IC-Behavior: An interdisciplinary taxonomy of behaviors.

Academic disciplines are often organized according to the behaviors they examine. While most research on a behavior tends to exist within one discipline, some behaviors are examined by multiple disciplines. Better understanding of behaviors and their relationships should enable knowledge transfer across disciplines and theories, thereby dramatically improving the behavioral knowledge base. We propose a taxonomy built on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF), but design the taxonomy as a stand-alone extension rather than an improvement to ICF. Behaviors considered important enough to serve as the dependent variable in articles accepted for publication in top journals were extracted from nine different behavioral and social disciplines. A six-step development and validation process was employed, leading to the final taxonomy. A hierarchy of behaviors under the top banner of Engaging in activities/participating, reflective of ICF's D. hierarchy was constructed with eight immediate domains addressing behaviors ranging from learning, exercising, self-care, and substance use. The resulting International Classification of Behaviors (IC-Behavior), provides a behavior taxonomy targeted towards the interdisciplinary integration of nomological networks relevant to behavioral theories. While IC-Behavior has been labeled v.1.0 to communicate that it is by no means an endpoint, it has empirically shown to provide flexibility for the addition of new behaviors and is tested in the health domain.

Estudio descriptivo sobre la Clasificación Internacional del Funcionamiento y el diagnóstico de fisioterapia / Descriptive study on the International Classification of Functioning and diagnosis of physiotherapy

ANTECEDENTES/OBJETIVO: El diagnóstico de fisioterapia es uno de los eslabones menos desarrollados en la profesión y, aunque se reconoce a la Clasificación Internacional del Funcionamiento (CIF) como marco teórico, no se interpretan adecuadamente las propuestas y etiquetas diagnósticas. El objetivo de este estudio es describir los elementos clave que configuran el diagnóstico en fisioterapia integrando el contexto de la CIF. MÉTODO: Estudio descriptivo, observacional, transversal de corte cualitativo, basado en el modelo de análisis interpretativo de Grounded Theory. En primer lugar, se lleva a cabo una encuesta tipo Likert (n = 42) y, en segundo lugar, se realiza un análisis interpretativo de un grupo de discusión. RESULTADOS: El diagnóstico de fisioterapia es percibido por los participantes del grupo de discusión como un sello de identidad de la profesión, por su objetividad, su carácter científico y por favorecer la comunicación interdisciplinar. Se identificaron trece códigos organizados en cuatro categorías. Estas categorías son: las áreas de desarrollo del diagnóstico de fisioterapia, los perfiles de los fisioterapeutas, los conocimientos sobre la Clasificación, y las competencias de la Clasificación. Los códigos que definen estas categorías son, respectivamente: los roles académico, profesional e investigador; los perfiles clínico-asistencial, científico y afectivo-emocional; las definiciones, desventajas, mejoras y utilidad en el diagnóstico de fisioterapia; y los componentes de salud, conjuntos básicos y nivel internacional. CONCLUSIÓN: Los códigos obtenidos definen el diagnóstico de fisioterapia en el contexto actual de la CIF. Estos son aspectos para el estudio y elementos de referencia para desarrollar etiquetas diagnósticas acordes con las necesidades de la fisioterapia actual

BACKGROUND/OBJECTIVE: Physiotherapy assessment is one of the least developed elements of the profession. Diagnostic proposals and labels are not properly interpreted, although the International Classification of Functioning (ICF) is recognized as a theoretical framework. The objective of the study is to describe the key elements that make up the physiotherapy assessment within the context of the ICF. METHOD: A descriptive, observational, cross-sectional qualitative study based on the Grounded Theory interpretative analysis model. First, a Likert-type survey (n = 42) is carried out, and second, an interpretative analysis of a discussion group. RESULTS: Physiotherapy assessment is perceived by the discussion group respondents as a hallmark of the profession, due to its objectivity, its scientific nature and in promoting interdisciplinary communication. Thirteen codes organized into four categories were identified. These categories are areas of development of physiotherapy diagnosis, physiotherapist profiles, knowledge about the ICF, and domains of the classification. The codes that define these categories are: academic, professional and research roles; clinical, scientific and affective-emotional profiles; definitions, disadvantages, improvements and diagnostic suitability; and health-related domains, basic sets and international level. CONCLUSION: The codes obtained define the physiotherapy assessment in the current context of the ICF. These elements are essential for study and to develop diagnostic labels according to the needs of current physiotherapy

Towards a standardized nutrition and dietetics terminology for clinical practice: An Austrian multicenter clinical documentation analysis based on the International Classification of Functioning, Disability and Health (ICF)-Dietetics.

