International Classification Of Functioning Research Articles

Identifying the content of the Lower Extremity Motor Activity Log based on the International Classification of Functioning, Disability and Health

Purpose To identify the content and the constructs measured in the Lower Extremity Motor Activity Log (LE-MAL) based on the International Classification of Functioning, Disability and Health (ICF) framework and to determine whether the instrument items fit within the ICF mobility domain. Methods Concepts and constructs measured within each scale were linked to the best-matched ICF categories and classified using established linking rules. Two independent researchers determined the initial linkages. A final consensus was reached with the other researchers. The agreement was analysed through the agreement percentage and the kappa coefficient. Results The subscales assess performance through information about need or dependency, personal and environmental factors, and appraisal of the items. Thirteen concepts were identified in LE-MAL: two concepts for the Assistance Scale are covered in the environmental factors component; 10 concepts for the Functional Performance Scale where all items are covered in the mobility domain; one concept for the confidence scale is covered in the body functions component. Conclusions The general construct of LE-MAL assessed is performance in the ICF mobility domain and provides additional information about the mental function, environmental factors, independence, appraisal, and personal factors. The study highlighted the conceptual connection between the LE-MAL and the ICF framework.

The evaluation of daily activity questionnaire for stroke survivors: cross-cultural adaptation, content validity and digitisation

ObjectiveThe study's objective was to culturally adapt and digitise the Evaluation of Daily Activity Questionnaire (EDAQ), originally designed for rheumatoid arthritis and various other musculoskeletal conditions, creating a version for stroke survivors (EDAQ-SS). This adaptation also aimed to develop a comprehensive electronic Patient Reported Outcome Measure (ePROM) intended to refine stroke survivors' self-assessment of their daily activity limitations. Materials and methodsCross-cultural adaptation of the EDAQ was completed by a review of expert panel, which included healthcare professionals to increase the clarity and relevancy of the items, followed by cognitive debriefing interviews with British stroke survivors to rate their understanding of the questionnaire items. After developing the paper version of the questionnaire, this was digitised (eEDAQ-SS) and disseminated online via the Stroke Survivors Hub (SSHUB). Content validity of the EDAQ-SS was evaluated using the International Classification of Functioning (ICF) Core Set for Stroke. ResultsThe expert panel meeting (n:11) and cognitive debriefing interviews with stroke survivors (n:10) resulted in an EDAQ-SS with 160 items across 15 domains, which was understandable and relevant to stroke survivors. The SSHUB was deemed to be a user-friendly platform, providing easy access to eEDAQ-SS and aid self-assessment of daily activities of stroke survivors. Mapping the EDAQ-SS items to the ICF Core Set for Stroke demonstrated good content validity with 44/55 matching categories. ConclusionThe EDAQ-SS offers a comprehensive measure for self-assessment, which may serve to guide stroke survivors’ self-management by overcoming limitations of existing PROMs. Further psychometric testing of the EDAQ-SS and wider testing of the digital version is recommended. Contribution of the Paper•The Evaluation of daily activity questionnaire for stroke survivors (EDAQ-SS) is a culturally adapted, comprehensive PROM for British stroke survivors, enhancing self-assessment of daily activities.•Methodically developed using guidelines, expert feedback, and stroke survivor interviews, the EDAQ-SS ensures relevance and clarity.•The EDAQ-SS demonstrates good content validity against the International Classification of Functioning Core Set for Stroke, with potential to improve clinical practice by providing a detailed, sensitive measure to help stroke survivors and healthcare professionals identify and manage daily activity limitations more effectively.

Patient lived experiences of functioning and disability following lumbar discectomy: a secondary analysis of qualitative data

