ICF Core Set Research Articles

Changes in the International Classification of Functioning, Disability, and Health Components "Activity/Participation" as Predicted Through Patient-Reported Outcomes Along With Comprehensive Back Pain Rehabilitation.

Objectives:The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, validated mapping algorithm.Materials and Methods:Of 2718 cLBP patients recruited, data from 1541 (64% females) were available from before and at the end of 6 months comprehensive outpatient rehabilitation. Assessments included the Roland Morris Disability Questionnaire (RMDQ) and Pain Disability Index (PDI) questionnaires, the percentage of patients with predicted limitations and restrictions in important activity and participation ICF categories, bodily functional measurements, pain intensity, and anxiety/depression (EQ-5D).Results:At baseline, both the RMDQ and the PDI measures were within the third of the lowest disability scores whilst 80% of the patients had limitations with “maintaining a body position” and 30% with “walking” ICF categories. Intervention-associated gains in the maximum isometric lumbar extension and flexion strength and the lumbar range of motion were significant overall, but improvements in patients’ ICF limitations/restrictions varied. Anxiety/depression, lumbar range of motion, and extension strength all had a significant impact on the majority of the ICF categories, whereas flexion strength had none.Discussion:The rate of patients with predicted limitations/restrictions in activity/participation ICF core categories for cLBP partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions in ICF categories was varied. Thus, assessing problems in the ICF activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.

The Usability of the Preliminary ICF Core Set for Hospitalized Patients After a Hematopoietic Stem Cell Transplantation From the Perspective of Nurses: A Feasibility Study.

Background: A hematopoietic stem cell transplantation (HSCT) has a major impact on the functioning and perceived quality of life of patients. To describe the functioning of patients, a preliminary set of 53 categories of the International Classification of Functioning, Disability and Health (ICF) as relevant for HSCT patients has been selected earlier by a Delphi study. For the implementation of this preliminary ICF core set for patients after HSCT in clinical practice, a feasibility study was requested.Methods: A feasibility study was conducted in an explanatory mixed-methods research design. Qualitative data were collected cross-sectionally by semi-structured interviews based on specific topics related to feasibility regarding the use of the preliminary ICF core set for HSCT patients from the perspective of nurses (five in ICF-trained nurses and five regular, untrained, nurses). Quantitative data, were collected longitudinally by using a mobile health application based on ICF in which the ICF trained nurses registered HSCT patients' functioning.Results: Qualitative analysis indicated that using the preliminary ICF core set is practical and acceptable for providing information about the functioning of HSCT patients from the perspective of nurses. In addition, nurses indicated a demand for this information due to its impact on multidisciplinary meetings and clinical decision-making by involving relevant aspects of the functioning of patients. Management support, trained staff, and designated time to focus on functioning are mentioned as requirements for successful implementation. Quantitative analysis demonstrated that the most used 30% (n = 17) ICF categories are included in the preliminary ICF core set for HSCT patients (n = 24). Energy (b130) was the most used ICF category. Family relationships (d760) was the most frequently and highly positively associated ICF category.Conclusions: From the perspective of nurses, the preliminary ICF core set for HSCT patients is feasible and relevant in gaining information regarding functioning. Applying this preliminary ICF core set for HSCT patients in the anamnesis and the nursing consultations contributes to this information. Further research is needed to look at the perspective of other professionals and HSCT patients themselves.

The Reliability and Validity of the Brief ICF Core Set in Patients with Chronic Obstructive Pulmonary Disease.

PurposeTo analyze the reliability and validity of the Brief international classification of functioning, disability and health (ICF) core set for chronic obstructive pulmonary disease (COPD).Patients and MethodsA cross-sectional study was conducted in four tertiary hospitals in Tianjin, China. A total of 100 patients with COPD were selected to evaluate functioning and disability involving body functions, body structures, activities and participation as well as environmental factors of the Brief ICF core set for COPD. Internal consistency was calculated by Cronbach’s α. Content validity was examined using the content validity index (CVI), scale-level CVI/universal agreement, and scale-level CVI/average agreement (S-CVI/Ave). In addition, construct validity and convergent validity were also examined.ResultsThe Brief ICF core set for COPD had a high internal consistency, 0.873 for the total scale, with values of 0.750, 0.640, and 0.843 for body functions, body structures, and activity and participation, respectively. The content validity was calculated by the CVI, scale-level CVI/universal agreement, and S-CVI/Ave at values of 0.80–1, 0.929, and 0.986, respectively. Meanwhile, the ICF core set for COPD had good convergent validity, correlating with the mMRC dyspnea score (r=0.690, P<0.01), and there were significant correlations between the ICF core set for COPD and COPD clinical severity grade (r=0.363, P<0.01). A four-factor model of functions and disability in the Brief ICF core set for COPD had the best fit according to confirmatory factor analysis (CFA).ConclusionThe Brief ICF core set for COPD is a reliable and valid convenient instrument for assessing comprehensive problems in the functioning of patients with COPD, which can be used to design and to evaluate rehabilitation strategies.

