Developing and Implementing ICF-Based Tools for Occupational Rehabilitation Supporting the Communication and Return to Work Process Between Sickness Absentees, Clinical Team and Jobcentre Contacts

Abstract

BackgroundThe ICF model is applied as a conceptual framework in occupational rehabilitation in Norway.ObjectiveTo systematically apply the ICF model in rehabilitation this study had the following aims: (1) apply an ICF subset by merging an ICF core set and an ICF set to assess functioning in rehabilitation patients related to work; (2) develop a patient-reported ICF questionnaire and a clinician-friendly ICF report complementing the clinician-rated ICF subset and (3) evaluate whether ICF-based tools (subset, questionnaire, report) support the communication between a clinical team, patient and jobcentre contacts during return to work (RTW) follow up.MethodsForty-one patients completing four weeks rehabilitation were recruited. The patients were referred from general practitioners and jobcentres. The ICF subset was a combination of the EUMASS core set for disability evaluation and suggested ICF categories by experts in vocational rehabilitation from Iceland. A clinical rehabilitation team interviewed the patients using the ICF subset and problems were quantified on a generic qualifier scale for body functions, activities and participation and environmental factors. The research team and clinical team developed an ICF questionnaire, by cross-culturally adapting the Work Rehabilitation Questionnaire to Norwegian. The same teams also developed an ICF report. The rehabilitation clinic forwarded the report and questionnaire to the patients' jobcentre contact, which was responsible for the RTW follow up. To evaluate the benefits of ICF-based tools, the clinical team, user representative and jobcentre contacts together participated in four workshops. They were asked the degree to which and in what way the tools supported the communication between them.ResultsThe ICF subset captured RTW challenges but was found to be time consuming. The jobcentres experienced the ICF report and questionnaire beneficial in the follow up as it strengthened their RTW decision-making basis and communication with the rehabilitation clinic and the patients about follow-up interventions.ConclusionThe development and implementation of ICF-based tools for clinical practice was a preliminary success in supporting the communication between three stakeholders during RTW follow up. Future applications of ICF-based tools ought to integrate personal factors to capture both facilitators and barriers related to functioning and work, thus, getting closer to a holistic assessment.

Personbezogene und Umweltfaktoren in sozialmedizinischen orthopädischen Gutachten

“…Um die gewonnenen Ergebnisse besser zu verstehen, wird über die Anwendbarkeit der umfangreichen Kontextfaktoren im Sinne von Förderfaktoren, Barrieren und Methoden in der sozialmedizinischen Begutachtung mit involvierten Expert:innen im Rahmen einer Fokusgruppe diskutiert werden. So könnten beispielsweise standardisierte Arbeitshilfen, wie die der Bundesarbeitsgemeinschaft Rehabilitation, Checklisten oder Assessments zu den Kontextfaktoren, möglicherweise auch in digitaler Form, Anwendung finden [14,[29][30][31][32]. Ein gezieltes Erfassen person-und umweltbezogener Faktoren sowie ein strukturierter, individualisierter Decision-making-Prozess könnten eine ressourcenorientierte Zuweisung hinsichtlich individualisierter Maßnahmenplanung zum RTW ermöglichen [3,9,29].…”

Welche Kontextfaktoren der ICF haben für die sozialmedizinische Begutachtung im Rahmen der Erwerbsminderungsrente eine Relevanz? Ergebnisse einer Delphi-Befragung

“…Für die Jobcenter waren die darin enthaltenen Informationen sehr relevant und es entstand ein gemeinsames Verständnis von fördernden und hemmenden Faktoren für den RTW auf Basis der ICF. Die Arbeitsämter berichteten, dass der Bericht und der Fragebogen ihnen eine bessere Grundlage für Entscheidungen über weitere arbeitsbezogene Maßnahmen zur Wiedereingliederung in den Arbeitsmarkt lieferten, um eine ganzheitliche Perspektive auf die Möglichkeiten für RTW zu erlangen 17 . Weitere Assessments sind derzeit in Arbeit.…”

Application of the international classification of functioning, disability, and health to disability assessment for older people in China

“…The International Classification of Functioning, Disability, and Health (ICF) is a classification of health and functioning framework ( 11 , 12 ). In the ICF, functioning and disability are viewed as a complex interaction between an individual's health condition and the contextual factors of the environment, as well as personal factors ( 13 ).…”