[Health, social, societal and organizational political effects of the implementation of the ICF on integrated rehabilitation--a vision of the conversion and its consequences]. / Gesundheits-, sozial-, gesellschafts- und organisationspolitische Auswirkungen der Anwendung der ICF auf eine integrierte Rehabilitation - Vision der Umsetzung und ihrer Folgen.

Fundamental joint principles on expert opinions according to the social law code no. IX (SGB IX) and their application to a virtual individual case history were published recently in this journal. They are based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). A visionary review of the chances and prospects for the further development of the rehabilitative system is outlined and the necessary steps for their implementation are demonstrated.

[Aspects of expertise which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX - Teil II: Fallbeispiel -

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurance. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[Aspects of expertising which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX--Teil I: Grundlagen.

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurances. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[The Duke Health Profile (DUKE)]. / Das DUKE-Gesundheitsprofil (DUKE).

The Duke Health Profile is a 17-item generic questionnaire instrument designed to measure adult self-reported functional health status quantitatively during a one-week time window. It is appropriate for both patient and non-patient adult populations. It can be self-administered by the individual respondent or administered by another person. The administration time is less than five minutes. It is crucial that each question is answered. There are 11 scales. Six scales (i.e., physical health, mental health, social health, general health, perceived health, self-esteem) measure function, with high scores indicating better health. Five scales (i.e., anxiety, depression, anxiety-depression, pain disability) measure dysfunction, with high scores indicating greater dysfunction. Most extensive use has been in family practice patients with the broadest spectrum of diagnoses, but it has also been used in patient populations with specific diagnoses such as insulin-dependent diabetes mellitus, endstage renal disease, ischemic disease, and impotence. Both internal consistency (Cronbach's alpha) and temporal stability (test-retest) testing have supported reliability of the DUKE. Validity has been supported for the DUKE scales by: (a) comparison of the DUKE scores with scores of other health measures for the same patients, (b) comparison of DUKE scores between patient groups having different clinical diagnostic profiles and severity of illness, (c) prediction of health-related outcomes by DUKE scores. Convergent and discriminant validity have been shown when comparing with other instruments.

The International Classification of Impairments, Disabilities and Handicaps (ICIDH)--results and problems.

In 1980, the World Health Organization (WHO) published the International Classification of Impairments, Disabilities and Handicaps (ICIDH). Although these three concepts of impairment, of disability, and especially of handicap have been criticized for many reasons, the ICIDH has given rise to extensive research and other activities world-wide, resulting in more than a thousand publications. The ICIDH has been translated into numerous languages. The classification itself, developed for trial purposes, shows the large variety for the items of each basic term. Practical experience, however, has shown that the ICIDH cannot be applied without problems. This is especially true for the handicap concept.

[International Classification of Impairments, Disabilities and Handicaps ICIDH--results and problems]. / Die internationale Klassifikation der Impairments, Disabilities und Handicaps ICIDH--Ergebnisse und Probleme.

Published by the World Health Organization in 1980, the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) provides a conceptual framework for information by enabling classification, and hence description, of the three dimensions of the phenomenon of "disablement" (as a consequence of disease, injury or congenital condition). The ICIDH permits a highly complex issue to be easily grasped to a certain extent, and has gained almost worldwide recognition as a valuable tool in the perception of the problem of disablement, in describing this problem and developing solutions for this problem. With modern definitions in rehabilitation using its basic terms, the ICIDH will before long also be established as a tool for purposes of documentation, evaluation and treatment planning in the field of rehabilitation. Notwithstanding its successes, the ICIDH not only raises practical problems but theoretical ones as well. The points of criticism relate to the consequences of disease model, the definitions of the basic terms, and the overlap of basic term extensions. In order to overcome the definitional and overlap problems it is suggested, for one, to clearly distinguish between the phenomena and their symptoms and, for the other, to eliminate any overlap that may exist in the formulation of the concepts the definitions of the basic terms build on. The ICIDH model of disease consequences may be viewed as a preliminary step towards developing a theory of disablement. Such a theory would in particular be designed to enable explanation and prognosis of disablement creation processes as well as development of causally founded methods of intervention in rehabilitation. It should moreover include a theory of the etiologic processes involved in disablement as well as a theory of rehabilitative intervention. The crucial future tasks of the rehabilitation sciences will include the further development of a theory of disablement enabling provision of assistance to persons with disablement, or at risk of being disabled, in a more purposeful and causally founded manner than has been the case so far.