts participated in this expert consensus. Through two rounds of a questionnaire survey, 69 items were finally selected to form the ICF-based postpartum functional assessment tool for women. The items included 32 items of body function, 12 items of body structure, 17 items of activity and participation, and 8 items of environmental factors. In addition, we identified 8 items of personal factors. The expert positive coefficients of the two rounds of expert consensus were both 100%, the authority coefficient was 0.789, and the coefficient of variation was between 0.09 to 0.31.

CONCLUSION

A postpartum functional assessment tool for women based on the ICF model was constructed based on the Delphi method, which can provide more comprehensive health management and life intervention for postpartum women.

TRIAL REGISTRATION

The Registration number of the Chinese Clinical Trial Registry is ChiCTR2200066163, 25/11/2022.

Factors influencing sustainable employment of persons with acquired brain injury (ABI) or spinal cord injury (SCI): A qualitative study evaluating the perspective of health and work professionals

Background

The number of persons with acquired brain injury (ABI) or spinal cord injury (SCI) who leave the labor market early despite successfully return to work post-injury, demonstrates the challenge for them to remain employed. Evidence on how enabling and hindering factors influence daily work across the lifespan and how they affect employment-related services is scarce. Professionals directly involved in work integration can add to this evidence through their experiential knowledge.

Purpose

To identify and explore the factors that enable or hinder sustainable employment for persons with ABI or SCI from the perspective of health and work professionals.

Methods

We conducted 23 semi-structured interviews with professionals in Switzerland, directly involved in work reintegration and retention of persons with ABI or SCI. Interviews were transcribed verbatim and thematically analyzed.

Results

Participants identified three main themes related to the concept of "sustainable employment". First, the value and impact of initial work integration; an early, multidisciplinary, person-centered work integration, with the early involvement of employers is ideal. A good match between the worker and the workplace is sought. Second, critical factors for long-term sustainable work: the main risks for persons with ABI are changing supervisors, workplace restructuring and the introduction of new technologies, while deteriorating health and the occurrence of secondary health problems are the greatest risk for persons with SCI. Third, the relevance of knowledge, experience and attitudes of professionals; Knowledge of the consequences of an ABI or SCI, the legal basis and the social security process, and the attitude of professionals towards the injured worker were considered important.

Conclusions

From the professional's perspective, enabling and hindering factors for sustainable employment in the long-term are fundamentally very similar for persons with ABI and SCI. But different physical, mental and neuropsychological effects call for individually adapted measures. While persons with SCI primarily require ongoing medical care, conscious management of changes in the workplace is critical for persons with ABI. For both groups, an easily accessible counseling and support service should be established for work-threatening problems in the long-term. Furthermore, diagnosis-specific training programs for professionals of employment-related services and disability management should be developed.