International classification of functioning disability and health pdf

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international classification of functioning disability and health pdf

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The International Classification of Functioning, Disability and Health: a systematic review of observational studies. This study is a systematic review of articles that use the ICF in observational studies. We excluded those in which the samples did not comprise individuals, those about children and adolescents, and qualitative methodology articles.

International Classification of Functioning, Disability and Health (ICF)

Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. International Classification of Disease ICD diagnoses included disorders of the nervous system The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist.

Poor oral health is the commonest health problem in the world and as such, is a major public health issue and a major consumer of health spending [1]. Extreme inequalities in oral health exist however, in relation to functional capacity and disability, socioeconomic status and socio-political environment, both for adults and children [2] — [10].

Studies describe poor oral health in young populations with medical, social or psychological problems but these populations are ill-defined and difficult to identify and target. Many reports describe their study population solely in terms of medical diagnosis, but this gives very little information as to the capacity of the child to maintain oral health, within his or her socio-environmental context [11].

Other studies concentrate on quantifying disease prevalence but this again gives little insight into the actual determinants of poor oral health [4]. The most comprehensive model for describing human functioning in relation to health and the environment is the International Classification of Functioning, Disability and Health ICF , adopted by the WHO in [18] and adapted for use in children and adolescents from Child and Youth version: ICF-CY [19] , [20]. These aspects of human functioning influence, and are influenced by, Health condition, Environmental factors and Personal factors.

The ICF model is illustrated in Figure 1 , with an oral health example. The basic premise of the ICF is that it is Universal , i. This characteristic is extremely important, as it allows comparison of equivalent health conditions of different aetiology and may reveal situational inequality or inequity in health and functioning. Examples of specific items and their codes can be seen in Figure 1.

Personal factors are not yet listed within the full classification. The ICD is an exhaustive list of human disease and the ICF was developed in part to remedy the reductive nature of such an approach. An ICF-Checklist has been developed by the WHO for standardised data collection, which consists of a list of items considered to be the most relevant ICF categories for clinical purposes [23]. The ICF Checklist has been modified for use in many different domains and disciplines to collect holistic data regarding human functioning [24] — [30].

The ICF has only twice been used empirically in the domain of oral health [16] , [31]. Practical use of the ICF is notoriously difficult as the classification is unwieldy and deliberately exhaustive, listing over items. The WHO solution to this problem has been to develop ICF Core Sets — reduced lists of ICF items specific to a particular domain and designed for practical use in clinical and epidemiological contexts [32].

ICF Core Sets are defined following strict methodological protocols and have been produced for over 30 different health domains so far e. It is hoped that this process, once completed, will provide a holistic but practical tool for investigating and reporting oral health in children. The study reported here is the first to describe the functional, social and environmental profiles of an international sample of children within the specific context of oral health.

It has been used in a large number of medical domains but never before in the field of oral health, or using the ICF-CY [24] — [30] , [32]. Other items that only exist in the ICF-CY such as items relating to early language development or schooling were added to the questionnaire. An additional question was added to the general medical section of the questionnaire regarding perception of oral health [42] , [43] , as it has been proposed that oral and general health must be regarded as separate constructs [44].

Training was given using case studies, item by item examples, and peer review of questionnaire completion to ensure consensus and consistency. Inter-rater reliability was not formally tested however. Calibration of the investigators involving repeat examination and interview of the same children was not feasible in terms of time constraints, or in terms of the difficulty organising a clinical session for an international group of investigators. It is also likely that ethical considerations would have restricted participation of vulnerable children in such a calibration exercise.

This study used the ICF-CY Checklist for Oral Health to describe the medical, functional, social and environmental context of children and adolescents referred to special care or paediatric dental services.

This population was chosen for data collection, as it was assumed that these children accumulate a higher prevalence of potential risk factors for poor oral health than the general child population. Children are generally referred to services because they are dentally fearful, because of a disability that directly or indirectly affects their oral health [41] , or because of the magnitude of treatment required, either in terms of quantity or severity of oral pathology [46].

The aim was therefore to recruit a convenience sample of children or adolescents referred to Paediatric or Special Care Dental Units in France, Sweden, Ireland and Argentina. In this centre potential participants had to be informed of the study by a gatekeeper and agree to be approached prior to contact from the investigator. In case of doubt, discussion between investigators was used to reach consensus.

