Expert consensus on protocol of rehabilitation for COVID-19 patients using framework and approaches of WHO International Family Classifications.

Coronavirus disease 2019 (COVID-19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO-FICs) framework to form an expert consensus on the COVID-19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO-FICs.

Validation of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in persons with disabilities and chronic illnesses for Chinese population.

PURPOSE: The aim of this study is to test the psychometric properties and validity of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in Traditional Chinese-speaking persons with disabilities and chronic illnesses. METHOD: The WHODAS II CT has been administrated to a sample of 1020 persons with disabilities and chronic illnesses. The construct validity, internal consistency, concurrent validity and convergent validity were evaluated. RESULTS: WHODAS II CT showed a satisfactory model fit for the second-order confirmatory factor analysis model (χ(2)/df = 3.05, root means square error of approximation = 0.053, comparative fit index = 0.912, standardized root mean square residual = 0.076), high internal consistency (Cronbach's α = 0.98), high correlation with all domains of Dartmouth Primary Care Cooperative Research Network/World Organization of National Colleges, Academies, and Academic Associations of General Practices/Family Physicians (COOP/WONCA) charts (partial correlation coefficient ranged from 0.26 to 0.74) and significance between persons with and without co-morbidity (all regression coefficients >0). CONCLUSIONS: WHODAS II CT is a reliable and valid instrument to measure the disability in persons with disabilities and chronic illnesses among Traditional Chinese-speaking population. A further study is required to validate the short version of WHODAS II in order to enhance its applicability in usual and clinical practices. Implications for Rehabilitation This is the first study to evaluate the reliability and validity of WHODAS II in persons with disability and chronic illnesses among Traditional Chinese-speaking population. The WHODAS II CT is a valid instrument in Chinese adults with disabilities and chronic illnesses. The WHODAS II CT is recommended to be used in population-based survey to investigate the health needs of persons with disabilities and chronic illnesses as well as in the rehabilitation programs as an outcome measure.

The feasibility and validity of the comprehensive ICF core set for stroke in Chinese clinical settings.

OBJECTIVE: To inspect the feasibility and content validity of the comprehensive International Classification of Functioning, Disability and Health (ICF) core set for stroke by describing relevant aspects of functioning, disability and environmental factors affected in Chinese patients post stroke. DESIGN: Multicentre, cross-sectional study. SETTING: Department of rehabilitation medicine. SUBJECTS: The content validity was evaluated using frequency and percentage of 208 patients with a mean age of 60 years post stroke in China. OUTCOME MEASURES: Aspects of body function and structure, activity and participation, and environmental factors in the comprehensive ICF core set for stroke. RESULTS: Six ICF categories of body function were identified as a problem in over 90% (n = 187) of the patients (functions of the cardiovascular system and neuromusculoskeletal and movement-related functions). Impairments of brain, upper and lower extremity were identified as a problem in over 50% (n = 104) of the patients. Four ICF categories of activities and participation were documented as a problem in 100% (n = 208) of the patients (domestic and civic life). In environmental factors, nine ICF categories were documented as barriers by more than 10% (n = 20) and fewer than 50% (n = 104) of the patients (products and technology, physical geography, societal attitudes, services, systems and polices). Six ICF categories were identified as facilitators in over 90% (n = 187) of the patients (support and relationships and attitudes). CONCLUSION: The findings suggest that it is feasible to apply the comprehensive ICF core set for stroke in the Chinese clinical setting, after the appropriate reduction of some categories according to Chinese patients' characteristics and culture.

Content comparison of questionnaires and scales used in low back pain based on the international classification of functioning, disability and health: a systematic review.

PURPOSE: To identify questionnaires and scales that measure functioning and disability in low-back pain (LBP) and determine whether the measurements are comparable with the International Classification of Functioning, Disability and Health (ICFDH). METHODS: We searched MEDLINE, EMBase, CINAHL and PEDro in English, and CNKI and Wanfang Data in Chinese in a period from the date of the database establishment to September 2010. From the identified literature, questionnaires and scales used to assess LBP-related functioning and disability were collected and classified. Each item in each questionnaire and scale was extracted and classified according to the ICFDH categories. RESULTS: We have reviewed 7968 published articles and identified a total of fifteen questionnaires. A total of 219 items were analyzed and a total of 354 concepts contained in these items and 345 could be linked to ICFDH components, 138 linked to body function, 20 to body structure, 174 to activities and participation, and 13 to environmental factors, and 9 to a non-classifiable cluster. In the body functions component, only the single category "sensation of pain" was covered by most questionnaires. In the activity and participation component, "changing basic body position"; "walking" and "maintaining a body position" were covered by most questionnaires. Analyzing individual questionnaires, we found that two questionnaires (Clinical Back Pain Questionnaire and Million Disability Questionnaire) demonstrate a well-balanced distribution of items across different ICFDH components. CONCLUSION: This study may help researchers and clinicians to choose the most appropriate questionnaires for a specific purpose as well as help compare studies that have used different questionnaires for low back pain assessment and provide valuable information on the content quality of these questionnaires for them. Furthermore, based on our results, more comprehensive and balanced instruments may be developed for more accurate assessment of functioning in LBP and perhaps other clinical conditions.

The research on the status, rehabilitation, education, vocational development, social integration and support services related to intellectual disability in China.

Intellectual disability (ID) is a prevalent form of non-progressive cognitive impairment. The objectives of this articles are: to analyze the changes of ID in China, including its definition, prevalence, rehabilitation, education, vocational development, social life and support services; to review and to compare the issues of intellectual disability in China with the international literatures and research studies and to provide useful updated information and reference data for scholars and researchers who study intellectual disability. Analyzed the data obtained from two national sample surveys on disability with respect to intellectual disability in China. The estimated prevalence of individuals with intellectual disabilities in China was 7.5‰ in 2006 nationally which was lower than the previous results obtained in the 1987 national survey. The fourth level of ID showed a downward trend, while the proportion among the population aged 60 and over with ID tended to increase. The 2006 national survey indicated that the prevalence of ID in rural areas was higher than that in urban areas. This finding was consistent with the national survey conducted in 1987. As indicated by the 2006 national survey, 29.4% cases had no known causes for the ID, the proportion tended to decrease as compared with the first survey. However, when compared to the 1987 report, the proportion of senile dementia among older people as indicated by the 2006 report was higher than before. During the past years, the prevention of ID and the quality of life of individuals with ID have improved due to the enactment and implementation of a series of national laws and regulations, however, there is more that needs to be done in the areas of education, vocational development, social integration and support services for individuals with ID in order to improve the quality of life of individuals with ID in China. The findings of this study are consistent with the research findings presented in the international literatures. ID is the conditions that deserve further study and deserve the attention of policy makers and rehabilitation professionals in China. Furthermore, with the ageing of population in China and its impact to the social security system, the in-depth study of ID and its implications has become more pertinent in China in the future.