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Sakamoto D, Hamaguchi T, Nakayama Y, Hada T, Abo M. Upper-Limb Functional Recovery in Chronic Stroke Patients after COVID-19-Interrupted Rehabilitation: An Observational Study. J Clin Med 2024; 13:2212. [PMID: 38673485 PMCID: PMC11050468 DOI: 10.3390/jcm13082212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: Upper-limb function of chronic stroke patients declined when outpatient rehabilitation was interrupted and outings restricted, owing to the novel coronavirus infection (COVID-19) pandemic. We investigated whether these patients recovered upper-limb function post-resumption of outpatient rehabilitation. Methods: In this observational study, 43 chronic stroke hemiparesis patients with impaired upper extremity function were scored for limb function via the Fugl-Meyer assessment of the upper extremity (FMA-UE) and the Action Research Arm Test (ARAT) after a structured interview, evaluation, and intervention. Scores at 6 and 3 months pre- and 3 months post-rehabilitation interruption were examined retrospectively; scores immediately and at 3 and 6 months post-resumption of care were examined prospectively. The amount of change for each time period and an analysis of covariance were performed with time as a factor, changes in the FMA-UE and the ARAT scores as dependent variables, and statistical significance at 5%. Results: The time of evaluation significantly impacted the total score, as well as part C and part D of FMA-UE and total, pinch, and gross movement of the ARAT. Post-hoc tests showed that the magnitude of change in limb-function scores from immediately to 3 months post-resumption was significantly higher than the change from 3 months pre- to immediately post-interruption for the total score and part D of the FMA-UE, as well as grip and gross movement of the ARAT (p < 0.05). Conclusions: Upper-limb functional decline in chronic stroke patients, caused by the COVID-19 pandemic-related therapy interruption and outing restrictions, was resolved approximately 3 months post-resumption of rehabilitation therapy. Our data can serve as reference standards for planning and evaluating treatment for chronic stroke patients with inactivity-related impaired upper-limb function.
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Affiliation(s)
- Daigo Sakamoto
- Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital, Tokyo 105-8471, Japan;
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Saitama 343-8540, Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Saitama 343-8540, Japan
| | - Yasuhide Nakayama
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (Y.N.); (T.H.)
| | - Takuya Hada
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (Y.N.); (T.H.)
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (Y.N.); (T.H.)
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Scalvini S, Olivares A, Giardini A, Comini L, Zanelli E, Corica G, Tarro Genta F. ICF framework in cardiac rehabilitation: a real-life implementation in post-cardiac surgery and chronic heart failure patients. Eur J Phys Rehabil Med 2023; 59:605-614. [PMID: 37377129 PMCID: PMC10664764 DOI: 10.23736/s1973-9087.23.07666-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND The International Classification of Functioning, Disability, and Health (ICF) is growing in importance in cardiac rehabilitation (CR) as the number of elderly comorbid patients increases. AIM To classify through the ICF framework a group of post-cardiac surgery (CS) and chronic heart failure (CHF) patients undergoing rehabilitation. Then, to compare the two groups and identify possible factors at admission that could affect ICF evaluations at discharge. DESIGN Observational retrospective real-life study. SETTING Two inpatient CR units. POPULATION Consecutive CS and CHF patients admitted for CR (January-December 2019). METHODS Clinical, anthropometric data and functional status at admission and discharge were extracted from patient health records. A set of 26 ICF codes regarding body functions (b) and activities (d) was analyzed to identify: 1) the qualifiers attributed (from 0=no impairment to 4=severe impairment) for each code, 2) the percent distribution of qualifiers (0/1/2/3/4) attributed per patient. We then evaluated changes in both (1) and (2 - defined as ICF Delta%) from admission to discharge. RESULTS All patients (55% males; mean age 73±12 years) showed an improvement post-rehabilitation in the ICF qualifiers attributed (P<0.0001 for all codes). CS patients (N.=150) were less functionally impaired at admission than CHF (N.=194) (P<0.05 for all codes), and at discharge showed greater Delta% in the qualifiers 0/1/2 attributed than CHF (P<0.0001 for b codes; P<0.05 for d codes). Delta% for qualifiers 3 and 4 was similar in the two groups. No impairment at admission (qualifier 0), CS group, and presence/complexity of comorbidities were identified as possible covariates influencing ICF qualifiers at discharge, impacting the rate of both no/mild impairment (ICF% aggregate 0+1 - adjusted R2=0.627; P<0.0001) and moderate impairment (ICF% qualifier 2 - adjusted R2=0.507; P<0.0001). CONCLUSIONS CHF patients showed a worse ICF picture at admission and less improvement at discharge than CS. The presence and complexity of comorbidities negatively influenced the ICF classification at discharge, especially in CHF patients. CLINICAL REHABILITATION IMPACT This study shows the utility of ICF classification in CR as a means for describing, measuring, and comparing patient functioning across the care continuum.
