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Aarts J, Saddal SRD, Bosmans JE, de Groot V, de Jong BA, Klein M, Ruitenberg MFL, Schaafsma FG, Schippers ECF, Schoonheim MM, Uitdehaag BMJ, van der Veen S, Waskowiak PT, Widdershoven GAM, van der Hiele K, Hulst HE. Don't be late! Postponing cognitive decline and preventing early unemployment in people with multiple sclerosis: a study protocol. BMC Neurol 2024; 24:28. [PMID: 38225561 PMCID: PMC10789039 DOI: 10.1186/s12883-023-03513-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Up to 65% of people with multiple sclerosis (PwMS) develop cognitive deficits, which hampers their ability to work, participating in day-to-day life and ultimately reducing quality of life (QoL). Early cognitive symptoms are often less tangible to PwMS and their direct environment and are noticed only when symptoms and work functioning problems become more advanced, i.e., when (brain) damage is already advanced. Treatment of symptoms at a late stage can lead to cognitive impairment and unemployment, highlighting the need for preventative interventions in PwMS. AIMS This study aims to evaluate the (cost-) effectiveness of two innovative preventative interventions, aimed at postponing cognitive decline and work functioning problems, compared to enhanced usual care in improving health-related QoL (HRQoL). METHODS Randomised controlled trial including 270 PwMS with mild cognitive impairment, who have paid employment ≥ 12 h per week and are able to participate in physical exercise (Expanded Disability Status Scale < 6.0). Participants are randomised across three study arms: 1) 'strengthening the brain' - a lifestyle intervention combining personal fitness, mental coaching, dietary advice, and cognitive training; 2) 'strengthening the mind' - a work-focused intervention combining the capability approach and the participatory approach in one-on-one coaching by trained work coaches who have MS themselves; 3) Control group-receiving general information about cognitive impairment in MS and receiving care as usual. Intervention duration is four months, with short-term and long-term follow-up measurements at 10 and 16 months, respectively. The primary outcome measure of the Don't be late! intervention study will be HRQoL as measured with the 36-item Short Form. Secondary outcomes include cognition, work related outcomes, physical functioning, structural and functional brain changes, psychological functioning, and societal costs. Semi-structured interviews and focus groups with stakeholders will be organised to qualitatively reflect on the process and outcome of the interventions. DISCUSSION This study seeks to prevent (further) cognitive decline and job loss due to MS by introducing tailor-made interventions at an early stage of cognitive symptoms, thereby maintaining or improving HRQoL. Qualitative analyses will be performed to allow successful implementation into clinical practice. TRIAL REGISTRATION Retrospectively registered at ClinicalTrials.gov with reference number NCT06068582 on 10 October 2023.
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Affiliation(s)
- Jip Aarts
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - Shalina R D Saddal
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vincent de Groot
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Brigit A de Jong
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Martin Klein
- Medical Psychology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Marit F L Ruitenberg
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Frederieke G Schaafsma
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Esther C F Schippers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
| | - Menno M Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Sabina van der Veen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
| | - Pauline T Waskowiak
- Medical Psychology, MS Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Guy A M Widdershoven
- Ethics, Law & Medical Humanities, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Hanneke E Hulst
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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2
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Waskowiak PT, de Jong BA, Uitdehaag BMJ, Saddal SRD, Aarts J, Roovers AAM, van Oirschot P, de Groot V, Schaafsma FG, van der Hiele K, Ruitenberg MFL, Schoonheim MM, Widdershoven GAM, van der Veen S, Schippers ECF, Klein M, Hulst HE. Don't be late! Timely identification of cognitive impairment in people with multiple sclerosis: a study protocol. BMC Neurol 2024; 24:26. [PMID: 38218777 PMCID: PMC10787411 DOI: 10.1186/s12883-023-03495-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation. METHODS In this cross-sectional multicentre study, 750 PwMS (aged 18-67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test-retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires. DISCUSSION Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS.
