Selection of Comprehensive Assessment Categories Based on the International Classification of Functioning, Disability, and Health for Elderly Patients with Heart Failure: A Delphi Survey among Registered Instructors of Cardiac Rehabilitation

Abstract

The development of a comprehensive assessment tool based on the International Classification of Functioning, Disability, and Health (ICF) for elderly patients with heart failure is urgently required. In this study, we classified the ICF categories relevant to heart failure in the elderly through a Delphi survey (3-step questionnaire survey) of 108 Registered Instructors of Cardiac Rehabilitation in the Hiroshima Prefecture. Questionnaires were conducted using postal mail or a web-based platform. The survey was conducted three times, and the survey results were provided as feedback to the participants in the second and third rounds. More than 80% of the respondents selected categories according to the ICF core set methodology. Data were collected from December 2018 to March 2019, with 67, 54, and 46 participants in the first, second, and third rounds, respectively. A total of 58 ICF items were adopted based on the results: 27 body function items, 4 body structure items, 20 activity and participation items, and 7 environmental factor items. This study is characterised by the inclusion of a large number of ICF items for mental function. This result seems to be influenced by the increasing interest in cognitive dysfunction in elderly patients with heart failure. The ICF categories selected for this study allow for a comprehensive assessment of clients for occupational therapy. The findings of this study are expected to provide a basis for an outcome measure to determine the effectiveness of occupational therapy for these patients.

The International Classification of Functioning, Disabilities, and Health categories rated as necessary for care planning for older patients with heart failure: a survey of care managers in Japan

“…The ICF categories in this study matched the 19 categories of the ICF core set for chronic ischaemic heart disease in a previous study [ 23 ]. Furthermore, 43 ICF categories in this study were consistent with those in our previous study of cardiac rehabilitation instructors [ 16 ]. One explanation for the difference between the ICF core set for chronic ischaemic heart disease and the results of the present study is that the ICF categories specific to older people may have been selected because the present study included older patients with HF.…”

“…The questionnaire was then distributed and the completed questionnaires collected. The questionnaire was the same as the one used in the previous study, a survey study of Registered Instructors of Cardiac Rehabilitation [ 16 ]. This questionnaire is based on the ICF checklist with additional ICF categories specific to the older with heart failure according to the opinion of expert panel.…”

“…In Japan, the ICF is expected to be used as a common language between medical and welfare or care professionals. We selected the ICFs necessary for the comprehensive assessment of older people with heart failure in a Delphi survey of medical professionals [ 16 ].…”

Development and appropriateness of a scoring method for International Classification of Functioning, Disabilities, and Health assessment in older patients with heart failure: a Delphi survey of expert panel in Japan

“…We developed scoring methods for the 43 ICF categories linking to existing assessment batteries. 34 35 To develop the questionnaire, we first conducted a literature review of the ICF linking rules. The ICF linking rules are a systematic methodology for linking the existing assessment batteries to the ICF codes.…”

“… 32 33 Therefore, 43 ICF categories were selected for the comprehensive assessment of older patients with HF through the questionnaire survey of a multidisciplinary group of medical professionals and care professionals. 34 35 The 43 ICF categories specific to older patients with HF consisted of 17 body functions and one body structure, 19 activities and participation, and 6 environmental factors. However, in order to efficiently use ICF-based assessments in clinical practice, it is necessary to develop scoring methods linked to existing assessments.…”