The generic HRQoL instrument and disability schedule used in this study demonstrated strong relationship between these two dimensions. It also gave a more detailed picture of the aspects of disability and HRQoL that are most relevant for the persons after stroke and that should be studied further in the future research.
Engel applied the term biopsychosocial to medicine to emphasize the need to take into account the psychologic and social aspects of medical practice. After an overview of the history of the biopsychosocial (BPS) model, we review criticisms of the model to reformulate its deficiencies and then analyze its application in mental health care. The objectives of this paper are 4-fold: (1) to examine the use of the BPS model since Engel's 1977 article to the present; (2) to examine the reasons for the popularity of the BPS model as well as the problems it faces when applied to mental health care; (3) to introduce two instruments, the International Classification of Functioning, Disability, and Health and the INTERMED, which implement the BPS model; and (4) to show why the BPS model is not yet a model of mental health practice. A total of 62 publications were retrieved and reviewed in the ScienceDirect, PubMed, and Scopus databases, and 32 of them were eventually included in this review. This is the first review of the studies published that applied the BPS model in mental health in the last 33 yrs. These criticisms are used to construct a more workable vision of the BPS model of clinical practice.
INTRODUCTION: Neurological conditions are associated with high levels of disability. OBJECTIVES: The aim of this study was to describe, using the International Classification of Functioning, Disability and Health (ICF), the most relevant aspects of disability in patients with neurological conditions. We collated data from previous studies on myasthenia gravis, migraine, Parkinson's disease, multiple sclerosis, traumatic brain injury, stroke, epilepsy, vegetative state and minimally conscious state, and identified as relevant those ICF categories reported by at least 50% of patients in each condition. CONCLUSIONS: Records from 1310 patients were available. A total of 97 ICF categories were reported, and 21 were commonly addressed in more than five conditions. Approximately half of the categories in body functions were related to mental and movement-related functions and more than 25% of the activities-related categories involved activities that require the support from a caregiver. Environmental factors were mostly reported as facilitators. Our data indicate a residual mind-body dichotomy, the relevance of disability not only for the patients but also for their caregivers, and the difficulties in addressing barriers in the environment.
The detailed description of functioning and disability provided by our methodology can help policy makers and administrators in decision making, on the basis of a description of real needs, and in targeting person-tailored interventions.
Our study provided a description of functioning and disability domains in migraine, MG and PD and enabled to report the impact of EF in determining the actual disability experience.
Life expectancy of people with Down's syndrome (DS) has increased considerably, now exceeding 60 years. People with DS start to get old around the age of 45. By referring to the WHO's International Classification of Functioning, Disability and Health (ICF) biopsychosocial perspective, this study aimed to present an up-to-date review of the past 14 years of literature concerning the ageing of people with DS. PUBMED, PsycInfo and the Social Sciences Citation Index were searched for studies published between 2000 and 2014. Studies were selected if they were written in English, focused on people more than 45 years of age with DS, and if terms related to DS and ageing appeared in either the title or the abstract. A total of 30 studies were retrieved and their meaningful concepts were linked to the ICF. In total, 38 ICF categories were identified that were mainly related to intellectual functions (b117) (19%), general metabolic functions (b540) (7.4%), mobility of joint functions (b710), muscle power functions (b730) (4.2%), gait pattern functions (b770) (4.2%) and structure of the brain (s110) (4.3%). Only two studies considered environmental factors, and only one considered the joint analysis of health condition and environmental factors. Data about the ageing of people with DS are predominantly based on medical evaluations and descriptions of their physical impairments. Few attempts have been made towards a comprehensive assessment of elderly people with DS with a joint analysis of their health condition and its interaction with environmental factors.
The aim of this study was to present the development of an instrument to collect disability information in school settings, based on the International Classification of Functioning, Disability and Health, Children and Youth version (ICF-CY): the ICF-PEI Schedule (ICF-CY-based schedule for Individualized Education Plan). Through an action-research process, a group of 14 teachers participated in the definition of a comprehensive list of ICF-CY categories, which were then used in a pilot test: categories relevant in at least 30% of the cases were retained. Teachers also reported the most relevant difficulties they had in using the ICF-CY questionnaires: these were discussed in plenary. On the basis of a pilot test and teachers' difficulties, a set of structured, easy to use and feasible questions for the school context were developed. A total of 118 ICF-CY categories were included in the preliminary list and 67 were retained. The most relevant difficulties in using ICF-CY questionnaires were as follows: obtaining reliable information on bodily impairments; using capacity in activities and participation; using qualifiers in 'borderline situations'; and identifying systems and policies as barriers or facilitators. The ICF-PEI Schedule is composed of 62 items, with a simplified rating scale. Teachers are asked to rate performance, which is directly observed, and to address which environmental factors impact it; thus, environmental factor rating is simplified. The ICF-PEI Schedule was drafted as a feasible instrument for school settings to collect and exploit functioning and disability data. Teachers can fruitfully employ it to assist in the definition of educational objectives and verify them longitudinally.
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