Validation of the ICF Core Set for Vocational Rehabilitation from the perspective of patients with spinal cord injury using focus groups

Abstract

Introduction: The International Classification of Functioning, Disability and Health (ICF) Core Set for Vocational Rehabilitation is an application of the ICF of the World Health Organization with the purpose of identifying problems and resources relevant for people in a vocational rehabilitation given a health condition. Objective: The objective of the study was to validate the Comprehensive ICF Core Set for Vocational Rehabilitation from the perspective of patients with spinal cord injury (SCI). The specific aims were to explore the aspects of functioning and health important to patients with SCI regarding return to work and to examine to what extent these aspects are represented by the current version of the Comprehensive ICF Core Set for Vocational Rehabilitation. Methods: Focus group interviews were conducted. The sampling of patients followed the maximum variation strategy. Sample size satisfied saturation criterion. The focus groups were digitally recorded and transcribed verbatim. The meaning condensation procedure was used for the data analysis. After qualitative data analysis, the resulting concepts were linked to ICF categories according to established linking rules. Results: Twenty-four SCI patients participated in seven focus groups. Sixty-three ICF categories out of 90 ICF categories contained in the Comprehensive ICF Core Set for Vocational Rehabilitation were reported by the patients. Forty-two additional categories that are not covered in the Comprehensive ICF Core Set for Vocational Rehabilitation were found but adding the health condition-specific ICF Core Set for SCI in long-term context, only 11 categories were not covered. Conclusions: The existing version of the Comprehensive ICF Core Set for Vocational Rehabilitation was confirmed almost entirely by the focus groups to explore the vocational situation of patients with SCI.Implications for RehabilitationValidation of the ICF Core Set for Vocational Rehabilitation as a useful tool to facilitate social reintegration and rehabilitation of patients with SCI.Return to work is a key outcome in vocational rehabilitation of patients with SCI including those who are young with long-term employment prospects.The results of this study could provide a foundation in utilizing the ICF Core Set for Vocational Rehabilitation to guide rehabilitation goals, service planning and evaluation, and fostering an engaging relationship with employers in the context of SCI rehabilitation.SCI patients have specific needs, not entirely covered by the both ICF Core Set for SCI long-term context and for Vocational Rehabilitation. Our results underline some of the second level categories, probably related to specific SCI impairment, which can be useful to plan specific rehabilitation programs to improve the return to work after SCI.