BackgroundKnowledge of patient lived experiences of functioning and disability is limited. This study aims to address the gap in the literature by exploring patient lived experiences of functioning and disability following lumbar discectomy.MethodA secondary analysis, reported in line with the Standards for Reporting Qualitative Research, was conducted of qualitative data exploring patient journeys following lumbar discectomy surgery (DiscJourn). Adult patients (≥ 16 years) undergoing elective or emergency primary lumbar discectomy were recruited from one National Health Service secondary care centre in the UK. Semi-structured interviews were conducted at 1–3 weeks and 1-year post surgery. Participants who completed both semi-structured interviews were eligible for the secondary analysis. Transcripts from the semi-structured interviews were analysed using interpretative phenomenological analysis (IPA). IPA involved two independent reviewers identifying themes for individual data sets followed by an iterative process involving the wider research team to identify overarching themes that represented the whole date set. Subthemes generated from the IPA were mapped against the International Classification of Functioning, Disability and Health (ICF) framework at the level of chapters, in order to ascertain the ICF’s utility in capturing experiences of functioning and disability. Strategies to enhance trustworthiness of data analysis included blind coding, peer examination and debrief, declaration of pre-conceived beliefs and active reflexivity throughout the study.ResultsNine participants met the eligibility criteria and their interview transcripts were analysed. Patient lived experiences of functioning and disability were captured by three overarching themes: Immediate impact following surgery, Multiple roads to recovery over 1 year, and Functioning influenced by personal loci of control. Each theme consisted of three subthemes which were subsequently mapped onto the ICF. Three subthemes mapped to the ICF’s body component, 1 to activity and participation and 3 to environment. Two subthemes themes did not map onto the ICF.ConclusionFindings provide valuable insights into patient experiences of functioning and disability following lumbar discectomy. Convergence in experiences of functioning and disability were identified immediately following surgery. Divergence in such experiences were identified with regards to the roads to recovery over 1 year and the individuals’ locus of control. Findings build on the body of literature exploring patients functioning and disability following discectomy and make recommendations for future research and clinical practice.

Examining the overlap between tinnitus and depression questionnaires-protocol for an ICF based content analysis.

Tinnitus is a common phenomenon with an estimated prevalence of 14.4% in the adult population. The experienced severity of tinnitus varies significantly among this population. Psychological factors have been identified as major contributors to this perceived severity, and numerous studies have demonstrated a correlation between symptoms of depression and tinnitus severity. However, the assessment of tinnitus severity and depressive symptoms often relies on self-report questionnaires, which show content overlap. This can pose challenges in distinguishing both conditions and interpreting their relationship. To address these challenges, the proposed study aims to examine the overlap between tinnitus and depressive symptom questionnaires by analyzing their content based on the International Classification of Functioning, Disability and Health (ICF) framework. Six validated, multi-item, self-report questionnaires measuring perceived tinnitus severity (THI, TQ, mTQ, THQ, TRQ, TFI) and seven validated, multi-item, self-report, depressive symptom questionnaires (BDI-II, HADS-D, SDS, PHQ-9, CES-D, SCL-90-R depression subscale, DASS-42 depression subscale) will be included in the content analysis. The content of all items of these questionnaires will be linked to ICF categories and item overlap between the tinnitus and depressive symptom questionnaires will be analyzed. By exploring the overlap between depression and tinnitus questionnaires, this study seeks to gain a better understanding of the relationship between tinnitus and depression, by distinguishing between shared content and independent constructs of symptom scores and shedding light on the factors influencing their measured severity. Ethical approval is not required for this study, due to the characteristics of the study design. Findings will be disseminated through peer-reviewed open access publication and scientific conferences.

International Classification of Functioning, Disability and Health and goal attainment scale approach as academic tools at student-run free clinic for diabetic patients with international collaboration

The prevalence of diabetes is rising globally these days. Multidisciplinary teamwork for diabetes patients in nursing care is essential to preventing both acute and long-term complications. Additionally, this method of providing services will give students access to modern medical practice while they are in school. 120 students were enrolled in the post-piloted courses and 133 students took the pre-test. Through the Erasmus+ project with international cooperation, we established a “student-run free clinic for diabetic patients” to support the treatment of diabetes, which makes use of the goal attainment scale method and the International Classification of Functioning, Disability and Health framework. Students are ready to offer free services for educational opportunities for other new generations of medical students and medical care to diabetic patients, according to the questionnaire for the student evaluation of the quality insurance of the piloted courses. In addition to offering diabetic patients and their families access to ongoing medical education, the “student-run free clinic for diabetic patients” also offers diabetic patients medical care.

Application of Non‐Immersive Virtual Reality in Cerebral Palsy Children: A Systematic Review

ABSTRACTCerebral palsy (CP) is a movement disorder caused by brain damage. Virtual reality (VR) can improve motor function and daily life activities in CP patients. This systematic review examines the use of non‐immersive VR in treating CP children. The objective is to evaluate the effectiveness of non‐immersive VR in rehabilitating CP children as a standalone intervention or in combination with traditional therapy. The review follows the PRISMA guidelines and includes a comprehensive search of five bibliographic databases. Two reviewers independently assess the search results, evaluate full‐text publications, and extract relevant data. The outcomes were described by the International Classification of Functioning, Disability, and Health for Children and Youth (ICF‐CY) framework. A total of 20 English‐language studies published between January 2013 and January 2023 are included in the review based on predefined inclusion and exclusion criteria. The findings demonstrate that non‐immersive VR, when used in conjunction with traditional therapy, yields positive effects on body structure and function (hand function, grip strength, and upper extremity function), activity (motor function, activities of daily life [ADL], balance), and participation (caretakers' assessment, usability, motivation, and user satisfaction) in CP children. Moreover, non‐immersive VR alone is found to be more efficient than traditional therapy in improving manual dexterity in CP children. The non‐immersive VR can be effective in rehabilitating CP children, and the review concludes by recommending future research with larger sample sizes and randomized trials to investigate further the potential benefits of non‐immersive VR in this population.