Selection of Comprehensive Assessment Categories Based on the International Classification of Functioning, Disability, and Health for Elderly Patients with Heart Failure: A Delphi Survey among Registered Instructors of Cardiac Rehabilitation.

The development of a comprehensive assessment tool based on the International Classification of Functioning, Disability, and Health (ICF) for elderly patients with heart failure is urgently required. In this study, we classified the ICF categories relevant to heart failure in the elderly through a Delphi survey (3-step questionnaire survey) of 108 Registered Instructors of Cardiac Rehabilitation in the Hiroshima Prefecture. Questionnaires were conducted using postal mail or a web-based platform. The survey was conducted three times, and the survey results were provided as feedback to the participants in the second and third rounds. More than 80% of the respondents selected categories according to the ICF core set methodology. Data were collected from December 2018 to March 2019, with 67, 54, and 46 participants in the first, second, and third rounds, respectively. A total of 58 ICF items were adopted based on the results: 27 body function items, 4 body structure items, 20 activity and participation items, and 7 environmental factor items. This study is characterised by the inclusion of a large number of ICF items for mental function. This result seems to be influenced by the increasing interest in cognitive dysfunction in elderly patients with heart failure. The ICF categories selected for this study allow for a comprehensive assessment of clients for occupational therapy. The findings of this study are expected to provide a basis for an outcome measure to determine the effectiveness of occupational therapy for these patients.

Assessment of the Concurrent Validity of the ICF Core Set to Classify the Physical Health of Community-Dwelling Older Adults in Relation to Self-Rated Health.

The present study aimed to assess the concurrent validity of the International Classification of Functioning, Disability and Health (ICF) core set to classify physical health of older adults in relation to self-rated health. This is a methodological study conducted in Santa Cruz, Rio Grande do Norte (RN) state, in Northeastern Brazil, with 101 community-dwelling older adults. The participants rated their health status, which was classified into 3 groups: very good, fair, and poor/very poor. An interview was then conducted using self-reported and objective measurements to classify physical health according to the ICF core set. It consists of 30 categories, 14 of which belong to the body function (b) component, 4 to body structures (s), 9 to activities and participation (d), and 3 related to environmental factors (e). To analyze the compromised and problematic categories in the ICF, an impairment index was created for each component. The relationship between self-rated health and the impairment indexes was assessed using the multinomial logistic regression test adjusted for age, sex, schooling, and perception of income sufficiency. A greater likelihood of poor or very poor self-rated health was found in older individuals with the highest impairment index in (b) (odds ratio [OR] = 1.18; P < .001); (s) (OR = 1.11; P ≤ .001); (d) capacity (OR = 1.09; P = .02); and (d) performance (OR = 1.08; p = 0.01). The results suggest that the ICF core set is a valid instrument to assess the physical health of older adults, since it is associated with self-rated health and shows potential for use in clinical practice and scientific research, with universal language regarding functionality and physical health in older adults.

Content validity of the Brief and Comprehensive ICF Core Sets for common disabling conditions in a developing country.

