1
|
Borysova I, Fesenko A, Fesenko H, Potapova T, Kirichenko A, Chub D. International classification of functioning, disability and health with long-term consequences of cranio-brain injury. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:29-34. [PMID: 38431804 DOI: 10.36740/wlek202401104] [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: 03/05/2024]
Abstract
OBJECTIVE Aim: To describe health status and related functioning of patients with different severity of traumatic brain injury (TBI) in past medical history in Ukraine and determining the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for TBI. PATIENTS AND METHODS Materials and Methods: A total of 102 patients, who were treated in the neurological department of Dnipropetrovsk regional clinical hospital and State Institution ≪Ukrainian State Scientific Research Institute of Medical and Social Problems of Disability of Health Ministry of Ukraine≫, had been examined. Patients were divided into three groups: mild, moderate and severe TBI in past history and evaluated using ICF Brief Core Set for TBI. RESULTS Results: Тhe most common problems in the functioning and health of patients in remote period of TBI, along with the influencing factors have been identified in the study. The most frequent categories from ≪Body Functions≫ and ≪Activity and Participation≫ sections in which patients had alterations were: memory functions, emotional functions, sensation of pain, functions of attention, brain structure, complex interpersonal interactions, family relationships. The increase in the amount and severity of disturbances with increasing severity of TBI had been established in all categories, except complex interpersonal interactions and family relationships. CONCLUSION Conclusions: Patients of all groups identified the family and close relatives, healthcare service and social welfare services, as the most frequent relieving factors of life activity. The use of the ICF Brief Core Set for assessing the subjects with TBI in past history provides a convenient procedure to standardize and structure functioning description. Information collected by the ICF Brief Core Set may be used for different purposes: clinical assessment, administration of medical services, planning and implementation of rehabilitation and evaluation of results, in scientific research, reports and health care statistics.
Collapse
Affiliation(s)
| | | | | | | | - Alla Kirichenko
- STATE INSTITUTION SCIENTIFIC RESEARCH INSTITUTE OF MEDICAL AND SOCIAL PROBLEMS OF DISABILITY, DNIPRO, UKRAINE
| | - Daria Chub
- DNIPRO STATE MEDICAL UNIVERSITY, DNIPRO, UKRAINE
| |
Collapse
|
2
|
Tarvonen-Schröder S, Koivisto M. World Health Organization Disability Assessment Schedule versus Functional Independence Measure in Traumatic Brain Injury. J Rehabil Med 2023; 55:jrm16274. [PMID: 38032144 DOI: 10.2340/jrm.v55.16274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE In patients with traumatic brain injury, to compare functioning measured using the 12-item patient and proxy World Health Organization Disability Assessment Schedule (WHODAS-12) with assessments made by professionals. PATIENTS AND METHODS At discharge from rehabilitation, 89 consecutive patients with traumatic brain injury (10 mild, 36 moderate, 43 severe) and their proxies completed the WHODAS-12. Professionals assessed functioning simultaneously using the WHO minimal generic set of domains of functioning and health and Functional Independence Measure (FIM). RESULTS From mild to severe traumatic brain injury, increasing disability was found in: sum, component and item scores of patient and proxy WHODAS, except for emotional functions in patients' ratings; in sum and item scores of the WHO minimal generic data-set, except for pain; and in FIM total score and sub-scores. The WHODAS participation component was more impaired than activities. Although proxies rated functioning more impaired than patients, the correlation between patient and proxy WHODAS was strong (0.74). The correlation between patient/proxy WHODAS and FIM was also strong (-0.56 and -0.78, respectively). Proxy WHODAS differentiated mild and moderate traumatic brain injury more accurately than the other assessments. CONCLUSION We recommend using the WHODAS-12 when planning patient- and family-oriented rehabilitation services after traumatic brain injury.