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Affiliation(s)
- Pauline T Waskowiak
- MS Center Amsterdam, Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, De Boelelaan, 1118, Amsterdam, The Netherlands.
| | - Brigit A de Jong
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Shalina R D Saddal
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
| | - Jip Aarts
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Aïda A M Roovers
- MS Center Amsterdam, Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, De Boelelaan, 1118, Amsterdam, The Netherlands
| | | | - Vincent de Groot
- MS Center Amsterdam, Rehabilitation Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Frederieke G Schaafsma
- MS Center Amsterdam, Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Marit F L Ruitenberg
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Menno M Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Guy A M Widdershoven
- Ethics, Law & Medical Humanities, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Sabina van der Veen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
| | - Esther C F Schippers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
| | - Martin Klein
- MS Center Amsterdam, Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, De Boelelaan, 1118, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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van der Veen S, van der Leeden M, Geleijn E, Vossen P, Meskers CGM, Widdershoven GAM. Artificial intelligence to improve rehabilitation care for children with developmental conditions: Some ethical considerations. Dev Med Child Neurol 2023; 65:12-13. [PMID: 35856286 PMCID: PMC10084355 DOI: 10.1111/dmcn.15348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Edwin Geleijn
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Piek Vossen
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Guy A M Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam
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Meskers CGM, van der Veen S, Kim J, Meskers CJW, Smit QTS, Verkijk S, Geleijn E, Widdershoven GAM, Vossen PTJM, van der Leeden M. Automated recognition of functioning, activity and participation in COVID-19 from electronic patient records by natural language processing: a proof- of- concept. Ann Med 2022; 54:235-243. [PMID: 35040376 PMCID: PMC8774059 DOI: 10.1080/07853890.2021.2025418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To address the feasibility, reliability and internal validity of natural language processing (NLP) for automated functional assessment of hospitalised COVID-19 patients in key International Classification of Functioning, Disability and Health (ICF) categories and levels from unstructured text in electronic health records (EHR) from a large teaching hospital. MATERIALS AND METHODS Eight human annotators assigned four ICF categories to relevant sentences: Emotional functions, Exercise tolerance, Walking and Moving, Work and Employment and their ICF levels (Functional Ambulation Categories for Walking and Moving, metabolic equivalents for Exercise tolerance). A linguistic neural network-based model was trained on 80% of the annotated sentences; inter-annotator agreement (IAA, Cohen's kappa), a weighted score of precision and recall (F1) and RMSE for level detection were assessed for the remaining 20%. RESULTS In total 4112 sentences of non-COVID-19 and 1061 of COVID-19 patients were annotated. Average IAA was 0.81; F1 scores were 0.7 for Walking and Moving and Emotional functions; RMSE for Walking and Moving (5- level scale) was 1.17 for COVID-19 patients. CONCLUSION Using a limited amount of annotated EHR sentences, a proof-of-concept was obtained for automated functional assessment of COVID-19 patients in ICF categories and levels. This allows for instantaneous assessment of the functional consequences of new diseases like COVID-19 for large numbers of patients.Key messagesHospitalised Covid-19 survivors may persistently suffer from low physical and mental functioning and a reduction in overall quality of life requiring appropriate and personalised rehabilitation strategies.For this, assessment of functioning within multiple domains and categories of the International Classification of Function is required, which is cumbersome using structured data.We show a proof-of-concept using Natural Language Processing techniques to automatically derive the aforementioned information from free-text notes within the Electronic Health Record of a large academic teaching hospital.
