International Classification of Functioning, Disability and Health: An Introduction for Rehabilitation Psychologists.

Abstract

The International Classification of Functioning, Disability and Health (ICF) represents a new way for rehabilitation psychologists and other health care providers to classify health and functioning. The ICF classifies functioning and disability through the constructs of Body Functions and Structures and Activities and Participation and addresses contextual influences through Environmental and Personal Factors. The ICF and its companion classification, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, provide a complementary, broad, and meaningful picture of the health of an individual or of entire populations. Research and clinical implementation efforts suggest that the ICF is a useful and meaningful public health tool. The development of the ICF and its universe and scope of application are reviewed. Critical concepts are defined, the structure of the ICF is illustrated, and clinical‐research utility are featured in light of the ethical considerations for responsible use by rehabilitation psychologists. The International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2001) was endorsed by the 54th World Health Assembly for international use on May 22, 2001. Given its focus on health, disability, and functioning, the ICF is an important and relevant development in rehabilitation psychology practice. This article orients rehabilitation psychologists to the ICF so they can apply it to research and practice. The structure of the ICF is described, and important concepts are defined. Reviewed are related research, clinical applications, and ethical considerations associated with the use of the ICF in rehabilitation psychology and general clinical practice. The ICF is intended to be used with its companion classification, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10; WHO, 1992). There is some overlap between the ICF and the ICD-10 in that they both classify impairments in various body systems. However, the ICD-10 provides an etiological classification of health conditions (e.g., diseases, disorders, injuries), whereas the ICF offers a framework for conceptualizing functioning and disability associated with health conditions. Disease may manifest itself differently in two individuals, and similar functioning does not necessarily imply similar health conditions. Thus, together the ICD-10 and the ICF yield a complementary, broad, and meaningful picture of the health of an individual or of entire populations. Health outcomes data gleaned from the ICF can be used in tandem with ICD-10 mortality data to monitor the health of international populations, allowing a much broader picture of public health to emerge than either alone could permit. For a comprehensive review of other health status measures, the reader is referred to Stucki, Ewert, and Cieza (2003).