Classification Of Disability Research Articles

Total sacrectomy rehabilitation: Implementation of the international classification of functioning, disability, and health model – A case report

This study aims to outline an evaluative diagnostic process and intervention for a patient who underwent total sacrectomy based on the International Classification of Functioning, Disability, and Health (ICF) model. A 70-year-old male with a history of an aggressive sacral chordoma experiencing intense pain, constipation, and polyuria without the sensation of bladder filling, underwent a total sacrectomy. Two evaluations at two-time points were conducted 12 weeks apart. The patient then underwent an individualized rehabilitation program tailored to address impairments, activity limitations, and participation restrictions. The care plan was adjusted based on the patient’s health status and relevant personal and environmental factors. The Barthel Scale scores improved from 60 to 80. Motor scores on the American Spinal Injury Association scale increased from 62 to 66, while sensory scores for light touch improved from 86 to 96. However, pain scores remained stable at 86. Functional reach tests showed notable enhancements, with anterior reach increasing from 16.4 cm to 23.7 cm and lateral reach from 9.6 cm to 15.2 cm. The patient also showed progress in mobility, increasing the number of steps taken from 0 to 10. This case report highlights the positive therapeutic outcomes achieved, illustrating improvements in functional activities and patient independence, thereby underscoring the effectiveness of the ICF model in managing patients undergoing total sacrectomy.

Comparing the economic burden of disease by physical activity levels among persons with and without disabilities in the Republic of Korea

IntroductionThe World Health Organization recommends at least 150 min of physical activity per week for persons with and without disabilities. This study compared the differences in the economic burden of diseases between persons with and without disabilities based on their physical activity. What is known in the field is that physical activity is beneficial to health, but there is a disparity between persons without disabilities and persons with disabilities, and our research aims to increase physical activity among persons with disabilities.MethodsEconomic burden of disease includes service costs such as outpatient, hospitalization, and pharmaceutical expenses for disease treatment, and persons with disabilities are those who have received a disability classification legally registered by the Korean Ministry of Health and Welfare, and there are 15 types of disabilities. For exercise records, we calculated the cost in 2020 for people with exercise records in 2018 so that they can have at least 1 year of exercise records, as health checkups are available from January to December of the year. Physical activity attainment is defined as 150 min or more of physical activity per week based on World Health Organization guidelines.ResultsCalculating the economic burden of disease by physical activity for persons with and without disabilities, both experienced a difference in hospitalization costs owing to fewer hospital days with physical activity achievement, with the difference being greater for persons with disabilities. Regarding disability type, achievers showed a 41.1% difference in total costs for mental class disorders, 16.7% for external bodily function disorders, and 11.1% for internal organ disorders.DiscussionPhysical inactivity has a significant impact on the economic burden of persons with disabilities compared to persons without disabilities, with 11.8% fewer persons without disabilities who were physically active for 150 min or more per week compared to 21.4% fewer persons with disabilities. In terms of healthcare spending, exercise can help keep persons with disabilities healthy. Therefore, there is a need for exercise programs tailored to persons with disabilities to increase physical activity in line with World Health Organization recommendations to reduce health inequalities between persons with and without disabilities.

ATIVIDADE E PARTICIPAÇÃO SOCIAL: ANÁLISE DE CORRELAÇÃO EM PACIENTES HEMIPARÉTICOS CRÔNICOS

The International Classification of Functioning, Disability and Health (ICF) defines activities as actions performed by an individual, while social participation refers to involvement in life situations. The use of participation assessment questionnaires allows investigating the impact of these chronic conditions on functionality. In this cross-sectional study, ten individuals with chronic stroke sequelae were recruited. Activity and social participation were assessed using the Brazilian version of the Assessment of Life Habits 3.1. The results showed that nutrition-related activities had a significant positive correlation with community living (rs=0.7, p=0.02) and recreation (rs=0.7, p=0.01), while personal care and housing correlated significantly with responsibility (rs=0.6, p=0.02). Housing had a positive correlation with employment (rs=0.6, p=0.02) and recreation (rs=0.7, p=0.02). The positive correlations observed in this study suggest that better performance in activities is associated with better levels of social participation.

