international federation of hard of hearing people institute for health and rehabilitation sciences...
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Development of ICF Core Setsfor Hearing Loss
Berth Danermark, Sophia Kramer, Louise Hickson, Jean-Pierre Gangé, Claes Möller, De Wet Swanepoel, Bradley McPerson,
et al.
Partner-Organisations:International Federation of Hard of Hearing PeopleInternational Federation of Hard of Hearing People,
Institute for Health and Rehabilitation SciencesInstitute for Health and Rehabilitation SciencesICF Research Branch, WHO CC FIC GermanyICF Research Branch, WHO CC FIC Germany
Ludwig-Maximilian University of MunichLudwig-Maximilian University of Munich
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International Classification ofFunctioning, Disability
and Health
ICFApproved by the World Health Assembly in May 2001
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International
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ICF provides an international common language and universal conceptual framework for describing functioning, disability and health
Health condition(disease, trauma)
Environmental factors
Personal factors
Contextual factors
The biopsychosocial model of functioning and disability
ActivityBody functionand body structure
ParticipationParticipation
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Foundations of the ICF
• International
• Independent of health condition / etiology
• Independent of (health) profession
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A. Introduction
B. One-level classification
C. Two-level classification
D. Detailed classification with definitions
E. Annexes
F. Index
Contents
http://www3.who.int/icf/icftemplate.cfm
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Body Function & StructureBody Function & Structure
• Body functions are physiological functions of body systems, including psychological functions
• Body structures are anatomical parts of the body, such as organs, limbs and their components
– Impairments
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Activity & Participation
• Activity is the execution of a task or action by an individual. It represents the individual perspective of functioning.
• Participation is involvement in a life situation. It represents the societal perspective of functioning.
– Activity limitations
– Participation restrictions
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Environmental Factors
• Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives
– Environmental factors are external to individuals and can have positive (facilitator) or negative (barrier) influence on the individual
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Personal Factors
• e.g. gender, age, race, fitness, lifestyle, habits, social background, other health conditions …
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bb11 – – bb88 ss11 – – ss88 dd11 – – dd99 ee11 – – ee55 ChaptersChapters
ICF -- StructureICF -- Structure
ICFICF
Body Body FunctionsFunctions
Body Body StructuresStructures
Activity &Activity & ParticipationParticipation
Environmental Environmental FactorsFactors
PersonalPersonalFactorsFactors
bb ss dd ee
bb111010 – – bb889999 ss111010 – – ss889999 dd111010 – – dd999999 ee111010 – – ee559999 2nd Level2nd Level
bb11101000 – – bb77808099bb1114142200 – – bb5545450099
ss11101000 – – ss88303099ss1110100000 – – ss7760600099
dd11151500 – – dd99303099 ee11101000 – – ee55959599 3rd Level3rd Level4th Level4th Level
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One-Level Classification
Skin and related structuresSkin and related structures
Structures related to movementStructures related to movement
Structures related to the genitourinary Structures related to the genitourinary and reproductive systemsand reproductive systems
Structures related to the digestive, Structures related to the digestive, metabolic and endocrine systemsmetabolic and endocrine systems
Structures of the cardiovascular, Structures of the cardiovascular, immunological and respiratory immunological and respiratory systemssystems
Structures involved in voice and Structures involved in voice and speechspeech
The eye, ear and related structuresThe eye, ear and related structures
Structures of the nervous systemStructures of the nervous system
Functions of the skin and related Functions of the skin and related structuresstructures
Neuromusculoskeletal and Neuromusculoskeletal and movement-related functionsmovement-related functions
Genitourinary and reproductive Genitourinary and reproductive functionsfunctions
Functions of the digestive, metabolic Functions of the digestive, metabolic and endocrine systemsand endocrine systems
Functions of the cardiovascular, Functions of the cardiovascular, haematological, immunological and haematological, immunological and respiratory systemsrespiratory systems
Voice and speech functionsVoice and speech functions
Sensory functions and painSensory functions and pain
Mental functionsMental functions
Chapter 8Chapter 8
Chapter 7Chapter 7
Chapter 6Chapter 6
Chapter 5Chapter 5
Chapter 4Chapter 4
Chapter 3Chapter 3
Chapter 2Chapter 2
Chapter 1Chapter 1
Body Structures (s)Body Structures (s)Body Functions (b)Body Functions (b)
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One-Level ClassificationActivities and Participation (d)Activities and Participation (d)
Major Life AreasMajor Life AreasInterpersonal InteractionsInterpersonal InteractionsDomestic Life AreasDomestic Life AreasSelf CareSelf CareMovementMovementCommunicationCommunicationGeneral Tasks and DemandsGeneral Tasks and DemandsLearning & Applying KnowledgeLearning & Applying Knowledge
Community, Social & Civic LifeCommunity, Social & Civic LifeChapter 8Chapter 8Chapter 7Chapter 7Chapter 6Chapter 6Chapter 5Chapter 5Chapter 4Chapter 4Chapter 3Chapter 3Chapter 2Chapter 2Chapter 1Chapter 1
Chapter 9Chapter 9
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One-Level ClassificationEnvironmental Factors (e)Environmental Factors (e)
Services, systems and policies Services, systems and policies AttitudesAttitudesSupport and relationshipsSupport and relationships
Natural environment and human-made changes to the Natural environment and human-made changes to the environmentenvironment
Products and technologyProducts and technology
Chapter 5Chapter 5Chapter 4Chapter 4Chapter 3Chapter 3
Chapter 2Chapter 2Chapter 1Chapter 1
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Uniform or generic scale (qualifier)