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Affiliation(s)
- Carel G. M. Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jenia Kim
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline J. W. Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Quirine T. S. Smit
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stella Verkijk
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Edwin Geleijn
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Guy A. M. Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Piek T. J. M. Vossen
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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5
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van der Veen S, Evans N, Huisman M, Welch Saleeby P, Widdershoven G. Toward a paradigm shift in healthcare: using the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA) jointly in theory and practice. Disabil Rehabil 2022:1-8. [PMID: 35732595 DOI: 10.1080/09638288.2022.2089737] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Over the past two decades, healthcare systems have shifted to adopt a more holistic, patient-centered care system. However, operationalization in practice remains challenging. Two frameworks have contributed substantially to the transformation toward more holistic and patient-centered care: the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA). Using these frameworks jointly can contribute to improved patient-centered care in clinical practice. METHODS This article explores the strengths and weaknesses of the use of the two frameworks in care and investigates whether using them jointly might contribute to more appropriate and patient-centered care. We will present a practical example of this integration in the form of a novel e-health application. RESULTS The exploration indicated that if the frameworks are used jointly, the individual weaknesses can be overcome. The application, used to exemplify the joint use of the frameworks, contains all categories of the ICF. It offers a unique tool that allows a person to self-assess, record, and evaluate their functioning and capabilities and formulate related goals. CONCLUSIONS Using the ICF jointly with the CA can foster holistic, patient-centered care. The e-health application provides a concrete example of how the frameworks can be used jointly. Implications for rehabilitationUsing the International Classification of Functioning, Disability and Health jointly with the capability approach can foster holistic, patient-centered care.The joint use of the frameworks is demonstrated by an e-health application which enables users to evaluate their functioning in relation to their own goals, provides them with the opportunity to increase control over their health and have a more active role in their care.Tools to record both functioning and goals from a patient's perspective can support professionals in offering patient-centered care in daily practice.Individual recording, monitoring and evaluation of functioning, capabilities and goals regarding functioning can provide a basis for research and quality improvement.
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Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Natalie Evans
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Patricia Welch Saleeby
- Department of Sociology, Criminology and Social Work, Bradley University, Peoria, IL, USA
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
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Leonardi M, Lee H, van der Veen S, Maribo T, Cuenot M, Simon L, Paltamaa J, Maart S, Tucker C, Besstrashnova Y, Shosmin A, Cid D, Almborg AH, Anttila H, Yamada S, Frattura L, Zavaroni C, Zhuoying Q, Martinuzzi A, Martinuzzi M, Magnani FG, Snyman S, El Oumri AA, Sylvain N, Layton N, Sykes C, Saleeby PW, Winkler AS, de Camargo OK. Avoiding the Banality of Evil in Times of COVID-19: Thinking Differently with a Biopsychosocial Perspective for Future Health and Social Policies Development. ACTA ACUST UNITED AC 2020; 2:1758-1760. [PMID: 32905109 PMCID: PMC7462656 DOI: 10.1007/s42399-020-00486-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 11/01/2022]
Abstract
The COVID-19 pandemic provides the opportunity to re-think health policies and health systems approaches by the adoption of a biopsychosocial perspective, thus acting on environmental factors so as to increase facilitators and diminish barriers. Specifically, vulnerable people should not face discrimination because of their vulnerability in the allocation of care or life-sustaining treatments. Adoption of biopsychosocial model helps to identify key elements where to act to diminish effects of the pandemics. The pandemic showed us that barriers in health care organization affect mostly those that are vulnerable and can suffer discrimination not because of severity of diseases but just because of their vulnerability, be this age or disability and this can be avoided by biopsychosocial planning in health and social policies. It is possible to avoid the banality of evil, intended as lack of thinking on what we do when we do, by using the emergence of the emergency of COVID-19 as a Trojan horse to achieve some of the sustainable development goals such as universal health coverage and equity in access, thus acting on environmental factors is the key for global health improvement.
