Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice

Abstract

INTRODUCTION: Although deemed a globally accepted framework, there remains scare evidence on the process and outcome of implementing the International Classification of Functioning, Disability and Health (ICF) within neurorehabilitation. OBJECTIVES: This review briefly explores the existing, broader literature and then reports on two action research projects, undertaken in England, specifically within stroke and neurorehabilitation. Working with participants, including clinicians from in-patient and community settings, there are now 35 different ways identified for the use of the ICF. CONCLUSION: The outcome of the first project highlights that using the ICF enhances communication within and beyond the acute stroke service, fosters holistic thinking and clarifies team roles. To adopt it into clinical practice, the ICF must be adapted to meet local service needs. The use of action research has facilitated the knowledge translation process which has enabled the ICF to become a clinical reality in neurorehabilitation, with clinicians identifying a range of potential uses.

Value of using the international classification of functioning, disability, and health for stroke rehabilitation assessment

“…It is noteworthy that using the ICF for patients with acute stroke improves communication and leads to more holistic thinking among staff. [ 11 ] However, there is still only scant evidence on the extent to which the ICF is being used in clinical practice. [ 11 ]…”

“…[ 11 ] However, there is still only scant evidence on the extent to which the ICF is being used in clinical practice. [ 11 ]…”

“…Studies of the ICF have been carried out in some countries and the results have indicated that this classification system may be useful to assess disability and functional status. [ 10 , 11 ] However, no studies of the ICF have been conducted using a large sample. Therefore, we planned to establish a large-sample, multicenter ICF database for stroke, and then evaluate the status of patients with regard to their function, structure, activities, participation, and environmental factors.…”

Biopsychosocial model in health care: reflections in the production of functioning and disability data

“…The ICF has been recognized internationally as a useful tool and it is becoming a global trend [36]. The previously reported experiences demonstrate that it is used by health professionals to improve communication [37] and to enable the creation of more effective therapeutic goals [38].This tool can be a roadmap to define specific objectives as well as appropriate interventions. Incorporating the ICF in different levels of health care will contribute to the diffusion of the biopsychosocial model [39].…”

Identificação de Conceitos da Classificação Internacional de Funcionalidade, Incapacidade e Saúde em Medidas de Qualidade de Vida para o Câncer do Colo do Útero

“…Tais procedimentos podem, por si só, melhorar a autonomia, motivação e adesão ao tratamento dos usuários, sendo essa estratégia uma ferramenta poderosa na reabilitação. Esse processo, no entanto, é um desafio na rotina clínica dos serviços de saúde 25 . As necessidades dos usuários devem ser avaliadas não somente pelos indicadores tradicionais de sobrevida, devendo ser incluídas nos modelos de avaliação biopsicossocial utilizados na atenção oncológica informações sobre atividades, participação, fatores ambientais e fatores pessoais 26 .…”