BACKGROUND: High quality, continuity and safe interdisciplinary healthcare is essential. Nutrition and dietetics plays an important part within the interdisciplinary team in many health conditions. In order to work more effectively as an interdisciplinary team, a common terminology is needed. This study investigates which categories of the ICF-Dietetics are used in clinical dietetic care records in Austria and which are most relevant to shared language in different medical areas. METHOD: A national multicenter retrospective study was conducted to collect clinical dietetic care documentation reports. The analysis included the "best fit" framework synthesis, and a mapping exercise using the ICF Linking Rules. Medical diagnosis and intervention concepts were excluded from the mapping, since they are not supposed to be classified by the ICF. RESULTS: From 100 dietetic records, 307 concepts from 1807 quotations were extracted. Of these, 241 assessment, dietetics diagnosis, goal setting and evaluation concepts were linked to 153 ICF-Dietetics categories. The majority (91.3%) could be mapped to a precise ICF-Dietetics category. The highest number of ICF-Dietetics categories was found in the medical area of diabetes and metabolism and belonged to the ICF component Body Function, while very few categories were used from the component Participation and Environmental Factors. CONCLUSIONS: The integration of the ICF-Dietetics in nutrition and dietetic care process is possible. Moreover, it could be considered as a conceptual framework for interdisciplinary nutrition and dietetics care. However, a successful implementation of the ICF-Dietetics in clinical practice requires a paradigm shift from medical diagnosis-focused health care to a holistic perspective of functioning with more attention on Participation and Environmental Factors.

Health-related quality of life in coronary heart disease: a systematic review and meta-analysis mapped against the International Classification of Functioning, Disability and Health.

BACKGROUND: Health-related quality of life (HRQoL) is an important outcome in coronary heart disease (CHD). However, variability in HRQoL indicators suggests a need to consider domain coverage. This review applies a globally accepted framework, the International Classification of Functioning, Disability and Health (ICF), to map HRQoL measures that are reliable and valid among people with CHD. METHODS: The Embase, Pubmed and PsycInfo databases were searched, with 10 observational studies comparing HRQOL among 4786 adults with CHD to 50949 controls identified. Study reporting quality was examined (QualSyst). Hedges' g statistic (with 95% CIs and p values) was used to measure the effect size for the difference between group means (≤ 0.2 small, ≤ 0.5 medium, ≤ 0.80 large difference), and between-study heterogeneity (tau, I2 test) examined using a random effects model. RESULTS: Adults with CHD reported lowered HRQoL (gw = - 0.418, p < 0.001). Adjusted mean differences in HRQoL ratings, controlling for socio-demographics, were smaller but remained significant. Large group differences were associated with individual measures of activity and participation (WHOQOL g = - 1.199, p < 0.001) and self-perceived health (SF 36 g = - 0.616, p < 0.001). CONCLUSIONS: The ICF provides a framework for evaluating and understanding the impact of CHD on HRQoL. The results demonstrate that HRQoL goes beyond physical symptoms, with activity limitations, social support and participation, and personal perceptions identified as key ICF domains in CHD assessment. Further investigations are needed to unravel the dynamic and inter-relationships between these domains, including longitudinal trends in HRQoL indicators.