For Environmental Factors , absolute frequencies and relative frequencies prevalence of items entered as either a barrier or facilitator were reported. Only 18 patients 8. Demographic and general medical and functional information is presented in Table 1. The perceived quality of physical, mental and oral health of the patients is shown in Table 2. The patients The most common diagnosis was chromosomal abnormalities Other common diagnoses included disorders of the nervous system Table 5 also shows the frequency of impairment reported for items of oral function.

This prospective, international study describes a population of children and adolescents referred to special care or paediatric dental services. The ICF-CY was used to identify aspects that are common to children and adolescents attending oral health services with different health conditions and in different socio-cultural contexts.

The fact that these categories were cited so often, in such a heterogeneous population, confirms that certain items of functional impairment and participation restriction are particularly relevant to oral health. The results of this empirical study need now to be confronted with those from other preliminary studies before consensus on an ICF-CY Core Set in Oral Health can be reached [32].

The study provides a detailed description of children referred to secondary oral health services. A significant medical diagnosis, over and above anxiety, was reported for However, medical diagnosis alone is insufficient to quantify or qualify the degree to which the maintenance of oral health and the receipt of dental care might be difficult.

In particular, the danger of extrapolating medical diagnoses to reflect individual patient experience is illustrated by the fact that In terms of oral health, disease prevalence was high with It is widely recognised that oral health is generally poorer in children with special health needs than in the general population [8] , [49].

No direct comparison can be made between the caries prevalence reported here and caries rates reported for the general population of the study countries because the study populations are very different. However, in Sweden, where the caries rate was lowest, early intensive preventive intervention seems to have a positive effect for children with disability. It must be remembered, however, that the Swedish population reported here did not include any children with dental anxiety only, or any children referred to secondary services for extensive treatment under general anaesthesia, so the caries rates could be expected to be different to those of the other study centres.

These results are interesting as they suggest that children with significant medical diagnoses may be excluded from mainstream oral health preventive measures in many countries, but that positive intervention might be used to address these underlying situations of inequality.

Despite high prevalence of oral disorders, This may be compared to a previous investigation of perception of oral health, where The literature confirms the validity of such single-item proxy measures [43] , [51] — [53] and also the tendency for persons to maintain a positive sense of well-being when coping with oral disability [17].

Thus maintenance of oral health seems more related to the cognitive ability to comprehend daily oral care and cope with examination and treatment than to specific medical diagnoses. This corresponds with previous studies of the ICF profile of disabled patients with difficulty tolerating dental treatment or patients requiring treatment under general anaesthesia [16] , [31].

It is interesting that no other, more physical domains of function were cited frequently, such as movement function which could be anticipated to affect ability to maintain oral hygiene. The lack of a link between manual dexterity and oral hygiene was noted by Martens et al. The items most frequently cited in the Activities and Participation domain were distributed amongst all 9 chapters of the domain.

It is important to note that restriction in these activities is likely to be demonstrated not only by children with a recognised medical condition, but also by those exhibiting anxiety. On a more practical side, the children were limited in activities related to self-care, such as washing themselves and cleaning their teeth.

This echoes results of a previous study, where young persons with Down syndrome were found to have more difficulty in performing all acts of hygiene and health care than their siblings [57].

It was enlightening to find that all except one item highlighted in the Environmental Factors domain were rated as facilitators positive environmental factors as opposed to barriers. These facilitators were firmly embedded in the social context of the child — the support and attitudes of friends, family and health professionals.

The vast majority of patients and their parents also acknowledged the help received from various services, systems and policies within their national context, despite these services varying greatly between the different countries in the study. These results are comparable to those found in a similar, multicentre study using a modified ICF Checklist to investigate patients with head and neck cancer [26]. Discrimination and exclusion are recognised as powerful social determinants of health [59].

When comparing the results of different countries, the differences demonstrated in prevalence of items were to be expected given that all countries have different health system structures.

In addition, existing services in some countries are demand led and therefore the profile of patients presenting to services may be different even between regions or neighbouring services.

The inter-country differences may, however, reflect the fact that children with an equal level of impairment may be more or less disadvantaged, depending on their social and environmental context. Another potential reason for inter-country differences was inter-investigator variability. A previous study has demonstrated high reliability between investigators when assigning ICF codes to children with special health care needs from parental report using structured interview [60].

However, in the current study, inter-rater reliability was not controlled, although all investigators participated together in a case-based ICF training session prior to data collection. This study is limited in its scope by design as a convenience sample was used. The study population was consciously limited to those referred to secondary services, as it was assumed that these children accumulate a higher prevalence of potential risk factors for poor oral health than the general population.