Collapse
Affiliation(s)
- Sinikka Tarvonen-Schröder
- Neurocenter, Turku University Hospital, Turku, Finland and Clinical Neurosciences, University of Turku, Turku, Finland; Finnish Institute for Health and Welfare, Finland.
| | - Mari Koivisto
- Department of Biostatistics, University of Turku, Turku, Finland
| |
Collapse
|
3
|
Simpson G, Coxe Hyzak KA, Hawley L, Vunkhanching M, Mantell A. Psychosocial assessment in brain injury: An international social work survey. Brain Inj 2023; 37:517-524. [PMID: 36876993 DOI: 10.1080/02699052.2023.2183258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To survey social workers in the field of traumatic brain injury (TBI)/acquired brain injury (ABI) about their practice in conducting psychosocial assessments. Design: A cross-sectional quality assurance study. DESIGN A cross-sectional quality assurance study. PARTICIPANTS Social workers from professional social work rehabilitation networks spanning Sweden, the United Kingdom, North America, and Asia Pacific regions. MEASURE Purpose-designed survey comprising closed and open items, organized into six sections and administered electronically. RESULTS The 76 respondents were mainly female (65/76, 85.5%) from nine countries (majority from Australia, United States, Canada). Two-thirds of respondents were employed in outpatient/ community settings (51/76, 67.1%), with the balance working in inpatient/rehabilitation hospital settings. Over 80% of respondents conducted psychosocial assessments, with the assessments informed by a systemic focus, situating the individual within their broader family and societal networks. The top five issues identified in inpatient/rehabilitation settings were housing related needs, informed consent for treatment, caregiver support, financial issues and navigating the treatment system. In contrast, the leading issues identified in community settings related to emotional regulation, treatment resistance and compliance issues, depression, and self-esteem. DISCUSSION Social workers assessed a broad range of psychosocial issues spanning individual, family, and environmental contextual factors. Findings will contribute to future development of a psychosocial assessment framework.
Collapse
Affiliation(s)
- Grahame Simpson
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia.,Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | | | - Lenny Hawley
- Research Department, Craig Hospital, Englewood, Colorado, USA
| | | | | |
Collapse
|
4
|
Kjeldsen SS, Brodal L, Brunner I. Activity and rest in patients with severe acquired brain injury: an observational study. Disabil Rehabil 2020; 44:2744-2751. [PMID: 33161752 DOI: 10.1080/09638288.2020.1844317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine activity levels, types of activities and their distribution across the day in patients with severe acquired brain injury including disorders of consciousness admitted to subacute neurorehabilitation. METHODS In this observational cross-sectional study, a modified behavioural mapping tool was used to document activity of patients admitted to a specialized rehabilitation ward for three consecutive days from 8.00 am to 8.00 pm. Observers walked a fixed route and returned to each patient every 10 min. RESULTS Complete data was obtained in 1722/1728 observations on eight patients. Patients were registered as being in any activity in 55.6% and resting or sleeping in 30.3% of all observations. Patients were alone for 50.4% and were lying or sitting for 98.5% of the time. The major part (45%) of rehabilitation activities occurred during the morning before noon. The odds of being engaged in a rehabilitation activity were significantly different from afternoon and evening p = 0.02. Patients with higher function were more active. CONCLUSION Patients with severe ABI were involved in some kind of activity for more than half the day and resting approximately 1/3 of the day. Health personnel and visitors were present in most activities.Implications for rehabilitationRehabilitation of patients with severe acquired brain injury (ABI) comprises a high level of a broad range of activities and interactions.In order to truly offer round the clock rehabilitation, rehabilitation hospitals need to focus on delivering rehabilitation activities evenly across the waking hours.The long periods of daytime sleep and rest in patients with severe ABI should be further examined as there might be a potential to intensify rehabilitation.