Determinación de la situación de dependencia funcional. Revisión sobre los instrumentos de evaluación más utilizados / Determination upon functional dependence situation. Reviewing the most used evaluation tools

Introducción: la medición de la situación de dependencia es un acto fundamental para las diferentes administraciones públicas con competencias en el campo de la salud y de los servicios sociales, para así poder planificar de forma idónea las políticas encaminadas a la atención e intervención en este ámbito. Objetivo: el objetivo del presente trabajo es analizar los instrumentos de valoración de la situación de dependencia más utilizados en España, informando de su contenido y sus campos de aplicación más relevantes. Del mismo modo, conocer en qué se diferencian estas escalas de medida, del baremo de valoración de dependencia utilizado como puerta de acceso al Sistema para la Autonomía y Atención a la Dependencia. Método: este estudio se lleva a cabo mediante una revisión bibliográfica en las siguientes bases de datos: Dialnet, Scopus, SciELO y Fisterra.com. Conclusiones: Tras la pertinente revisión de la literatura existente, los resultados apuntan a que, a causa de la variabilidad de contextos en los que se enmarcan las situaciones de dependencia, existen una gran variedad de instrumentos de medida

Background: the measure of the dependence situation is a fundamental act for the different public administration, which are concerned with the health and also the social services; therefore appropriate way to plan the policies toward the assistance and procedure as well at this field. Objective: the aim of the present work is analyzing the most used valuation tools in Spain about the dependence situation. Reporting upon its content and its outstanding application fields is the goal. Knowing about the differences between these measurement scales, in relation to the dependence evaluation rate, is other goal as well. These scales are used to access to the System for Autonomy and Assistance to Dependence. Method: this study is made through a bibliographic review in the following database: Dialnet, Scopus, SciELO and Fisterra.com. Conclusion: after the appropriate reviewing of currently literature, the results indicate a wide variety of measure tools in spite of the fact that there are a huge variety of possible contexts inner dependence

[Evaluation of Contextual Factors in Psychosomatic Rehabilitation]. / Evaluation von Kontextfaktoren in der psychosomatischen Rehabilitation.

Objectives: Although individualized and ICF-oriented implementation of rehabilitation treatment requires knowledge of relevant contextual factors, there is a lack of operationalized documentation and measurement tools to evaluate these factors. Therefore, an ICF-oriented semi-structured interview was designed. Methods: 20 contextual factors were externally assessed whether they negatively affected mental functioning and participation of psychosomatic patients. Additionally, psychometric scales were applied. Results: Six relevant impairing contextual factors were identified. Contextual factors significantly correlated with psychometric scales. Patients with higher contextual impairment showed significantly higher psychological stress levels. Conclusions: Anamnesis of contextual factors at the beginning of psychosomatic rehabilitation yields important information for therapy planning. Further research on contextual factors in medical rehabilitation is needed.

Towards a Common Understanding of the Health Sciences.

OBJECTIVE: The aim of health sciences is to maintain and improve the health of individuals and populations and to limit disability. Health research has expanded astoundingly over the last century and a variety of scientific disciplines rooted in very different scientific and intellectual traditions has contributed to these goals. To allow health scientists to fully contextualize their work and engage in interdisciplinary research, a common understanding of the health sciences is needed. The aim of this paper is to respond to the call of the 1986 Ottawa Charter to improve health care by looking both within and beyond health and health care, and to use the opportunity offered by WHO's International Classification of Functioning, Disability and Health (ICF) for a universal operationalization of health, in order to develop a common understanding and conceptualization of the field of health sciences that account for its richness and vitality. METHODS: A critical analysis of health sciences based on WHO's ICF, on WHO's definition of health systems and on the content and methodological approaches promoted by the biological, clinical and socio-humanistic traditions engaged in health research. RESULTS: The field of health sciences is presented according to: 1) a specification of the content of the field in terms of people's health needs and the societal response to them, 2) a meta-level framework to exhaustively represent the range of mutually recognizable scientific disciplines engaged in health research and 3) a heuristic framework for the specification of a set of shared methodological approaches relevant across the range of these disciplines. CONCLUSION: This conceptualization of health sciences is offered to contextualize the work of health researchers, thereby fostering interdisciplinarity.

An Item Bank to Measure Systems, Services, and Policies: Environmental Factors Affecting People With Disabilities.

