Use of ICF in Rehabilitation: a Clinical Case

Abstract

The article describes a clinical case of a patient with an acute cerebrovascular accident (CVA) at the second stage of medical rehabilitation, conducted by a psychologist as part of a multidisciplinary team. It presents the main concepts and content of the International Classi-fication of Functioning, Disability and Health (ICF). Attention is drawn to a unified language of its application, available to all members of such a multidisciplinary team implementing the process of rehabilitation. The importance of psychological evaluation within the ICF catego-ries for effective interaction between this team’s specialists has been shown. A specific fea-ture of this case was a possibility of using categories belonging to almost all the ICF sections. The purpose of this work is to introduce psychologists to a clinical psychologist’s com-petencies and possibilities of applying the ICF in the rehabilitation of patients with an acute CVA at the second stage of medical rehabilitation. Materials and methods. The article focuses on a clinical case of a female patient with an acute CVA during the early recovery period at the second stage of medical rehabilitation with a description of the dynamics of her psychological status, using the ICF categories. Results. The article provides a list of psychological domains presented in the following ICF sections: "Body Functions", "Activity and Participation", and "Environmental Factors", which can be used by a clinical psychologist within rehabilitation activities. The rehabilitation diagnosis for this patient with an acute CVA in her early recovery period was provided by means of the ICF categories based on her individual characteristics and impairments, and the dynamics of recovery has been revealed. The ICF domains are presented with an indication of the content aspect and the degree of impairment. Discussion of results. The clinical case demonstrates the importance of taking into ac-count personal and environmental factors when describing one’s rehabilitation diagnosis and organizing the rehabilitation process. Applying the ICF categories makes the patient's features and problems clear to all the multidisciplinary team members. The main difficulties of working with the ICF are related to the selection of domains due to the discrepancy between the conceptual apparatus of foreign and domestic psychology. The importance of understanding the semantic component of the domain has been shown. Limitations of screening tests have been noted, and the need to conduct a qualitative analysis of mental disorders within the framework of a personality-oriented approach has been updated. Conclusions. Applying the ICF allows one to maintain a productive interaction with all the members of the multidisciplinary team, describe the patient’s current problems and visually assess the dynamics of recovery. At the same time, its use in the practice of a clinical psychologist requires a specialist to have a deep understanding of the content of the ICF psychological domains and skills to select them for each specific case.