Collapse
Affiliation(s)
- Simon S Kjeldsen
- Hammel Neurocenter and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - Liv Brodal
- Department of Physiotherapy, Faculty of Health Science, VIA University College, Aarhus, Denmark
| | - Iris Brunner
- Hammel Neurocenter and University Research Clinic, Aarhus University, Aarhus, Denmark
| |
Collapse
|
5
|
van Ierssel J, O'Neil J, Sveistrup H, Marshall S, Graham I. A qualitative study of persons with persistent postconcussion symptoms and clinicians with concussion expertise to inform the development of a concussion-specific questionnaire. Disabil Rehabil 2020; 43:3365-3376. [PMID: 32223453 DOI: 10.1080/09638288.2020.1743772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the experiences of adults with persistent postconcussion symptoms and clinicians to inform the development of a concussion-specific questionnaire. METHODS Using a qualitative descriptive design, we conducted 10 focus groups with persons with persistent post-concussion symptoms (n = 35; female 66%; age range 19.0-65.1 years) and semi-structured interviews with clinicians with concussion expertise (n = 16; female 81%). Thematic analysis was used to identify themes within their narratives. The International Classification of Functioning, Disability and Health (ICF) provided a standardized language for coding. RESULTS Three overarching themes emerged from the data: Functioning, Environmental and Personal Factors, and Capacity. Functioning mapped closely onto Activities and Participation within the ICF. Contextual factors, both Environmental and Personal, had a significant influence on functioning following concussion. Capacity was a unique finding that described how long a person is able to engage in a task before the onset or worsening of symptoms. CONCLUSIONS Capacity is fundamental to measuring limitations in functioning based on symptom threshold and time to recovery. The impact of contextual factors on functioning needs to be considered on a continuum from barrier to facilitator. These findings provide the basis for the development of a concussion-specific questionnaire.Implications for RehabilitationClinicians should explore with their patients limitations across all areas of functioning.Clinicians should explore and address support and relationships, attitudes of others, access to affordable and high-quality healthcare, coping strategies, and a patient's own knowledge of concussion as these influence functioning.Current guidelines recommend a symptom-based approach to concussion management, whereas persons with concussion emphasize the importance of measuring functional capacity.Capacity is defined as the length of time one can perform a task before symptom onset, primarily fatigue.Currently, no concussion-specific measure of functioning exists.
Collapse
Affiliation(s)
- Jacquie van Ierssel
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jennifer O'Neil
- School of Rehabilitation Science, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Heidi Sveistrup
- School of Rehabilitation Science, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Shawn Marshall
- Division of Physical Medicine and Rehabilitation, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,School of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ian Graham
- Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
6
|
Radhakrishnan S, Kohler F, Gutenbrunner C, Jayaraman A, Pieber K, Li J, Schiappacasse C. Mobility in persons with lower extremity amputations and influencing factors: Using the International Classification of Functioning, Disability and Health to quantify expert views. Prosthet Orthot Int 2019; 43:88-94. [PMID: 30095358 DOI: 10.1177/0309364618792714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: International Classification of Function, Health and Disability provides a common framework and universal language for rehabilitation professionals across the globe. OBJECTIVES: To identify problems in functioning and mobility relevant to persons with lower-limb amputation from an expert's point of view and quantify these problems using the International Classification of Function, Health and Disability. STUDY DESIGN: Qualitative study using electronic and paper surveys. METHODS: Electronic or paper survey was done across six countries targeting clinicians involved in pre- and post-amputation care. Meaningful concepts were extracted from the responses and linked to suitable second-level and where applicable third-level International Classification of Function, Health and Disability categories. Categorical frequency analysis was completed for the combined data and for each location. RESULTS: A total of 183 experts from 6 different countries responded to the survey. A total of 2171 concepts were identified, 82% of which could be linked to a second-level International Classification of Function, Health and Disability category. The categorical frequency analysis revealed that the categories of walking, design and construction of buildings for public and private use and sensation of pain were the most frequently occurring concepts and was similar across the six countries. CONCLUSION: The International Classification of Function, Health and Disability can be utilised as a common framework for communication among clinicians involved in rehabilitation of persons with lower-limb amputation across the globe. The most important factors that were identified by experts in amputee rehabilitation working in different international locations were similar. CLINICAL RELEVANCE The challenges faced by the clinicians involved in care of persons with lower extremity amputation vary across different parts of the world. The overarching goal for the clinician irrespective of the location is to improve mobility and quality of life of their clients. The International Classification of Function, Health and Disability provides a common language between the various stakeholders in amputee rehabilitation across the globe.