OBJECTIVES: To develop a measure of perceived systems, services, and policies facilitators (see Chapter 5 of the International Classification of Functioning, Disability and Health) for people with neurologic disabilities and to evaluate the effect of perceived systems, services, and policies facilitators on health-related quality of life. DESIGN: Qualitative approaches to develop and refine items. Confirmatory factor analysis including 1-factor confirmatory factor analysis and bifactor analysis to evaluate unidimensionality of items. Rasch analysis to identify misfitting items. Correlational and analysis of variance methods to evaluate construct validity. SETTING: Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place. PARTICIPANTS: Participants (N=571) had a diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18 years or older and English speaking. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: An item bank to evaluate environmental access and support levels of services, systems, and policies for people with disabilities. RESULTS: We identified a general factor defined as "access and support levels of the services, systems, and policies at the level of community living" and 3 local factors defined as "health services," "community living," and "community resources." The systems, services, and policies measure correlated moderately with participation measures: Community Participation Indicators (CPI) - Involvement, CPI - Control over Participation, Quality of Life in Neurological Disorders - Ability to Participate, Quality of Life in Neurological Disorders - Satisfaction with Role Participation, Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role Participation, and PROMIS Isolation. CONCLUSIONS: The measure of systems, services, and policies facilitators contains items pertaining to health services, community living, and community resources. Investigators and clinicians can measure perceptions of systems, services, and policies resources reliably with the items described here. Moderate relations between systems, services, and policies facilitators and PROMIS and CPI variables provide support for the measurement and theory of environmental effects on social functioning related to participation.

Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments.

OBJECTIVES: To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments. DESIGN: Cross-sectional, observational cohort. SETTING: Community. PARTICIPANTS: A sample of community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury (N=568). INTERVENTIONS: None. MAIN OUTCOME MEASURES: EFIB covering domains of the built and natural environment; systems, services, and policies; social environment; and access to information and technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey/Mobility (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of the Environment (MQE) short form; and 3 of the Patient Reported Outcomes Measurement Information System's (PROMIS) Quality of Social Support measures. RESULTS: The EFIB and legacy instruments assess most of the International Classification of Functioning, Disability and Health (ICF) environmental factors chapters, including chapter 1 (products and technology; 75 items corresponding to 11 codes), chapter 2 (natural environment and human-made changes; 31 items corresponding to 7 codes), chapter 3 (support and relationships; 74 items corresponding to 7 codes), chapter 4 (attitudes; 83 items corresponding to 8 codes), and chapter 5 (services, systems, and policies; 72 items corresponding to 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE barriers, HACE technology mobility, FABS/M community built features, and PROMIS item banks and by small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, whereas all intra-EFIB correlations were at least moderate. CONCLUSIONS: The EFIB measures provide a brief and focused assessment of ICF environmental factor chapters. The pattern of correlations with legacy instruments provides initial evidence of construct validity.

Fragilidad: ¿Cómo podemos detectarla? / Fragility: how do we detect it?

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Enhancing interprofessional education and practice: Development and implementation of a new graduate-level course using the international classification of functioning, disability, and health.

Since the introduction of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), there is increasing awareness among health professionals to consider a biopsychosocial approach to patients' health and functioning. Although diffusion of the ICF as a concept is widely recognized, application of the ICF within health education and practice requires attention, training, and support. This article describes the development and implementation of a new graduate-level course using the ICF to assist health professionals and graduate trainees in rehabilitation. The innovation behind this course is its focus on application of the ICF in research and practice through a combination of peer support and instructor mentorship. The value of the ICF for interprofessional education, research, and practice includes promotion of a broad perspective to health, application of theory in practice, and enhanced communication and collaboration in healthcare.

The Communication Supports Inventory-Children & Youth (CSI-CY), a new instrument based on the ICF-CY.

