Laying the foundation for a primary care core set of the International Classification of Functioning, Disability and Health (ICF) for community-dwelling older adults: A qualitative study

Abstract

Objective To explore relevant areas of functioning from the perspective of community-dwelling adults aged 75 years and over, in order to develop a Core Set of the International Classification of Functioning, Disability and Health (ICF) for community-dwelling older adults for use in primary care. Design Qualitative study using semi-structured interviews and focus groups. Participants A total of 27 community-dwelling older adults participated in the interviews and 24 of them in the focus groups. Methods Following the proposed methodology of the ICF Research Branch, this is 1 of 4 preparatory studies in the Core Set development process. Within the transcripts, concepts of functioning were identified, based on Mayring’s qualitative content analysis using deductive category assignment with the ICF being the category system. Results Overall 6,667 concepts were identified. Most were linked to the Activities and Participation component. The most frequently identified categories were “recreation and leisure” and “family relationships”. Conclusion Categories from all ICF chapters were identified, demonstrating the complexity and multidimensionality of the ageing process, with a special emphasis on the component Activities and Participation. This qualitative study provides a list of relevant categories from the perspective of community-dwelling elderly people, which will be used to develop a Core Set for older primary care patients. LAY ABSTRACT Physicians usually focus on diagnosing and treating diseases. In old age this might be less appropriate, and other biopsychosocial aspects (e.g. independent living) should also be considered. Therefore, we aim to develop an International Classification of Functioning, Disability and Health Core Set for older adults, which physicians can use to assess these aspects during consultations. In the development process several perspectives should be considered; one of them being the view of the target group. To explore this view, interviews and group discussions were conducted with community-dwelling adults aged 75 years and over. Almost 200 relevant aspects of functioning were identified. Leisure activities, family relationships and mobility were mentioned most often. Body functions, which are normally in the focus of physicians, seem to be less important to older adults. The results suggest that including biopsychosocial information in the consultation might help to better tailor medical interventions to the patients’ needs.

Laying the foundation for an International Classification of Functioning, Disability and Health Core Set for community-dwelling elderly adults in primary care: the clinical perspective identified in a cross-sectional study

“…9 Capturing these different perspectives will make it possible to obtain a holistic understanding of the specific health-related aspects of community-dwelling geriatric patients aged 75 and older. The four studies consist of: (1) a systematic literature review covering the research perspective, 10 (2) a qualitative study covering the perspective of geriatric patients aged 75 and older, 11 (3) an expert survey covering the experts' perspective and (4) this empirical study covering the clinical perspective in which a health professional conducted semi-structured interviews with geriatric patients.…”

“…This empirical study is one of four independent preparatory studies 9 that were conducted to develop an ICF Core Set for community-dwelling elderly adults in primary care. 12 The next step will be to put together the results of this empirical study and the other three preparatory studies (systematic literature review, 10 qualitative study 11 and expert survey). The final Core Set will provide GPs with a short list of the most important aspects of the functioning of community-dwelling elderly adults aged 75 and above.…”

Older individuals' perspectives on the prerequisites for living at home: A mixed‐methods systematic review

“…They knew that in order ‘to remain control autonomous’, they needed to stay in control and not allow others to make decisions for them (Hatcher et al., 2019). According to them, keeping busy and occupied (Ballesteros et al., 2013; Hatcher et al., 2019; Saajanaho et al., 2014; Strobl et al., 2013; Tomandl et al., 2021) and remaining mentally and physically active (Hatcher et al., 2019; Klomstra et al., 2019) were part of their healthy lifestyle practices. Also, having enough daily sleep time was deemed important as it impacted the physical prerequisites (Wang et al., 2019).…”

“…Many professionals believe that they motivate older individuals to participate and communicate with others, but older individuals do not support this view (Eloranta et al., 2010). Environmental factors are also important to older individuals (Tomandl et al., 2021). Some of them utilize OTs (occupational therapist) to help them recognize their needs in the context of making changes in the home.…”

Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment

“…Numerous articles can be found regarding ICF. These describe how the ICF framework can be used in multidisciplinary health care [ 13 , 14 , 15 , 16 , 17 , 18 ] and discuss the development and validation of ICF Core Sets (sets of ICF categories relevant for patients with a certain heath condition) to facilitate multidisciplinary assessment [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Articles compare the content of instruments to measure functioning of patients [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] and describe the linking of problems experienced from a patient perspective in daily life [ 36 , 37 , 38 ].…”