ICF-based hearing and functioning assessment: validation and research outcomes of utilizing the HEAR-COMMAND tool for patients with mild to moderately severe hearing loss and individuals with normal hearing.

Current clinical assessments for Hearing Loss (HL) are often limited to controlled laboratory settings in which a narrow spectrum of hearing difficulties can be assessed. A majority of the daily life challenges caused by HL cannot be measured in clinical methodologies. To screen the individuals' needs and limitations, a questionnaire named the HEAR-COMMAND tool was developed and qualitatively validated through an international collaboration, aligning with the World Health Organization's International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss. The tool empowers healthcare professionals (HCPs) to integrate the ICF framework into patient assessments and patient-reported outcomes (PRO) in clinical and non-clinical settings. The aim is to provide a general foundation and starting point for future applications in various areas including ENT and hearing acoustics. The outcome can be employed to define and support rehabilitation in an evidence-based manner. This article presents the validation and research outcomes of using the tool for individuals with mild to moderately severe HL in contrast to normal-hearing individuals. Using a cross-sectional multicenter study, the tool was distributed among 215 participants in Germany, the USA, and Egypt, filled in German, English, or Arabic. Three outcome scores and the corresponding disability degree were defined: hearing-related, non-hearing-related, and speech-perception scores. The content and construct validation were conducted, and the tool's internal consistency was assessed. The extracted constructs included "Auditory processing functionality", "Sound quality compatibility", "Listening and communication functionality", "Interpersonal interaction functionality and infrastructure accessibility", "Social determinants and infrastructure compatibility", "Other sensory integration functionality", and "Cognitive functionality". Regarding content validity, it was demonstrated that normal-hearing participants differed significantly from individuals with HL in the hearing-related and speech-perception scores. The reliability assessment showed a high internal consistency (Cronbach's alpha = 0.9). The outcome demonstrated the HEAR-COMMAND tool's high content and construct validity. The tool can effectively represent the patient's perspective of HL and hearing-related functioning and enhance the effectiveness of the treatment plans and rehabilitation. The broad range of targeted concepts provides a unique overview of daily life hearing difficulties and their impact on the patient's functioning and quality of life.

Analysis of rehabilitation of individuals after cholecystectomy in sanatorium-resort conditions as a prerequisite for the development of the concept of physical therapy

Laparoscopic cholecystectomy (LCС) is the most commonly performed surgical intervention. The presence of diseases of several body systems in individuals may indicate metabolic syndrome. The consequences of cholecystectomy are manifested by various symptoms and are generally called postcholecystectomy syndrome. The purpose of the article is to analyze the methods and means of rehabilitation of patients after LCC at the sanatorium stage on the example of the functioning of the Department "Lavanda Sanatorium" of CJSC "Ukrprofozdorovnytsia" of the sanatorium-resort complex "Morshynkurort". Research methods: analysis and synthesis of scientific and methodological literature, analysis of methods and means of rehabilitation of patients after LCC for one calendar year. A total of 1296 people diagnosed with gallbladder and biliary tract diseases received rehabilitation services, including those after LCC. Patients undergoing rehabilitation in the post-acute and long-term stages after surgical interventions are treated at the Lavanda Sanatorium department. The treatment period is from 18-24 days at the patient's request. The criteria for the quality of rehabilitation services were as follows: improvement of health, disappearance of pain, dyspeptic phenomena, increased appetite, normalization of bowel movements, normalization of instrumental and laboratory blood tests, etc. Patients after LCC have signs of metabolic and postcholecystectomy syndromes. In addition to the dysfunction of the gastrointestinal tract, there are also limitations of other various body systems, their functions, activities and participation. Therefore, it is necessary to use the international assessment tool "International Classification of Functioning and Participation" and, according to the established disorders, to set individual rehabilitation goals for patients. The use of mineral therapeutic water from well No. 3 in the village of Horishne, Stryi district, Lviv region, in a dilution of 3.0-3.4 g/dm3 on the functional state of the liver of patients after LCC in the conditions of the Morshynkurort sanatorium-resort complex leads to an improvement in liver function, which is confirmed by the results of biochemical studies of patients' blood. Conclusions. Preformed physical factors (physical procedures), heat therapy, various baths, mud therapy, reflexology, microclysters, exercise therapy and massage are traditionally the most popular in the prescription department. However, the use of such remedies, in addition to the use of mineral healing water, is a matter of great debate among the professional community and requires more detailed study in terms of evidence-based practice in health care.