ICF based comparison of musculoskeletal health in regions of Poland and Spain.

The International Classification of Functioning, Disability and Health (ICF) is the framework for describing disability. The aim of the study was to compare differences in health status between the populations of the Podkarpackie region of Poland and the Castilla y León region of Spain, using the ICF core set for post-acute musculoskeletal conditions. A total of 840 people were included in the study. The brief version of ICF core set for post-acute musculoskeletal conditions was used in the study. Information obtained from semi-structured interviews and a physiotherapy assessment was recoded into ICF qualifiers to obtain comparable data. Significant differences in functioning were found between the two samples, with a higher prevalence in all the ICF entities for the Spanish sample. Similarities were found in the ICF components 'Body Functions' and 'Environmental Factors', with the most prevalent ICF entities being 'b280 Sensation of pain' and 'e225 Climate' respectively. For 'Activities and Participation', differences were observed, with 'd430 Lifting and carrying objects' being the most common for the Spanish sample and 'd450 Walking' for the Polish sample. Significant differences were found between the two samples, indicating better musculoskeletal health in the Polish sample. Future research using the ICF Core Sets in practice should be expanded and carried out in other countries to improve the ability to make comparisons between populations and to develop policies for territorial equity in health.Trial registration: NCT06283407.

The impact of stroke support groups on stroke patients and their caregivers

Background: Stroke survivors often face multifaceted challenges encompassing physical, psychological and social aspects of health during their recovery journey.Aim: To explore the impact of stroke support groups on stroke patients and their caregivers in Kenya.Setting: The study was conducted in eight Kenyan county referral facilities.Methods: The study applied a qualitative interpretive paradigm and collected data from semi-structured face-to-face interviews with eight stroke survivors and their caregivers. Thematic content analysis was employed to extract and analyse data.Results: The analysis of data revealed four key themes: (1) mental functioning, (2) environmental impact, (3) personal impact and (4) social participation. These themes were organised and related to the World Health Organization’s (WHO’s) International Classification of Functioning, Disability, and Health (ICF).Conclusion: Peer stroke support groups significantly enhanced the ICF component of mental functioning, environmental and personal, through emotional support, social connection, coping, learning, mobility, communication and domestic life of stroke survivors and caregivers. Participation promoted affirmation and acceptance, and reduced loneliness, which led to increased involvement in a range of activities. Moreover, stroke support groups played a vital role in empowerment, education and advocating for systemic change.Contribution: This study provides new information that improves understanding of the positive impact of stroke support groups in Kenya. It highlights the importance of integrating peer support into post-stroke rehabilitation programmes.

Disability and Participation in Colorectal Cancer Screening: A Systematic Review and Meta-Analysis

Background: The aim of this study is to assess the impact of disability on participation in CRC screening and to determine the overall effect size. Methods: We conducted a systematic review and meta-analysis to compare CRC screening participation in individuals with and without disabilities. The search encompassed five databases (PubMed, EMBASE, Scopus, Google Scholar, medRxiv). Pooled estimates were calculated for each type of CRC screening and disability categories to synthesize the findings. The participation in CRC screening was derived using a random effects model. Results: A total of 20 articles were included, most of them from the USA. Based on pooled estimates, individuals with disabilities have lower odds of undergoing CRC screening versus those without disabilities (OR = 0.80, 95%CI 0.73–0.87). Analysis by screening type indicated that individuals with a disability have lower odds of a fecal occult blood test or a fecal immunochemical test (OR: 0.72, 95%CI 0.65–0.81), with no significant difference for a colonoscopy. Individuals with intellectual disabilities had significantly lower rates of CRC screening participation (OR = 0.65, 95%CI 0.53–0.79), especially for FOBT/FIT (OR = 0.58, 95%CI 0.49–0.69). Conclusions: Disparities exist for CRC screening participation in people with disabilities. Further research and coordinated efforts are essential to develop interventions for improving early cancer diagnosis for this non-negligible patient group.