0 NO problem (none, absent, negligible,...)
1 MILD problem (slight, low,...)
2 MODERATE problem (medium, fair...)
3 SEVERE problem (high, extreme,...)
4 COMPLETE problem (total,...)
8 not specified (the available information does not suffice to specify the severityof the problem)
9 not applicable (it is inappropriate or not possible to apply the code)
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ICFICF
ICFICF
Body Body FunctionsFunctions
Body Body StructuresStructures
Activity &Activity & ParticipationParticipation
Environmental Environmental FactorsFactors
PersonalPersonalFactorsFactors
bb ss dd ee
0 NO problem (none, absent, negligible,…)
1 MILD problem (slight, low,...)
2 MODERATE problem (medium, fair...)
3 SEVERE problem (high, extreme,...)
4 COMPLETE problem (total,...)
8 not specified (the available information does not suffice to specify the severity of the problem)
9 not applicable (it is inappropriate or not possible to apply the code)
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ICFICF
ICFICF
Body Body FunctionsFunctions
Body Body StructuresStructures
Activity &Activity & ParticipationParticipation
Environmental Environmental FactorsFactors
PersonalPersonalFactorsFactors
bb ss dd ee
0 NO barrier
1 MILD barrier
2 MODERATE barrier
3 SEVERE barrier
4 COMPLETE barrier
0 NO facilitator
+1 MILD facilitator
+2 MODERATE facilitator
+3 SEVERE facilitator
+4 COMPLETE facilitator
8 not specified9 not applicable
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ICF Core Sets
Fractions of the ICF relevant for specific health conditions and/or a specific context
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• Dictionaries of human languages
– Words and descriptions of these words which enable us to communicate all aspects of the human experience
• The ICF dictionary
– Names, codes, and descriptions of categories which enable us to communicate about the human experience in relation to functioning and disability
• 300´000 - 600´000 words
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• How many of the 300´000 - 600´000 words of a spoken language do we need inday-to-day reality?
– 2000 words cover 85% of the spoken language– With additional 2500 words one covers 95%!
• How many of the 1454 ICF categories do we need in clinical practice or research?
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• ResearchClinical encounter (by a single profession)
– Approximately 10-20
• Multi-disciplinary assessment (by a team)
– approximately 70-150
• Selection depends on
– Health condition – Context (acute, postacute, long-term; age)
Brief ICF Core Sets
ComprehensivelyICF Core Sets
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ClinicalPerspective
Researchers’Perspective
Patients’Perspective
Health professionals’Perspective
What problems of persons with the
health condition are measured and
reported in the literature?
Phase IPhase I Phase IIPreparatory PhasePreparatory Phase
Year 1 Year 2
What problems of persons with the
health condition are found in clinical
practice?
What are the problems that persons
with the health condition experience from
their perspective?
What problems of persons with the health
condition are considered relevant by the
health professionals that treat them?
Empirical multicenter study
Systematic literature review
Focus groupsPatients’ interviews
Experts’ survey via email
Relevant
Categories
International ICF
consensus
conference
1st version of the
ICF Core Sets for hearing loss
Phase IPhase I Phase II
Testing and
Validation of the
1st version of the
ICF Core Sets for hearing loss
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Comprehensive ICF Core Set
List of ICF categories that includes as few categories as possible to be practical, but as many as necessary to describe the typical spectrum of problems in functioning of patients with a specific condition in a comprehensive, multidisciplinary assessment
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Brief ICF Core Set
List of ICF categories that serves as a minimum data set that will be reported in every clinical study to provide a standardized description of the burden of disease
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ICF Core Sets for e.g. Chronic widespread pain Low back pain Osteoarthritis Osteoporosis Rheumatoid arthritis Chronic ischemic heart disease Diabetes Obesity Obstructive pulmonary diseases Depression Breast cancer Stroke
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The aim
A brief and a comprehensive core set for hearing loss for field tests and validations in year 2011
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Invitation
We invite all members of ICRA to participate in the core sets project!