PURPOSE: Two studies are presented that evaluated the Communication Supports Inventory-Children & Youth (CSI-CY), an instrument designed to facilitate the development of communication-related educational goals for students with complex communication needs (CCN). The CSI-CY incorporates a code set based on the ICF-CY. The studies were designed to determine the effect of using the CSI-CY on IEP goals for students with CCN and to evaluate consumer satisfaction. METHOD: In Study 1, sixty-one educators and speech-language pathologists were randomly assigned to either (a) provide a student's current IEP (control group) or (b) complete the CSI-CY prior to preparing a student's next IEP and to submit the new IEP (experimental group). Study 2 was a field test to generate consumer satisfaction data. RESULTS: Study 1 showed that IEP goals submitted by participants in the experimental group referenced CSI-CY-related content significantly more frequently than did those submitted by control participants. Study 2 revealed high satisfaction with the instrument. CONCLUSIONS: The code set basis of the CSI-CY extends the common language of the ICF-CY to practical educational use for children with CCN across diagnostic groups. The CSI-CY is well regarded as an instrument to inform the content of communication goals related to CCN. Implications for Rehabilitation The CSI-CY will guide rehabilitation professionals to develop goals for children with complex communication impairments. The CSI-CY is a new instrument that is based on the ICF-CY for documentation of communication goals.

Development of a Swedish Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for adult patients with attention-deficit hyperactivity disorder (ADHD).

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) in adults is a phenomenon that attracts a lot of attention in society today. Advances in research have made it clear that many conditions that make people seek medical and psychiatric care may have pervasive deficits in attention, motor control and impulsivity at their roots. Since ADHD in adults is a relatively new and very versatile concept, there is a great need for systemized classification of the ramifications of the deficit that extends into every aspect of these patients' lives. AIMS: To develop a Swedish Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for adult patients with ADHD. METHODS: A national expert survey was conducted using the Delphi technique and a formal consensus conference. Forty-two experts from different professions and organizations, including psychiatrists and physicians, psychologists, occupational therapists, a counsellor, a specialist nurse, representatives from a patient organization and representatives from the Swedish Social Insurance Agency, participated in the Delphi process and 28 participants from the expert group attended the consensus conference. RESULTS: At the formal consensus conference, 66 categories from the ICF were identified and included in the national Comprehensive Core Set for ADHD: 21 categories from the component body functions, 26 categories from the component activities and participation, and 19 categories from the component environmental factors. CONCLUSION: The Comprehensive Core Set for ADHD should be regarded as national and preliminary, and should be further tested and evaluated by experts in ADHD in clinical settings in Sweden.

Implementing disability evaluation and welfare services based on the framework of the International Classification of Functioning, Disability and Health: experiences in Taiwan.

BACKGROUND: Before 2007, the disability evaluation was based on the medical model in Taiwan. According to the People with Disabilities Rights Protection Act, from 2012 the assessment of a person's eligibility for disability benefits has to be determined based on the International Classification of Functioning, Disability, and Health (ICF) framework nationwide. The purposes of this study were to: 1) design the evaluation tools for disability eligibility system based on the ICF/ICF-Children and Youth; 2) compare the differences of grades of disability between the old and new evaluation systems; 3) analyse the outcome of the new disability evaluation system. METHODS: To develop evaluation tools and procedure for disability determination, we formed an implementation taskforce, including 199 professional experts, and conducted a small-scale field trial to examine the feasibility of evaluation tools in Phase I. To refine the evaluation tools and process and to compare the difference of the grades of disability between new and old systems, 7,329 persons with disabilities were randomly recruited in a national population-based study in Phase II. To implement the new system smoothly and understand the impact of the new system, the collaboration mechanism was established and data of 168,052 persons who applied for the disability benefits was extracted from the information system and analysed in Phase III. RESULTS: The measures of the 43 categories for body function/structure components, the Functioning Scale of Disability Evaluation System for activities/participation components, and the needs assessment have been developed and used in the field after several revisions. In Phase II, there was 49.7% agreement of disability grades between the old and new systems. In Phase III, 110,667 persons with a disability received their welfare services through the new system. Among them, 77% received basic social welfare support, 89% financial support, 24% allowance for assistive technology, 7% caregiver support, 8% nursing care and rehabilitation services at home, and 47% were issued parking permits for persons with disability. CONCLUSION: This study demonstrated that disability evaluation system based on the ICF could provide a common language between disability assessment, needs assessment and welfare services. However, the proposed assessment protocol and tools require additional testing and validation.