Dysphagia-Specific Instrument Based on Item Response Theory and International Classification of Functioning, Disability and Health.

This study aimed to identify functional challenges faced by individuals with non-esophageal dysphagia and to offer a tool for quantitatively evaluating the person abilities within the framework of the International Classification of Functioning, Disability and Health (ICF). Additionally, this study attempted to differentiate the personal abilities of individuals with dysphagia and hierarchize item difficulties using the ICF-based Item Response Theory (IRT) modeling approach. This cross-sectional study enrolled a cohort of 150 patients with dysphagia (105 male and 45 female) from a tertiary hospital in China. Participants were assigned to evaluate the 114-item ICF dysphagia questionnaire. To further assess their swallowing capabilities, eating patterns, quality of life, and nutritional status, participants underwent a battery of five additional scales. The ICF qualifiers underwent data shaping including dichotomization and missing value imputation, Mokken scale analysis (MSA) for checking unidimensionality, local independence, monotonicity, and invariant item ordering (IIO), and parametric IRT modeling for identifying an optimal model from the 1-parametric logistic model (1PLM), 2PLM, 3PLM, and 4PLM. Finally, we tested the robustness of the optimal model via Monte Carlo simulation and illustrated the usefulness of the model by its person-item map. The 1PLM emerged as the optimal model with a total of 50 ICF items (12 'd-Activities and Participation', 33 'b-Body Functions', and 5 'e-environmental' items). The final scale presented strong reliability with Cronbach's Alpha = 0.967. Furthermore, the scale showed good validity with a significant positive correlation (p < 0.001, = 0.60) between model-estimated person abilities and swallowing-quality of life (SWAL-QoL) scores. The findings also demonstrated measurement equivalence of the final model for individuals with different genders or across various age groups. The utilization of the person-item map can effectively compare the difficulty levels of items with the abilities of patients, thereby facilitating the delivery of tailored care and precise rehabilitation strategies that match the individual competency of those suffering from dysphagia. This study developed a parsimonious dysphagia-specific ICF outcomes tool derived from the IRT, named iSWAL-Performance Scale. The findings complement quantitative information on the psychometric characteristics of this 50-item scale.

The impact of surgical treatment of benign ovarian tumors on the reproductive health of women, taking into account the International Classification of Functioning

The article presents a systematic analysis of studies evaluating the impact of surgical treatment of benign ovarian tumors on reproductive health, taking into account the criteria stated by the International Classification of Functioning, Disability and Health. To identify articles, foreign and domestic scientific databases were used (PubMed, Cochrane, eLibrary). After the initial identification of 704 scientific publications, 46 articles were selected using inclusion and exclusion criteria.The conducted systemic analysis allows us to formulate the conclusion that surgical interventions performed for benign ovarian tumors contribute to damage to ovarian tissue, and as a result, a decrease in the ovarian reserve of patients, which is associated with impaired fertility. A number of authors have demonstrated some recovery of anti-Mullerian hormone (AMH) levels 3-12 months after surgery. A significant portion of the studies have demonstrated a more pronounced postoperative decrease in AMH rates in patients with endometriomas compared with women operated on for non-endometrioid ovarian tumors. Lower AMH rates were noted in women with bilateral surgeries for bilateral ovarian tumors compared to patients who had unilateral surgeries. The performed systemic analysis showed higher postoperative AMH rates in patients with intraoperative suture hemostasis in comparison with the use of bipolar energy; in addition, there is a relationship between the number of coagulations and the severity of the decrease in AMH rates. In a few studies, it was noted that patients who underwent surgical treatment of ovarian tumors experienced an earlier onset of menopause. In connection with these possible functional disorders, further clinical studies of a high level of evidence are needed, aimed at developing effective strategies for preserving the functioning of the reproductive system after surgical treatment of benign ovarian tumors.