The International Classification of Functioning, Disability and Health (ICF) features associated tools, the Brief and Comprehensive ICF Core Sets. These are designed to be universally applicable, but have limited evidence of content validity (i.e. comprehensiveness and relevance) in low income, non-Western countries. In this cross-sectional study, we aimed to assess the content validity of the ICF Core Sets in Nepal. We interviewed 161 participants with stroke, spinal cord injury (SCI), chronic obstructive pulmonary disease (COPD), and musculoskeletal conditions and asked them to identify activities they had difficulty performing due to their health condition. We mapped 544 participant responses to the ICF and assessed if these ICF categories were represented in the respective ICF core sets. The Comprehensive Core Sets for stroke, COPD, SCI, and musculoskeletal conditions contained more items identified by participants than the respective Brief Core Sets (e.g., 89% vs. 26% in stroke). Among ICF categories that represented at least 5% of participants' responses, the Brief Core Sets covered 40%-71% of participants' responses whereas the Comprehensive Core Sets covered 67%-100% of responses. This is the first study to evaluate the content validity of the ICF Brief and Comprehensive core sets in Nepali individuals with stroke, SCI, MSK conditions, and COPD. The Comprehensive Core Sets for stroke, COPD, and SCI have adequate content validity for use in clinical practice and research in Nepal; the Brief Core Sets may not adequately meet local and individual needs unless supplemented with additional ICF categories.

Study of environmental factors and quality of life in children with cerebral palsy based on international classification of functioning, disability and health

Introduction Identification of environmental barriers is an important factor for improving quality of life. The aim was to investigate the relationship between environmental factors and quality of life of children with cerebral palsy and to prioritize environmental factors affecting the quality of life. Method In this cross-sectional study, participants were children with cerebral palsy ( n = 67) 8–12 years. The European Child Environment Questionnaire and cerebral palsy quality of life questionnaire were used. In order to prioritize environmental codes, each of the items in the European Child Environment Questionnaire was linked to environmental codes of the cerebral palsy ICF Core Set. Data were analyzed using SPSS and Pearson correlation and regression tests. Results There was a significant negative relationship between quality of life and environmental barriers ( p &lt; 0.05, r = −0.36). The European Child Environment Questionnaire covered 75% of the environmental codes of cerebral palsy ICF Core Set. Also, e5 (services, systems and policies) was identified as the main priority of environmental factors affecting the quality of life. Conclusion Occupational Therapists should devote part of the interventional plan to reduce environmental barriers. On the other hand, decision-making organizations have to make supportive laws to improve the physical environment of the home, community, school, and work.

Studying subjective hearing loss in older adults measured by speech, spatial, and quality of hearing scale within the framework of the ICF core set for hearing loss

Objective This study aimed to assess categories underlying subjective hearing loss (SHL) in older adults using the International Classification of Functioning, Disability (ICF) and Health-Brief Core Set for Hearing Loss (ICF-BCS-HL). Design A cross-sectional study. One-hundred and thirty-one independent-living older adults (Mage = 72.32, SD = 6.83), who completed the speech, spatial, and quality of hearing (SSQ) scale and a set of clinically accepted outcome measurements linked with selected categories listed in the ICF-BCS-HL. Results A linear regression analysis model was fitted with the outcome measurements after controlling for age, sex, education, multimorbidity, and hearing aid use. The model showed 5 significant predictors underlying the SSQ-total score: HL (ß = −.38, p ≤ .001), dizziness handicap (ß = −.35, p ≤ .001), cognitive decline (ß = .17, p < .05), multimorbidity (ß = .12, p < .005), and poor ability to accept the noise level (ß = −.16, p = p < .05). Predictors varied across the SSQ-subscales scores, however. Conclusion A link of SHL with HL, cognitive deficits, poor ability to accept background noise level, and multimorbidity, collectively or individually, were well-established. So far, little attention has been paid to the impact of dizziness handicap of elderly patients when evaluating their SHL.

Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries.

Burn injuries cause disability and functional limitations in daily living. In a 2015 fire explosion in Taiwan, 499 young people sustained burn injuries. The construction of an effective and comprehensive rehabilitation program that enables patients to regain their previous function is imperative. The International Classification of Functioning, Disability, and Health (ICF) includes multiple dimensions that can contribute to meeting this goal. An ICF core set was developed in this study for Taiwanese patients with burns. A consensus process using three rounds of the Delphi technique was employed. A multidisciplinary team of 30 experts from various institutions was formed. The questionnaire used in this study comprised 162 ICF second-level categories relevant to burn injuries. A 5-point Likert scale was used, and participants assigned a weight to the effect of each category on daily activities after burns. The consensus among ratings was assessed using Spearman’s ρ and semi-interquartile range indices. The core set for post-acute SCI was developed from categories that attained a mean score of ≥4.0 in the third round of the Delphi exercise. The core ICF set contained 68 categories. Of these, 19 comprised the component of body functions, 5 comprised body structures, 37 comprised activities and participation, and 7 comprised environmental factors. This preliminary core set offers a comprehensive system for disability assessment and verification following burn injury. The core set provides information for effective rehabilitation strategy setting for patients with burns. Further feasibility and validation studies are required in the future.