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Affiliation(s)
- Simonetta Scalvini
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Adriana Olivares
- Scientific Direction, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy -
| | - Anna Giardini
- Department of Information Technology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Laura Comini
- Scientific Direction, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Emanuela Zanelli
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Giacomo Corica
- Health Directorate, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy
| | - Franco Tarro Genta
- Department of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri, Turin, Italy
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Weijers M, Boumans N, van der Zwet J, Feron F, Bastiaenen C. A feasibility Randomised Controlled Trial as a first step towards evaluating the effectiveness of a digital health dashboard in preventive child health care: a mixed methods approach. Pilot Feasibility Stud 2023; 9:25. [PMID: 36793130 PMCID: PMC9930344 DOI: 10.1186/s40814-022-01214-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/29/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Within preventive Child Health Care (CHC), the 360°CHILD-profile has been developed. This digital tool visualises and theoretically orders holistic health data in line with the International Classification of Functioning, Disability and Health. It is anticipated that evaluating the effectiveness of the multifunctional 360°CHILD-profile within the preventive CHC-context is complex. Therefore, this study aimed at investigating the feasibility of RCT procedures and the applicability of potential outcome measures for assessing the accessibility and transfer of health information. METHODS During the first introduction of the 360°CHILD-profile in CHC practice, a feasibility RCT with an explanatory-sequential mixed methods design was executed. CHC professionals (n=38) recruited parents (n=30) who visited the CHC for their child (age 0-16). Parents were randomised to "care as usual" (n=15) or "care as usual with, in addition, the availability of a personalised 360°CHILD-profile during 6 months" (n=15). Quantitative data on RCT feasibility were collected on recruitment, retention, response, compliance rates and outcome data on accessibility and transfer of health information (n=26). Subsequently, thirteen semi-structured interviews (5 parents, 8 CHC professionals) and a member check focus group (6 CHC professionals) were performed to further explore and gain a deeper understanding of quantitative findings. RESULTS Integration of qualitative and quantitative data revealed that the recruitment of parents by CHC professionals was problematic and influenced by organisational factors. The used randomisation strategy, interventions and measurements were executable within the setting of this specific study. The outcome measures showed skewed outcome data in both groups and a low applicability to measure accessibility and transfer of health information. The study revealed points to reconsider regarding the randomisation and recruitment strategy and measures in the next steps. CONCLUSIONS This mixed methods feasibility study enabled us to gain a broad insight into the feasibility of executing an RCT within the CHC context. Trained research staff should recruit parents instead of CHC professionals. Measures, potentially for evaluating 360°CHILD-profile's effectiveness, need further exploration and thorough piloting before proceeding with the evaluation process. Overall findings revealed that executing an RCT within the context of evaluating 360°CHILD-profile's effectiveness in the CHC setting will be much more complex, time-consuming and costly than expected. Thereby, the CHC context requires a more complex randomisation strategy than executed during this feasibility study. Alternative designs including mixed methods research must be considered for the next phases of the downstream validation process. TRIAL REGISTRATION NTR6909; https://trialsearch.who.int/ .