The system of support for medical decision-making in the formation of a rehabilitation diagnosis in the categories of the International Classification of Functioning, Disability and Health

Introduction. Comprehensive rehabilitation of patients is a key task of the national healthcare system. To create an effective rehabilitation program, it is necessary to establish an accurate rehabilitation diagnosis. Designing an individual medical rehabilitation plan based on a biopsychosocial approach, the practical tool of which was the “International Classification of Functioning, Disability and Health” (ICF), has changed the global concept of rehabilitation. A priority in the field of digital healthcare is the introduction of medical decision support systems, one of the tasks of which is to help in diagnosis and minimize medical errors aimed at improving the quality of medical care. The purpose of the work: to create a software system for making medical decisions in the formation of a rehabilitation diagnosis in the ICF categories. Materials and methods. content analysis was used to study and analyze medical decision-making systems (foreign and domestic) and the ICF; scientific and methodological work was carried out on the development of software for medical decision-making systems. Results. based on the work carried out, software has been developed to automate, systematize, and optimize the process of establishing a rehabilitation diagnosis in patients with ischemic stroke, standardize approaches to individualizing diagnosis formulation taking into account the severity of functional disorders. Research limitations. During the development and description of the software, the capabilities of medical information systems applied in the healthcare of Moscow were used. Conclusion. The biopsychosocial approach is one of the main principles of modern rehabilitation. Digital healthcare facilitates the integration of decision support systems that improve the quality of medical care. The implementation of the developed program into digital platforms of the healthcare system will reduce time costs and unify the procedure for making a rehabilitation diagnosis and all related processes, consistently preserving the necessary information about the patient.

Validation of the Comprehensive and Brief International Classification of Functioning, Disability and Health Core Sets for Schizophrenia from the Perspective of Individuals Diagnosed with the Disorder: A Worldwide Study Using Focus Groups

The comprehensive and brief International Classification of Functioning, Disability and Health (ICF) core sets for schizophrenia, based on the World Health Organization (WHO) framework, aim to describe the functioning of individuals with schizophrenia. The objective of this study was to identify the most common problems faced by these individuals and validate the ICF core sets. Eight focus groups were conducted, recorded, and transcribed verbatim. The linking process involved two independent coders identifying meaningful units and linking agreed-upon concepts to the ICF categories. Data saturation was defined as the point at which no new categories emerged from additional focus groups. The 37 participants in this study represented the WHO regions of Africa, South-East Asia, the Western Pacific, and Europe. The focus groups confirmed the relevance of all ICF core set categories, with an additional 21 second-level categories being proposed in at least six of the eight focus groups. In this study, the ICF core sets for schizophrenia were validated from the perspective of individuals. However, several second-level categories not currently included in the ICF core sets also emerged. To ensure that the ICF core sets are truly international in scope, the potential relevance of these categories should be investigated further.

Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision – 2024

The Academy of Orthopaedic Physical Therapy (AOPT) has an ongoing effort to create evidence-based clinical practice guidelines (CPG) for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The 2024 Achilles Pain, Stiffness, and Muscle Power Deficit: Midportion Achilles Tendinopathy Clinical Practice Guideline (CPG) is a revision of the 2018 CPG and represents the third CPG from AOPT on this topic. The goals of the revision were to provide a concise summary of the contemporary evidence and to develop new recommendations or revise previously published recommendations to support evidence-based practice. This current CPG covers prevalence, pathoanatomical features, risk factors, clinical course, diagnosis, examination, imaging and physical therapy interventions for the management of midportion Achilles tendinopathy.

Exploring the Complexity of Falls in People With Multiple Sclerosis: A Qualitative Study.