However, this meant that other groups not attending services, or able to attend mainstream services, were missed. For example, it is recognised that children from socially deprived backgrounds are often poor dental attenders [61] , although this might have been compensated for by the fact that in two of the study centres such children were referred directly to the unit from social services or school screening programmes in anticipation of treatment under general anaesthesia.

It should be noted that this study was not designed to argue the need for specialist care but simply to describe the contextual factors affecting a group of children with high potential oral health needs. Another limiting characteristic of the current study was that data collection with regards to environmental context was restricted to those items listed in the ICF Checklist. This limits extrapolation of results in terms of the social determinants of health, as an important variable is socioeconomic status which was not measured [62].

The potential for practical application of the ICF in child populations has been regularly evoked [19] , [63] — [67] but rarely put into action [60] , [68] , [69]. The ICF-CY Checklist for Oral Health is the only questionnaire to date in the domain of oral health designed to give a holistic, biopsychosocial description of an individual, encompassing medical, functional, social and environmental context.

This tool was used to collect data in different clinical contexts, in different countries and in different languages, demonstrating that the ICF is adapted for use internationally. In addition, the ICF-CY was applicable for children with a huge range of different types of impairments and ICD diagnoses, confirming the robust, universal nature of the ICF items over a wide spectrum of human functioning.

The universal coherence of the ICF model was confirmed, as the results describe similar profiles relating to health conditions of different aetiology, and suggest different levels of disadvantage in different national contexts. A resulting Core Set would provide a practical tool for holistic assessment, as has been the case in other health domains [32].

An ICF-CY Core Set in Oral Health could be used to identify children requiring support to maintain their oral health either at the individual or the population level, encouraging targeted intervention in countries where the health care system permits. This would help prevent poor oral health becoming an additional disability for certain disadvantaged children, a well described problem in the adult population [71].

International Classification of Functioning, Disability and Health

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Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. International Classification of Disease ICD diagnoses included disorders of the nervous system The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

ICF is used across specialisations and national boundaries as a consistent standardised terminology to describe a person's functional health status, disability, social impairment and relevant environmental factors. ICF makes it possible to record systematically the bio-psycho-social aspects of the consequences of illness under consideration of contextual factors. Predecessors of the ICF have had a significance influence on social legislation in Germany. ICF is a multi-axial monohierarchical classification with alphanumeric codes. It consists of:. Thanks to the bio-psycho-social model that it is based on, the ICF is not primarily focused on deficits, i.

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Received 27th October, ; Received in revised form 30th November, ; Accepted 25th December, ; Published online 30th January, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Method: A reflexive study from the reading of texts on the said classification in professional practice. Results: It presents an approach about the family of classification of the World Health Organization with emphasis in this classification and a reflection on its use as a multiprofessional terminology with a focus on health, enabling systematic practice based on evidence and in decision-making according to the real needs of individuals.

Stroke is the third cause of long term disability worldwide and its rehabilitation program must to have into account all aspects of disability. International research and politics increasingly study the relationship between disability and the direct costs associated with living with a disability. Using the ICF, this article provides a correlation between financial assets and disability in participation and activities, in a context such as the Italian one where there is a twenty-year decentralization of the national health system Methods. Financial assets domains in environment and nine domains in participation and activities were correlated, in order to evaluate the relationship between familiar economic condition and disability.

Functioning and disability are viewed as a complex interaction between the health condition of the individual and the contextual factors of the environment as well as personal factors.

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National Library of Australia. Search the catalogue for collection items held by the National Library of Australia. World Health Organization. ICF : International classification of functioning, disability and health. The overall aim of the ICIDH is to provide a unified and standard language and framework for the description of health and health-related states including disabilities. Request this item to view in the Library's reading rooms using your library card.

Какая ирония, думал он, глядя в монитор Сьюзан. Хейл похитил пароли просто так, ради забавы. Теперь же он был рад, что проделал это, потому что на мониторе Сьюзан скрывалось что-то очень важное.

COMMENT 2

  • individuals' functioning, disability and health in various domains. ICF belongs to the “family” of international classifications developed by the. World Health. Armida C. - 15.06.2021 at 18:45
  • ICF is the WHO framework for measuring health and disability at both individual and population levels. ICF was officially endorsed by all WHO Member States. Uztetotheat - 17.06.2021 at 03:52

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