Collapse
Affiliation(s)
- Seema Radhakrishnan
- 1 Department of Rehabilitation Medicine, Braeside Hospital, Wetherill Park, NSW, Australia.,7 University of New South Wales, Sydney, Australia
| | - Friedbert Kohler
- 1 Department of Rehabilitation Medicine, Braeside Hospital, Wetherill Park, NSW, Australia.,7 University of New South Wales, Sydney, Australia
| | | | | | | | - Jianin Li
- 5 The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | |
Collapse
|
7
|
Robertson CMT, DeForge SM, Dosman CF. Goal setting within a tertiary-level early developmental intervention program. Paediatr Child Health 2017; 22:184-189. [PMID: 29479211 PMCID: PMC5804939 DOI: 10.1093/pch/pxx043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine the domains of parent-therapist collaboratively set goals for intervention within a family-centered, tertiary-level early developmental intervention (EDI) program. To report changes in ratings for performance and satisfaction of performance pre- and postintervention for the set goals. METHODS This study includes all children with complex developmental disabilities (30 ± 3 months of age, 61% boys) registered in a tertiary-level EDI program from 2009 to 2012 whose parents completed the Canadian Occupational Performance Measure (COPM) to evaluate goal setting. The International Classification of Functioning, Disability and Health: Children & Youth version (ICF-CY) domain for each goal was recorded. Pre- and postintervention ratings for individual and averaged goals per child were calculated. Positive changes in ratings were determined by an increase of ≤2 and presented as a proportion and as means (standard deviation). Student t test, Fisher Exact and chi-square tests compared groups. RESULTS Of 483 individual goals set for 168 children, 65.4% were in the ICF-CY activity domain, 16.4% participation, 10.3% body function, 7.4% environment and 0.4% body structure. Positive changes in ratings for performance occurred in 70%; for satisfaction, 68%, with no difference in relation to domain. Positive changes in average ratings per child showed: performance, 67%; satisfaction, 66%. CONCLUSION Intervention goals for disabled children within tertiary-level EDI are primarily those of activity, not participation as ICF-CY recommends; two-thirds of goals show positive change. These results suggest the need for further evaluation of goal setting within EDI programs with the expectation of increasing goals of participation and improving ratings for performance and satisfaction.
Collapse
Affiliation(s)
- Charlene M T Robertson
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| | - Shannon M DeForge
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| | - Cara F Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, Alberta
| |
Collapse
|
8
|
Barrios M, Guilera G, Selb M, Gómez-Benito J. Identification of problems in the functioning of individuals with schizophrenia from the expert perspective: an Internet-based survey. Disabil Rehabil 2016; 39:2055-2062. [PMID: 27712119 DOI: 10.1080/09638288.2016.1217073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of the study was to identify aspects of functioning and related environmental factors that are relevant to schizophrenia from the perspective of health professionals experienced in treating individuals with this disorder using the International Classification of Functioning, Disability and Health (ICF). METHOD An international pool of experts from diverse health care disciplines was surveyed to identify problems in functioning experienced by individuals with schizophrenia and the environmental factors that impact their functioning. On the basis of established rules, all answers were translated to the ICF by two independent researchers. RESULTS One-hundred and eighty-nine experts from all six World Health Organization regions identified 4776 meaningful concepts, of which 92% were linked to 347 different ICF categories. Of the 347 categories, 194 were second-level categories, 151 were third-level categories and 2 were fourth-level categories. Ninety-five second-level ICF categories, 43 third-level categories and 1 fourth-level category reached percentage frequency of at least 5%. The majority of the categories were attributed to body functions, activities and participation, and environmental factors. CONCLUSIONS Health professionals identified a wide range of problems in functioning that reflect the complexity and breadth of schizophrenia, specifically activity limitations and participation restrictions that are particularly relevant for individuals with schizophrenia. Knowing these functioning problems can guide the design of patient-oriented rehabilitation programmes. Implications for rehabilitation Schizophrenia may result in impaired functioning in multiple daily life activities. The International Classification of Functioning, Disability and Health (ICF) can help in identifying the needs and problems of these individuals. The reported list of ICF categories can facilitate a systematic application of the ICF in schizophrenia and can help to design and implement coordinated and patient oriented rehabilitation programmes with a biopsychosocial approach. According to health professionals surveyed, activity limitations and participation restrictions are broadly affected in this population and are highly influenced by neurocognitive and social cognitive deficits and environmental factors.
Collapse
Affiliation(s)
- Maite Barrios
- a Department of Behavioral Sciences Methods , University of Barcelona , Barcelona , Spain.,b Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona , Barcelona , Spain
| | - Georgina Guilera
- a Department of Behavioral Sciences Methods , University of Barcelona , Barcelona , Spain.,b Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona , Barcelona , Spain
| | - Melissa Selb
- c ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI) , Nottwil , Switzerland.,d Swiss Paraplegic Research , Nottwil , Switzerland
| | - Juana Gómez-Benito
- a Department of Behavioral Sciences Methods , University of Barcelona , Barcelona , Spain.,b Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona , Barcelona , Spain
| |
Collapse
|