Why ICF? advantages of ICF in the clinical practice with regard to the medical care of people with mental health problems and intellectual disabilities

IntroductionThe International Classification of Functioning, Disability and Health (ICF) provides a framework rooted in patient-centered care and the biopsychosocial model that facilitates a comprehensive description of a person’s health and their level of societal participation. The importance of the ICF for assessing the needs of individuals with mental health problems (MHP) and intellectual disabilities (ID) is growing, especially in the social medicine.ObjectiveTo describe the benefits and limitations of the ICF in clinical practice, pertaining to the assessment of healthcare needs and societal participation in persons with MHP and ID.MethodComprehensive literature search in medical databases using the Keywords: ICF, mental health, intellectual disabilities, social and occupational participation.ResultsICF-based instruments such as the Mini-ICF-APP, with which impairments and competencies in social and occupational participation can be described, are playing an increasingly important role in healthcare and rehabilitation. In Germany, for example, in accordance with the Federal Participation Act, the entitlement to disability support benefits is assessed using ICF-based instruments, which therefore play a decisive role in social medical care.ConclusionThe functional descriptions of the ICF provide the opportunity for a standardized, yet individualized assessment of medical needs, general health and societal participation, thus facilitating the provision of a comprehensive package of care and support for people with disabilities. ICF-Core Sets and the Mini-ICF-APP are effective tools to describe level of function. It would be clinically valuable to further develop these instruments for use in persons with ID and MHP in the field of social medicine.DisclosureNo significant relationships.

Laying the foundation for an ICF core set for community dwelling older adults in primary care: an expert survey.

Aholistic biopsychosocial model focused on functioning in individual contexts (environment, task) is better suited to meet the needs of older patients than disease only based models. The International Classification of Functioning, Disability and Health (ICF) is the official standard for describing functional health. As the ICF is too detailed to be used in practice, brief core sets have been developed. This study aimed to identify relevant aspects of functioning for older primary care patients from the perspective of healthcare professionals in Germany. An internet-based cross-sectional expert survey was conducted in preparation for the development of an ICF core set for community-dwelling patients aged 75years and older. Open-ended questions to identify the most important aspects of functioning and disability in old age were used. Responses were analyzed based on acontent analysis approach to identify relevant concepts in the care of the target population. These concepts were then linked to ICF categories according to established linking rules. A total of 63 experts participated in this survey. Across all responses, 2240 meaningful concepts were identified. Atotal of 75ICF categories (4first level categories, 67second level categories, 4code combinations) were identified by at least 5% of respondents and will thus be considered as candidate categories for the final ICF core set. Most of concepts were associated with the environmental factors component. The most frequently identified categories were immediate family and family relationships. This survey provides alist of relevant ICF categories from the experts' perspective and together with other preparatory studies will be used for developing an ICF core set for community-dwelling older adults in primary care.

Convergent validity and reproducibility of the International classification of functioning, disability and health (ICF) core set for the physical health of community-dwelling older adults

BackgroundPhysical health is an important factor for what is considered successful aging. Using valid and reproducible tools to classify PH of older adults may help to develop appropriate rehabilitation protocols for this population. ObjectiveTo evaluate the convergent validity and reproducibility of the International Classification of Functioning, Disability and Health (ICF) core set to classify the physical health of older adults. MethodsA total of 101 older adults were evaluated for handgrip strength, physical performance (Short Physical Performance Battery), and physical activity level (International Physical Activity Questionnaire). Physical health was classified with the ICF core set (14 categories of body functions, 4 of body structures, 9 of activity and participation, and 3 environmental factors) and an impairment index was calculated for each component. ResultsHigher levels of physical activity were associated to lower impairment index in the body function and activity and participation components, but was not associated to environmental factors. Better physical performance and handgrip strength were also related to lower impairment index in all components. The Intraclass Correlation Coefficient analysis indicated good reproducibility for body function, body structure, the capacity component of the activity and participation, and for two environmental factors (use of medications and assistive devices), but moderate reproducibility for the performance component of activity and participation, and poor reproducibility for the environmental factor related to access to health services. ConclusionThe ICF core set for the physical health of older adults is a valid and reproducible tool and can be used in clinical practice and research.