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Affiliation(s)
- Miriam Weijers
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Nicolle Boumans
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Jonne van der Zwet
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Frans Feron
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - Caroline Bastiaenen
- grid.5012.60000 0001 0481 6099Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
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Knowledge and use of the International Classification of Functioning, disability and health (ICF) and ICF Core Sets for musculoskeletal conditions among saudi physical therapists. Musculoskelet Sci Pract 2022; 60:102573. [PMID: 35533598 DOI: 10.1016/j.msksp.2022.102573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The International Classification of Functioning, Disability, and Health (ICF) provides a coherent biopsychosocial view of health states. The ICF Core Sets were developed to facilitate and encourage the use of the ICF in clinical practice and research. OBJECTIVE To examine the level of knowledge and use of the ICF and ICF Core Sets for musculoskeletal conditions among Saudi physical therapists. DESIGN Cross-sectional study. METHOD We approached Saudi physical therapists (PTs) involved in managing patients with musculoskeletal conditions. Data were collected through an electronic survey consisting of multiple-choice questions related to the knowledge of the ICF, general ICF Core Sets and ICF Core Sets for musculoskeletal conditions. RESULTS A total of 203 PTs participated in this study. Seventy percent of PTs knew about the meaning of ICF, but only 33% recognized aspects of the ICF. For the osteoarthritis (OA) ICF Core Set, 71.9% had poor knowledge, and for the low back pain (LBP) ICF Core Set, 61.8% had poor knowledge. CONCLUSIONS The Saudi PTs surveyed in this study had a good level of knowledge about the meaning of the ICF; however, this knowledge appeared to be limited when they were asked about aspects of the ICF. They had poor knowledge of musculoskeletal ICF Core Sets but seemed to be more familiar with the LBP ICF Core Set compared to the OA ICF Core Set.
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Zhang L, Jia G, Ma J, Wang S, Cheng L. Short and long-term effects of robot-assisted therapy on upper limb motor function and activity of daily living in patients post-stroke: a meta-analysis of randomized controlled trials. J Neuroeng Rehabil 2022; 19:76. [PMID: 35864524 PMCID: PMC9306153 DOI: 10.1186/s12984-022-01058-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the effect of robot-assisted therapy (RAT) on upper limb motor control and activity function in poststroke patients compared with that of non-robotic therapy. Methods We searched PubMed, EMBASE, Cochrane Library, Google Scholar and Scopus. Randomized controlled trials published from 2010 to nowadays comparing the effect of RAT and control treatment on upper limb function of poststroke patients aged 18 or older were included. Researchers extracted all relevant data from the included studies, assessed the heterogeneity with inconsistency statistics (I2 statistics), evaluated the risk of bias of individual studies and performed data analysis. Result Forty-six studies were included. Meta-analysis showed that the outcome of the Fugl-Meyer Upper Extremity assessment (FM-UE) (SMD = 0.20, P = 0.001) and activity function post intervention was significantly higher (SMD = 0.32, P < 0.001) in the RAT group than in the control group. Differences in outcomes of the FM-UE and activity function between the RAT group and control group were observed at the end of treatment and were not found at the follow-up. Additionally, the outcomes of the FM-UE (SMD = 0.15, P = 0.005) and activity function (SMD = 0.32, P = 0.002) were significantly different between the RAT and control groups only with a total training time of more than 15 h. Moreover, the differences in outcomes of FM-UE and activity post intervention were not significant when the arm robots were applied to patients with severe impairments (FM-UE: SMD = 0.14, P = 0.08; activity: SMD = 0.21, P = 0.06) or when patients were provided with patient-passive training (FM-UE: SMD = − 0.09, P = 0.85; activity: SMD = 0.70, P = 0.16). Conclusion RAT has the significant immediate benefits for motor control and activity function of hemiparetic upper limb in patients after stroke compared with controls, but there is no evidence to support its long-term additional benefits. The superiority of RAT in improving motor control and activity function is limited by the amount of training time and the patients' active participation. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01058-8.
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Affiliation(s)
- Liping Zhang
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong, Chongqing, 400010, China
| | - Gongwei Jia
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong, Chongqing, 400010, China
| | - Jingxi Ma
- Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, 400013, China.,Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, 400013, China
| | - Sanrong Wang
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong, Chongqing, 400010, China
| | - Li Cheng
- Department of Health Management, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong, Chongqing, 400010, China.
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Stolz I, Weber E, Vreuls R, Anneken V. Rehabilitation Through Physical Activity and Sport in Light of the International Classification of Functioning, Disability, and Health–Current Research Perspectives. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:840850. [PMID: 36188984 PMCID: PMC9397674 DOI: 10.3389/fresc.2022.840850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022]
Abstract
The implementation of functioning by the World Health Organization (WHO) as the third global health indicator, along with mortality and morbidity, represents a promising advancement for a comprehensive assessment of international health systems and health strategies. The description of a person's health state operationalized by both biological and lived health via functioning provides a holistic picture of an individual's life situation and proved to be successful in building a framework for formulating therapy goals, achievable activities, and participational aspects against the background of an individual's life situation. Furthermore, improving an individual's functional ability and wellbeing could potentially affect the health indicators of morbidity and mortality and will be codable beyond the ICF in ICD-11. This methodological perspective emphasizes the use of ICF applications on the wider and narrower level of international rehabilitation systems and highlights the incorporation of the term functioning in rehabilitation through physical activity and sport. Current research perspectives in applying the ICF and functioning in clinical and rehabilitation practices are discussed and a current explorative study is presented, which applies the holistic orientation of functioning and the biopsychosocial model to the specific case by an individualized sports coaching intervention in rehabilitation. Subsequently, a unifying ICF- oriented language in rehabilitation is considered as a powerful foundation for a consistent international research strategy concerning increased international collaborations and future research perspectives.