The complexity of falls in people with multiple sclerosis (MS) needs further exploration to develop strategies to reduce fall risk. The aim of this study is to explore and describe factors contributing to falls and the complexity of fall situations in people with MS. This longitudinal study used individual interviews shortly after prospective reporting of falls. Manifest analysis was used to describe frequency, place, and time of falls. The International Classification of Functioning, Disability and Health (ICF) was used for deductive content analyses to describe fall-inducing factors. Participants were adults with MS (N = 33) who had experienced falls during the past year and who did not use walking aids. The 25 participants who fell during the study period reported 94 falls, mainly during the day (61%) and outdoors (56%). Fall situations were complex, with interaction between triggering and circumstantial factors related to all domains in the ICF, the impact of preceding factors, and fluctuating symptoms. The complexity of fall situations can be more clearly understood and managed by considering the preceding activities and circumstances in addition to describing single risk factors. This may facilitate discussions of fall risk between health care professionals and people with MS. Individualized fall risk assessments and interventions that strengthen self-management are recommended.

Affective disorders: eliminate WArning signs And REstore functioning: AWARE. Results from a randomized controlled multimodular intervention study targeting functioning in patients with affective disorders.

There is a compelling need for innovative intervention strategies for patients with affective disorders, given their increasing global prevalence and significant associated disability and impaired functioning. This study aimed to investigate whether a comprehensive multimodule individualized intervention (AWARE), targeting known mediators of functioning, improves functioning in affective disorders. AWARE was a randomized, controlled, rater-blind clinical trial conducted at two centers in the Capital Region of Denmark (Clinicaltrials.gov, NCT04701827). Participants were adults with bipolar disorder or major depressive disorder and impaired functioning. Participants were randomized to the six-month AWARE intervention or treatment as usual (TAU). The AWARE intervention is based on the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for Bipolar and Unipolar Disorder.The primary outcome was observation-based functioning using the Assessment of Motor and Process Skills (AMPS). Secondary outcomes were functioning, QoL, stress, and cognition. Between February 2021 and January 2023, 103 patients were enrolled; 50 allocated to AWARE treatment and 53 to TAU (96 included in the full analysis set). There was no statistically significant differential change over time between groups in the primary outcome (AMPS), however, both groups showed a statistically significant improvement at endpoint. The AWARE intervention had a statistically significant effect compared with TAU on secondary outcomes of patient-reported functioning, stress and cognition. Compared with TAU, the AWARE intervention was ineffective at improving overall functioning on the primary outcome, presumably due to the short duration of the intervention. Further development of effective treatments targeting functioning is needed.

Guideline-recommended standardized instruments in multiple sclerosis : Acomparative content analysis based on the International Classification of Functioning, Disability and Health (ICF)

Guidelines serve as practice-based decision support and recommend the use of standardized instruments to measure functional capacity in individuals with multiple sclerosis (MS). However, the extent to which aperson's functioning is captured by these instruments is unclear. The aim of this study is to link the content of the MS disease guideline with the International Classification of Functioning, Disability and Health (ICF) in order to capture the distribution of the content on the functional domains and contextual factors and to uncover existing gaps. Instruments of the S2k guideline "Diagnosis and therapy of multiple sclerosis, neuromyelitis optica spectrum diseases and MOG-IgG-associated diseases", which were available free of charge in German or English and designed for adult people, were included. The instruments were classified into their meaningful concepts (meaningful concepts = MCs) and subsequently coded using standardized ICF rules by two raters. The 23 included instruments contained 351 items and 718 MCs. Of these, 663 MCs could be linked to the ICF according to the coding rules. Of these, 51% (340 MCs) related to body functions, 44% (291 MCs) to the activity and participation component, and 5% (32MCs) to environmental factors. The most frequently coded chapter was mobility (d4) with 201 MCs. Interrater agreement was k = 0.79. The linking of the guideline-recommended instruments to the ICF shows that the instruments cover different themes. The area of environmental factors is underrepresented. The ICF linkage reveals abroad spectrum of functioning covered by the guideline-recommended instruments and facilitates the selection of appropriate instruments for the affected persons.

Development of a core predictor set of weaning in critically ill patients: a Delphi-based study protocol.