Development of an ICF Core Set for adults with cerebral palsy: capturing their perspective on functioning.

AimTo examine the most relevant aspects of functioning of adults with cerebral palsy (CP) from their perspective, in order to develop an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with CP.MethodWe conducted six focus group discussions with adults with CP without intellectual disability and seven interviews with adults with CP with intellectual disability and caregivers, addressing all ICF components. Meaningful concepts were identified from verbatim transcripts and linked to ICF categories by two independent researchers.ResultsIn total, 31 adults with CP without intellectual disability (mean [SD] age 46y 1mo [14y 1mo]; 20 females, 11 males; Gross Motor Function Classification System [GMFCS] levels I–IV) and seven adults with CP and intellectual disability (mean [SD] age 25y 8mo [6y 8mo]; four females, three males; GMFCS levels III–V) participated. We identified 132 unique second‐level categories: 47 body functions, seven body structures, 43 activities and participation, and 35 environmental factors. The most frequently mentioned categories were emotional function, pain, muscle tone function, support of family, products and technology, and health services.InterpretationAdults with CP experienced problems in a broad range of body functions and activities and indicated the importance of environmental factors for functioning. The identified categories will be added to the list of candidate items to reach consensus on an ICF Core Set for adults with CP. What this paper adds Including the lived experience is crucial for fully understanding functioning of adults with cerebral palsy (CP).Adults with CP perceive environmental factors as essential elements for everyday functioning.Adults with intellectual disability should be considered as a group with specific problems.

Experiences of Parents of Specialist Peer Mentored Autistic University Students

ABSTRCT Background: Parents continue to support to autistic university students, and consequently, experience considerable stress. Aim: To explore the experiences of parents of specialist peer mentored university students and to examine these using the ICF as a theoretical framework. Method: Thirteen semi-structured interviews were completed and analyzed using thematic analysis. Directive content analysis linked the data to the ICF core set for autism spectrum disorders (ASD). Results: Five interrelated themes emerged: The mentoring relationship is a facilitator, Developing skills for university, Mentoring changes lives, Mentoring is not a substitute for other supports, and University is an emotional rollercoaster. Specialist peer mentoring was linked to Activity and Participation (44%) and Environmental factors (32%) of the ICF core set for ASD. Conclusion: These results add to the specialist peer mentoring evidence-base, and indicate perceived benefits for autistic university students and their parents. An unintended consequence was that parents broadened their participation in activities.

Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan.

Osteoarthritis is one of the leading causes of disability. Total knee arthroplasty (TKA) is a surgical intervention for patients with severe osteoarthritis. Post TKA rehabilitation is crucial for improving patient’s quality of life. However, traditional rehabilitation has only focused on physical function; a systemic analysis of other dimensions such as social participation and environmental factors of post TKA rehabilitation is lacking. The aim of this study was to develop a core set from the International Classification of Functioning, Disability and Health (ICF) to create a comprehensive rehabilitation program for patients with osteoarthritis post TKA. Before the Delphi-based consensus process, a literature review process was performed for related ICF categories selection. We used a three-round Delphi-based consensus among 20 physical therapists with orthopedic rehabilitation expertise in a university-based hospital. A five-point Likert scale was used to rate the importance of each item. The consensus of ratings was analyzed using Spearman’s rho and semi-interquartile range indices. The ICF core set for post TKA rehabilitation was determined based on a high level of consensus and a mean score of ≥4.0 in the third Delphi-based consensus round. The ICF core set comprised 32 categories, with 13 regarding body function, four regarding body structures, nine regarding activities and participation, four regarding environmental factors, and two regarding personal factors. Our ICF core set for post TKA rehabilitation can provide information on effective rehabilitation strategies and goal setting for patients post TKA. However, further validation and feasibility assessments are warranted.

Laying the foundation for a Core Set of the International Classification of Functioning, Disability and Health for community-dwelling older adults in primary care: relevant categories of their functioning from the research perspective, a scoping review

ObjectivesThe objective of this study was to find relevant concepts of functioning in community-dwelling older adults within frequently used assessment instruments published in the scientific literature. This was part of...