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Affiliation(s)
- Isabel Stolz
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
- Institute for Movement-and Neurosciences, German Sport University Cologne, Cologne, Germany
- *Correspondence: Isabel Stolz
| | - Elisa Weber
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
| | - Ruud Vreuls
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
| | - Volker Anneken
- Research Institute for Inclusion Through Physical Activity and Sport, Affiliated Institute of the German Sport University Cologne, Frechen, Germany
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Assessment of CVD Risk Factors in Secondary Prevention after Ischemic Stroke Using the ICF. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063368. [PMID: 35329054 PMCID: PMC8948762 DOI: 10.3390/ijerph19063368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022]
Abstract
Background: Patients after undergoing ischemic stroke have a high risk of further cardiovascular disease (CVD) incidents. Monitoring risk factors is critical to prevent the recurrence of CVD. Objective: The aim of the study was to determine differences in the incidence of risk factors for CVD in a post-ischemic stroke patient group (SG) compared to the control group, which had not undergone ischemic stroke (CG), and to characterize them using the ICF (International Classification of Functioning, Disability and Health) classification system. Materials and Methods: The incidence of risk factors for recurrent CVD events were retrospectively analyzed in 55 patients in SG and 55 patients in CG. The results were translated into categories from the ICF classification system. Results: Atrial fibrillation (p = 0.013), carotid artery stenosis > 50% (p < 0.001), LDL > 71 mg/dL (p < 0.001), heart rate > 80/min (p = 0.007), taking NOAC (p = 0.008) and NSAIDs (p < 0.001) as well as nicotinism (p = 0.001) were significantly more common in SG compared to CG. The value of the distribution of the total incidence of CVD risk factors were observed to be higher for SG than for CG. In SG, both for males (p < 0.001) and females (p < 0.001) more risk factors for recurrent CVD incidents were observed compared to CG. Conclusions: Patients in SG differ in the occurrence of risk factors for CVD event compared to CG. The use of a single tool, such as the ICF assessment sheet, can be useful in assessing and analyzing risk factors for recurrent CVD events. This may help to reduce the risk of subsequent CVD events in secondary prevention.
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Measuring Equine-Assisted Therapy: Validation and Confirmatory Factor Analysis of an ICF-Based Standardized Assessment-Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052738. [PMID: 35270430 PMCID: PMC8910427 DOI: 10.3390/ijerph19052738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/07/2022]
Abstract
The International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO) was established as an international framework for monitoring rehabilitation outcomes and the impacts of health interventions since, as the term “functioning” implies, it emphasizes a person’s “lived health” in addition to their biological health status. Equine-assisted therapy (EAT) represents a holistic intervention approach that aims to improve both biomedical functioning and the patient’s lived health in relation to performing activities and participating in social situations. In this study, the psychometric properties of an ICF-based digital assessment tool for the measurement of the rehabilitation impacts of EAT were analyzed via simultaneous confirmatory factor analyses (CFA) and reliability and sensitivity tests. In total, 265 patients from equine-assisted therapy centers in Germany were included for CFA. Change sensitivity was assessed via multi-level analyses based on 876 repeated assessments by 30 therapists. Results show satisfactory model-fit statistics; McDonald’s omega (ML) showed excellent scores for the total scale (ω = 0.96) and three subscales (ω = 0.95; ω = 0.95, ω = 0.93). The tool proved itself to be change sensitive and reliable (change sensitivity p ≤ 0.001), retest r = 0.745 **, p ≤ 0.001). Overall, the developed assessment tool satisfactorily fulfills psychometric requirements and can be applied in therapeutic practice.