Prolonged mechanical ventilation in intensive care units (ICUs) leads to increased morbidity, higher mortality rates, and elevated healthcare costs. Predicting successful weaning from mechanical ventilation with accuracy is essential for optimizing resource use and improving patient outcomes. The International Classification of Functioning, Disability and Health (ICF) framework offers a holistic perspective on health conditions and can be adapted to identify key predictors of weaning readiness. This study aims to develop a Delphi-based core predictor set for weaning in critically ill patients, utilizing the ICF model. The core predictor set development comprises three steps: (1) Literature review and expert consultation to gather weaning predictors, (2) Predictor alignment with ICF categories per established rules, and (3) Three-round Delphi survey with a multidisciplinary team. A systematic review across major databases will be conducted to identify predictors related to weaning predictors in critically ill adults from cohort studies, trials, and reviews. Predictors will then be categorized within ICF domains. A multidisciplinary expert panel will evaluate the relevance of each predictor using a 9-point Likert scale to achieve consensus. This study will contribute to the development of a standardized, evidence-based predictor set for weaning readiness in critically ill patients. Using the ICF framework, this study aims to encompass the complex factors that influence weaning, thereby enabling personalized care plans and improving weaning outcomes. The Delphi methodology guarantees a thorough, iterative process for building consensus by integrating diverse clinical perspectives. The proposed Delphi-based study protocol aims to establish a core set of predictors for weaning in the ICU setting, guided by the ICF model. Successful implementation of this predictor set could enhance decision-making around weaning trials, reduce unnecessary ventilation days, and ultimately improve patient outcomes and healthcare efficiency. Future validation and implementation studies will be essential to confirm the utility and generalizability of this predictor set in clinical practice.

Functional outcomes in children and adolescents with neurodisability accessing music therapy: A scoping review.

To determine the evidence for functional outcomes experienced by a population with paediatric neurodisability (such as acquired brain injury, cerebral palsy, spinal cord injury, and other neurological disorders), who access music therapy through neurorehabilitation services across the rehabilitation spectrum. Using scoping review methodology of the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), a systematic search was conducted across eight databases and expert knowledge users were consulted. Articles were screened by title and abstract, and data from eligible studies were categorized using the International Classification of Functioning, Disability and Health: Children and Youth version (ICF-CY). From 1726 records identified, 53 eligible primary sources were included in the synthesis. Most literature (n = 30) related to children and adolescents with an acquired or traumatic brain injury. Physical functionwas the most frequently reported outcome across sources(n = 27), followed by communication (n = 25), social (n = 22), cognitive (n = 17), emotional (n = 13), psychological (n = 13), behavioural (n = 8), and sensory (n = 5). Evidence for functional outcomes experienced by children and adolescents accessing music therapy as part of their neurorehabilitation is limited. More than half of the included sources were clinical descriptions with small samples. High-quality studies involving children, adolescents, families, and interprofessional teams are needed to identify the most effective music therapy methods and techniques for functional outcomes in paediatric neurodisability.

Peer-Mediated Social Skills Interventions in Primary School Settings for Autistic Children in the Light of the ICF Bio-psycho-social Model. A Systematic Review.

This systematic review expands the current knowledge about Peer-Mediated Interventions (PMIs) for children with Autism Spectrum Disorder, focusing exclusively on primary school age (6-12years). The study has three aims: (1) describing the main features of the PMI programs; (2) discussing the PMIs efficacy on autistic children's social skills; (3) analyzing whether the PMIs were coherent with the bio-psycho-social model promoted by the International Classification of Functioning, Disability and Health (ICF) classification system, by referring to the person-environment interaction and to the concepts of body functions and structures, environmental factors, and activity and participation. The systematic review followed the PRISMA-P method. The literature search was conducted in August 2024 through PsycInfo, PsycArticles, Education Source, and PubMed databases. A total of 558 articles were generated; 1 study was later added. Twenty-four articles were finally included. Most of the studies used a multiple baseline design across subjects and proved to be effective. Yet, only 5 studies included a follow-up assessment, which showed contrasting results. PMIs partly fit the ICF bio-psycho-social vision, even if they were not designed for this purpose. Our analysis arises from the belief that systematically including the perspective of individual-environment interaction could better guarantee the intervention efficacy.

