Use of the international classification of functioning, disability and health to develop a home health care system

Abstract

Background: In Thailand, home health care is an essential service for persons with disabilities. TheMedical Service Center, Faculty of Medicine, Mahasarakham University, Thailand had responsibility for providing home health care to people in 6 communities; however, the outcome was not reached the optimum goal of the service. To improve effectiveness of the service, therefore, an action research was conducted to develop a home health care system of the center. The International classification of Functioning, Disability and Health (ICF) was applied in this development as it conformed to the holistic approach and could implement in community setting for several purposes. The research consisted of 2 parts, designing and implementing the system. This report revealed the findings of the first part of the research. Purpose: To explore the perception of the ICF among health personnel who were having roles in home health care service of the center, and to develop ahomehealth care system of the center. Methods: The research was conducted during January to September 2014. Eight health personnel in home health care team of the center participated in the study. They were a pharmacist, 3 nurses and 4 Thai traditional medicine personnel. To obtain the first purpose of the study, each participant was interviewed by the main investigator (PA) using a semistructured interview guide. Examples of interviewed issues were what the ICF was, how to use the ICF and how to apply it to the home health care service. For the second purpose, several group meetings were arranged for all of the participants. The 8 health personnel were encouraged to discuss and express their opinions about problems, supporting factors and barriers of the current home health care service of the center. Body of knowledge about the ICF and its application to health care service was presented to the participants. Then, an ICF-based home health care system of the center was collaboratively developed. Results: All of the participants were not familiar with the ICF and had no idea how to apply it to their works. However, after learning about the ICF and its application from the group meetings, the participants appeared to recognize the ICF as a useful framework for health care service such as goal setting, treatment planning and outcome measurement. In the home health care system developed by the participants, an ICF-based assessment tool with 12 ICF codes and their qualifiers selected from various Comprehensive ICF Core Sets was designed. How to manage and process all data were also established. Conclusion(s): The ICF was possibly used for guiding an effective service of home health care in which health care providers could design goals and appropriate implementation aswell as evaluation for clients in community setting. Further study to explore impacts of the developed home health care system after implementing it for the length of time is needed. Implications: Physical therapists and other health personnel may apply the findings of this study as a guideline for developing home health care services in their contexts.