Brief ICF Core Set for Obstructive Pulmonary Diseases: Validation from the Perspective of Chinese Respiratory Physicians

Obstructive pulmonary diseases (OPDs) are the leading causes of mortality and disability worldwide. The International Classification of Functioning, Disability and Health (ICF) provides a framework for systematically assessing functioning and disability in patients with chronic diseases. To date, the ICF core sets for OPDs have not been validated by respiratory physicians in China’s mainland. This study was aimed at validating the brief ICF core set for OPDs from the perspective of Chinese respiratory physicians. A three-round, consensus-building survey was conducted with Chinese respiratory physicians from Shanghai, Jiangsu, and Zhejiang from December 2 to December 16, 2017, using the Delphi technique. Their answers were analyzed for consensus degree. In this study, 52 experts (about 67.3% men) with a mean working experience of (19.3 ± 6.3) years completed the consensus process. After 3 rounds, the following 13 ICF categories were considered crucial for the assessment of OPDs, with an agreement of over 70%: 4 in body functions (b410-heart functions, b440-respiratory functions, b455-exercise tolerance functions, and b460-sensations associated with cardiovascular and respiratory functions), 2 in body structures (s410-structure of cardiovascular system, and s430-structure of respiratory system), 4 in activities and participation (d230-carrying out daily routine, d450-walking, d455-moving around, and d640-doing housework), and 3 in environmental factors (e110-products or substances for personal consumption, e225-climate, and e260-air quality). Twelve (70.6%) categories in the current brief ICF core set were validated, and one additional category, b410-heart functions, was added. In conclusion, Chinese respiratory physicians largely supported the current brief ICF core set for OPDs. However, the newly added and unconfirmed categories need further investigation.

Development of ICF based Assessment of Disability in Diabetic Neuropathy (ADDiN)

Background: Diabetes Mellitus (DM) is a clinical syndrome which has an enormous impact on theimmediate family, both in developed and developing countries. Assessment of Diabetic Poly Neuropathy(DPN) as a complication of DM becomes even more crucial. There is an urgent need to develop and validatean ICF based assessment on (DPN) relevant to our community life.Methods: The list of ICF categories that were considered relevant and typical for DPN by experts wasformulated, and the formulated assessment was christened as ADDiN (Assessment of Disability in DiabeticPeripheral Neuropathy). Following the ICF Core set for DM, current instrument ADDiN had 130 categoriesfor DPN. The results showed that Cronbach’s Alpha Score for all the 5 domains was 0.730 and the 194individual questions were analyzed and the score was 0.988, showing high reliability and consistency of theADDiN scale.Conclusion: The study results showing high sensitivity of ADDiN to DPN and fair specificity indifferentiating DM from DPN, and high sensitivity and high specificity in differentiating DPN from controland high sensitivity and high specificity in differentiating DM from control suggests that ADDiN may beemployed in future studies.

Occupational Therapists' Perspective on the International Classification of Functioning, Disability and Health Core Sets (ICF-CS) for Schizophrenia.

The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia. To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF-CSs for schizophrenia from their perspective. Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia. Occupational therapists experienced in the treatment of people with schizophrenia. Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated. Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF-CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF-CS for schizophrenia. The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia. The ICF-CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF-CSs for schizophrenia.

Development of a Short Version of ICF Core Set for Stroke Adapted for Rehabilitation in Korea: a Preliminary Study.

This study aimed to develop a short version of the International Classification of Functioning, Disability, and Health (ICF) core set and verify functioning levels of patients for stroke rehabilitation in Korea. Using the Delphi technique, a 3-round consensus process was conducted. Thirty multidisciplinary rehabilitation experts from different hospitals completed the consensus study. The questionnaire for this study adopted the comprehensive ICF core set for stroke developed by the Geyh group. A 7-point Likert-type scale was used by participants to weigh the impact of each category on activities of daily living or rehabilitation after a stroke. The consensus of ratings was assessed with Spearman's rho and inter-quartile range indices. A core set to assess functioning levels of patients with stroke was developed from those categories. A short version of ICF core set to assess and verify functioning levels of patients with stroke was developed for 12 categories, including 3 categories (consciousness, muscle power, and attention) from body functions, 1 (structure of brain) from body structures, 5 (eating, walking, moving around, changing basic body position, and carrying out daily routine) from activities and participation, and 3 (individual attitudes of immediate family members, immediate family, and personal care providers/personal assistants) from environmental factors. This preliminary study developed a Delphi consensus process, gathering statistical evidence and expert commands based on the short version of ICF core set for rehabilitation of stroke patients in Korea.