Measuring functioning and disability in Korea: comparing general and dedicated surveys using the ICF

Abstract Background Functioning is the third health indicator besides mortality and morbidity. Although Korea periodically collects functioning information, the functioning indicator has not been generated yet. This study aimed to evaluate how functioning information is currently collected in Korea’s health and disability surveys, especially in terms of comparability and comprehensiveness, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. Methods Data sources included three health and disability surveys in Korea (Population and Housing Census, Korean National Health and Nutrition Examination Survey, Survey on the Living condition of Persons with Disabilities) and two international ICF-based surveys (International Spinal Cord Injury Survey, Model Disability Survey). Functioning information was linked by category to the ICF Generic-30 Set utilizing the ICF linking rules. Results Three ICF categories (walking, washing oneself, dressing) were covered by all the data sources. Excluding the Census, which inherently differs from the other data sources, all the surveys addressed six ICF categories-b152 emotional functions; b280 sensation of pain; d240 handling stress and other psychological demands; d450 walking; d510 washing oneself; d540 dressing. Despite of the common ICF categories, important differences in the operationalization of questions and response options were found. Conclusions The overlap of content of health and disability surveys in Korea enables interoperability with other data sources. Available functioning data can be used for estimating the functioning indicator and metric, as recommended by WHO, which can serve as a valuable epidemiological indicator for complementing mortality and morbidity indicators and for estimating and monitoring rehabilitation or long-term care needs of the Korean population. Key messages • Korea’s health and disability surveys periodically collect functioning information at the national level, and the level of overlap across surveys enables interoperability with other data sources. • This study can contribute to generate a Korean common health metric based on functioning that can serve as a valuable epidemiological indicator by utilizing the international standard ICF.

Challenges of People With Disabilities With the Medical Commission of the State Welfare Organization

Background and Objectives: The international classification of functioning-disability and health (ICF) has been used by the State Welfare Organization in the medical commission in recent years. The present study was conducted with the aim of understanding the challenges of people with disabilities with the medical commission of the State Welfare Organization. Methods: The research method was qualitative and content analysis type. The method of data collection was done through in-depth and semi-structured interviews while respecting ethical considerations. The current research field of Tehran City and the medical commissions of the welfare organization departments in Tehran City and the samples were people with disabilities referring to this commission or their companions. To select a pooled sample, snowball sampling and theoretical targeted sampling were used. Data analysis was done using the method of qualitative content analysis with conventional approach. In order to ensure the reliability of the research, the four pillars of reliability, validity, transferability and verifiability were used. Results: In this research, 86 codes were finally extracted, which formed the theme of “challenges of people with disabilities” in two sub-topics: “Executive problems of clients with medical commission” and “communication problems of clients with members of medical commission". Conclusion: The findings of the research showed that those referring to the medical commissions of the welfare organization face problems related to the implementation of classification of function, disability and health, which need to be addressed by the authorities.

Contextual factors experienced by mothers of children with special needs.

Caring for children with special needs places a burden on caregivers. The challenges experienced can be conceptualised as personal and environmental, as per the International Classification of Functioning, Disability and Health Framework (ICF). Supported the caregiver experiences when caring for children with special needs and to conceptualise these needs in relation to the personal and environmental factors set out in the ICF. A qualitative exploratory study was conducted, using purposive and snowball sampling. Semi-structured interviews were used to collect the data, which were then analysed thematically. A total of six themes arose from the data. Two of these were related to personal factors: unemployment and caregiving, and marital uncertainty. The other four themes were related to environmental factors: family and caregiving factors, educational factors, health-systems challenges and perceptions of children with special needs. Caregivers of children with special needs experienced personal challenges, which resulted in feelings of isolation from family and society. They also faced environmental challenges in sectors such as education and health. The management of children with special needs should include interventions within their environments to assist caregivers with their tasks. This could contribute to improved quality of life for both the caregivers and their children.