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Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052491. [PMID: 35270184 PMCID: PMC8909013 DOI: 10.3390/ijerph19052491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/04/2022]
Abstract
Managing routinely collected data in health care and public health is important for evaluation of interventions and answering research questions using “real life” and ”big data”. In addition to the technical requirements of information systems, both standardized terminology and standardized processes are needed. The aim of this project was to analyse and assess the integration of standardized terminology and document templates for a dietetic care process (DCP) into the health information system (HIS) in a hospital in Austria. Using an action research approach, the DCP was analysed through four expert interviews and the integration into the HIS through two expert interviews with observations. Key strengths and weaknesses for the main criteria (“integration of the ICF catalogue”, “adaption of the document templates”, “adaption of the DCP”, and the “adaption of the user authorizations”) were presented and proposals for improvement given. The system and process integration of the DCP is possible, and the document templates can be adapted with the software currently in use. Although an increase in resources and finances required is to be expected initially, the integration of a standardized dietetic terminology in combination with a standardized process is likely to improve the quality of care and support outcomes management and research.
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The potential of prediction models of functioning remains to be fully exploited: A scoping review in the field of spinal cord injury rehabilitation. J Clin Epidemiol 2021; 139:177-190. [PMID: 34329726 DOI: 10.1016/j.jclinepi.2021.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The study aimed to explore existing prediction models of functioning in spinal cord injury (SCI). STUDY DESIGN AND SETTING The databases PubMed, EBSCOhost CINAHL Complete, and IEEE Xplore were searched for relevant literature. The search strategy included published search filters for prediction model and impact studies, index terms and keywords for SCI, and relevant outcome measures able to assess functioning as reflected in the International Classification of Functioning, Disability and Health (ICF). The search was completed in October 2020. RESULTS We identified seven prediction model studies reporting twelve prediction models of functioning. The identified prediction models were mainly envisioned to be used for rehabilitation planning, however, also other possible applications were stated. The method predominantly used was regression analysis and the investigated predictors covered mainly the ICF-components of body functions and activities and participation, next to characteristics of the health condition and health interventions. CONCLUSION Findings suggest that the development of prediction models of functioning for use in clinical practice remains to be fully exploited. By providing a comprehensive overview of what has been done, this review informs future research on prediction models of functioning in SCI and contributes to an efficient use of research evidence.
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Bickenbach J. Human Functioning: Developments and Grand Challenges. FRONTIERS IN REHABILITATION SCIENCES 2021; 1:617782. [PMID: 36570604 PMCID: PMC9782683 DOI: 10.3389/fresc.2020.617782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/04/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Jerome Bickenbach
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland,*Correspondence: Jerome Bickenbach
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Weijers M, Bastiaenen C, Feron F, Schröder K. Designing a Personalized Health Dashboard: Interdisciplinary and Participatory Approach. JMIR Form Res 2021; 5:e24061. [PMID: 33560229 PMCID: PMC7902185 DOI: 10.2196/24061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/14/2020] [Accepted: 01/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Within the Dutch Child Health Care (CHC), an online tool (360° CHILD-profile) is designed to enhance prevention and transformation toward personalized health care. From a personalized preventive perspective, it is of fundamental importance to timely identify children with emerging health problems interrelated to multiple health determinants. While digitalization of children’s health data is now realized, the accessibility of data remains a major challenge for CHC professionals, let alone for parents/youth. Therefore, the idea was initiated from CHC practice to develop a novel approach to make relevant information accessible at a glance. Objective This paper describes the stepwise development of a dashboard, as an example of using a design model to achieve visualization of a comprehensive overview of theoretically structured health data. Methods Developmental process is based on the nested design model with involvement of relevant stakeholders in a real-life context. This model considers immediate upstream validation within 4 cascading design levels: Domain Problem and Data Characterization, Operation and Data Type Abstraction, Visual Encoding and Interaction Design, and Algorithm Design. This model also includes impact-oriented downstream validation, which can be initiated after delivering the prototype. Results A comprehensible 360° CHILD-profile is developed: an online accessible visualization of CHC data based on the theoretical concept of the International Classification of Functioning, Disability and Health. This dashboard provides caregivers and parents/youth with a holistic view on children’s health and “entry points” for preventive, individualized health plans. Conclusions Describing this developmental process offers guidance on how to utilize the nested design model within a health care context.
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Affiliation(s)
- Miriam Weijers
- Department of Preventive Child Health Care, Municipal Health Services, Southern Limburg, Heerlen, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Caroline Bastiaenen
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Frans Feron
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Kay Schröder
- Data Visualization, Zuyd University of Applied Sciences, Heerlen, Netherlands
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