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Affiliation(s)
- Matilde Leonardi
- UOC Neurology, Public Health, Disability, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy.,Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Marie Cuenot
- School of public Health, École des hautes études en santé publique (EHESP), Rennes, France
| | - Liane Simon
- MSH Medical School Hamburg, Hamburg, Germany
| | | | - Soraya Maart
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Carole Tucker
- College of Public Health, Temple University, Philadelphia, PA USA
| | - Yanina Besstrashnova
- Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, St. Petersburg, Russia
| | - Alexander Shosmin
- Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, St. Petersburg, Russia
| | - Daniel Cid
- Centre for Innovations and Development in Healthcare (CIDEAS), Santiago del Chile, Chile
| | | | - Heidi Anttila
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Lucilla Frattura
- Strategical Directorate, Classification Area, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Carlo Zavaroni
- Strategical Directorate, Classification Area, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Qiu Zhuoying
- Research Institute of Rehabilitation Information, China Rehabilitation Research Center/WHO-FIC CC China, Beijing, China
| | - Andrea Martinuzzi
- Department of Conegliano-Pieve di Soligo, IRCCS E. Medea Scientific Institute, Conegliano, Italy
| | | | - Francesca Giulia Magnani
- UOC Neurology, Public Health, Disability, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Stefanus Snyman
- Centre for Community Technologies, Nelson Mandela University, Port Elizabeth, South Africa
| | - Ahmed Amine El Oumri
- Mohammed VI University Hospital of Oujda, Faculty of Medicine of Oujda, Mohammed First University of Oujda, Oujda, Morocco
| | | | - Natasha Layton
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, Victoria Australia
| | | | - Patricia Welch Saleeby
- Department of Sociology, Criminology, and Social Work, Bradley University, Peoria, IL USA
| | - Andrea Sylvia Winkler
- Center for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Olaf Kraus de Camargo
- CanChild - Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario Canada
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7
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Heerkens YF, de Weerd M, Huber M, de Brouwer CPM, van der Veen S, Perenboom RJM, van Gool CH, Ten Napel H, van Bon-Martens M, Stallinga HA, van Meeteren NLU. Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate. Disabil Rehabil 2017; 40:603-611. [PMID: 28129712 DOI: 10.1080/09638288.2016.1277404] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. METHOD Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. RESULTS The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. CONCLUSIONS There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health. Implications for Rehabilitation We propose policy makers on community, regional and (inter)national level to consider the use of the alternative schemes of the International Classification of Functioning, Disability and Health within their plans to promote functioning and health of their citizens and researchers and teachers to incorporate the alternative schemes into their research and education to emphasize the biopsychosocial paradigm. We propose to set up an international Delphi procedure involving citizens (including patients), experts in healthcare, occupational care, research, education and policy, and planning to get consensus on an alternative scheme of the International Classification of Functioning, Disability and Health. We recommend to discuss the alternatives for the present scheme of the International Classification of Functioning, Disability and Health in the present update and revision process within the World Health Organization as a part of the discussion on the future of the International Classification of Functioning, Disability and Health framework (including ontology, title and relation with the International Classification of Diseases). We recommend to revise the definition of personal factors and to draft a list of personal factors that can be used in policy making, clinical practice, research, and education and to put effort in the revision of the present list of environmental factors to make it more useful in, e.g., occupational health care.
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Affiliation(s)
- Yvonne F Heerkens
- a Dutch Institute of Allied Health Care , Amersfoort , The Netherlands.,b Research Group Occupation & Health , HAN University of Applied Sciences , Nijmegen , The Netherlands
| | | | - Machteld Huber
- d Institute for Positive Health , Amersfoort , The Netherlands
| | - Carin P M de Brouwer
- e Department of Epidemiology, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Sabina van der Veen
- f Innovation Health Care Professions & Education , Dutch Health Care Institute , Diemen , The Netherlands
| | | | - Coen H van Gool
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Huib Ten Napel
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Marja van Bon-Martens
- h The Trimbos Institute, Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands
| | - Hillegonda A Stallinga
- i School of Nursing & Health, University Medical Center, University of Groningen , Groningen , The Netherlands
| | - Nico L U van Meeteren
- j Topsector Life Sciences and Health (Health ∼ Holland) , The Hague , The Netherlands.,k CAPHRI, Maastricht University , Maastricht , The Netherlands
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