Staging of mobility, transfer and walking functions of elderly persons based on the codes of the International Classification of Functioning, Disability and Health

Jiro Okochi,Kiyoshi Takamuku,Tai Takahashi,Reuben Escorpizo

doi:10.1186/1471-2318-13-16

Abstract

BackgroundThe International Classification of Functioning, Disability and Health (ICF) was introduced by the World Health Organization as a common taxonomy to describe the burden of health conditions. This study focuses on the development of a scale for staging basic mobility and walking functions based on the ICF.MethodsThirty-three ICF codes were selected to test their fit to the Rasch model and their location. Of these ICF items, four were used to develop a Guttman- type scale of “basic mobility” and another four to develop a“walking” scale to stage functional performance in the elderly. The content validity and differential item functioning of the scales were assessed. The participants, chosen at random, were Japanese over 65 years old using the services of public long-term care insurance, and whose functional assessments were used for scale development and scale validation.ResultsThere were 1164 elderly persons who were eligible for scale development. To stage the functional performance of elderly persons, two Guttman-type scales of “basic mobility” and “walking” were constructed. The order of item difficulty was validated using 3260 elderly persons. There is no differential item functioning about study location, sex and age-group in the newly developed scales. These results suggested the newly developed scales have content validity.ConclusionsThese scales divided functional performance into five stages according to four ICF codes, making the measurements simple and less time-consuming and enable clear descriptions of elderly functioning level. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty using the Rasch model. In addition, each functional level might require similar resources and therefore enable standardization of care and rehabilitation. Illustrations facilitate the sharing of patient images among health care providers. By using the ICF as a common taxonomy, these scales could be used internationally as assessment scales in geriatric care settings. However these scales require further validity and reliability studies for international application.

Highlights

The International Classification of Functioning, Disability and Health (ICF) was introduced by the World Health Organization as a common taxonomy to describe the burden of health conditions
Unlike the International Classification of Diseases (ICD) [3], developed by the World Health Organization (WHO), to which medical records can serve as an information resource, the ICF measures the problems in an individual’s functioning with respect to a health condition
Staging offers standardization of rehabilitation and care management because patients of the same group in a certain level require a similar amount and type of resources. This was achieved by hierarchically rearranging the ICF items and constructing Guttman-type scales according to item difficulty

Summary

Introduction

The International Classification of Functioning, Disability and Health (ICF) was introduced by the World Health Organization as a common taxonomy to describe the burden of health conditions. In 2001, the World Health Organization (WHO) approved the International Classification of Functioning, Disability and Health (ICF) to describe functioning in health and health-related contexts. Unlike the International Classification of Diseases (ICD) [3], developed by the WHO, to which medical records can serve as an information resource, the ICF measures the problems in an individual’s functioning with respect to a health condition. The number of digits in an ICF code represents an increasing level of precision in the categorization or definition for each function in that domain. The high number of codes (n = 1434) makes the use of the ICF by health care professionals challenging. To facilitate the use of the ICF codes, it is necessary to tailor them to the target population

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