Incorporating Easy Language in the ICF: Benefits, Opportunities, and Challenges

The World Health Organization’s International Classification of Functioning, Disability and Health (ICF), the international standard for the description of functioning and disability, completely ignores a specific form of accessible communication despite its potential to improve functioning and reduce disability: Easy Language, a form of standard language with substantially reduced linguistic complexity. Starting with a proposal for how and where Easy Language could be appropriately integrated into the ICF, the commentary then outlines the various benefits and opportunities for social policy that could be associated with doing so. It also notes several potential challenges involved in this process. If used correctly, the integration of Easy Language into the ICF could prove useful for both professional users of the ICF and Easy Language target groups.

Measuring Disability in Participation Survey and Social Reporting

The "Representative Survey on the Participation of People with Disabilities" (Participation Survey), commissioned by the German Federal Ministry of Labour and Social Affairs, aims to work in conjunction with participation reporting to assess the social participation of people with disabilities. Both the participation reporting and the Participation Survey claim to operationalize impairment and disability in accordance with the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO). A critical analysis of the measurement concept reveals methodological problems: 1) The measurement concept is not consistently ICF-oriented because it does not clearly conceptualize impairments, does not adequately take into consideration environmental factors in the determination of disability and sees impairment as causal for disability. 2) Distinction made between impairment and disability is mainly pragmatic, without any coherent conceptual justification. 3) The chosen operationalization cannot ensure the desired international comparability. In order to achieve a stronger ICF orientation and better international comparability, it is proposed in this study to integrate the "Model Disability Survey", developed by the WHO and the World Bank, into the German Participation Survey's data collection tools. An alternative measurement proposal, which can be implemented with the available data, is to categorize groups solely according to the severity of impairment, forgoing the a priori distinction between impairment and disability. This approach embraces the fundamental idea of the ICF, which views disability as a situational rather than a personal characteristic.

Development and content validation of a questionnaire identifying patients’ functional priorities and abilities after hip or knee arthroplasty

Purpose To develop a self-report questionnaire evaluating functional priorities after hip or knee arthroplasty and evaluate patients’ understanding of its items and conceptual relevance. Methods A self-report questionnaire was first developed based on the International Classification of Functioning, Disability, and Health (ICF) core set for osteoarthritis (OA). In the second stage, two research physiotherapists thoroughly reviewed and refined the questionnaire, and another physiotherapist conducted cognitive think-aloud interviews with 18 patients to assess the face and content validity of the questionnaire. Results All categories and corresponding activities of ICF core set for OA were used to develop the questionnaire. Several questionnaire issues were identified and addressed. Most challenges were related to comprehension, followed by item ordering and visual elements. Patients identified ambiguous wording which we subsequently simplified. Ten activities of the core set were excluded due to lack of face validity, two activities were added, and four activities were modified. Conclusion The findings suggest that the ICF core set for OA needs to be adjusted for patients undergoing hip or knee arthroplasty and highlight the feasibility of applying a modified core set to assess functional priorities after hip or knee arthroplasty.

Caregiver and child perspectives of wellbeing in school-age children with childhood apraxia of speech

Purpose Childhood apraxia of speech (CAS) is a communication deficit that impacts a child’s overall quality of life, including their academic and social interactions, yet few studies have investigated the impact from the child’s perspective. Using The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) framework, we examined the children’s and caregivers’ perspectives on the impact of CAS on their overall wellbeing. Method Survey data were collected from 32 child-caregiver dyads for children ages 9–17 years with CAS. Items elicited responses along a 5-point scale to examine the perceived impact of children’s speech impairments using the framework, including impact on communication, interpersonal interactions/relationships, and major life events. Result Results from non-parametric statistical analyses revealed: (a) caregivers reported a significantly greater impact than children across individual ICF domains; (b) child responses were not significantly correlated with their caregiver’s responses or with the child’s age, gender, or severity indicators; and (c) both caregivers and children indicated the domain of communication was impacted more than other domains. Conclusion Results suggest a potential disconnect in the perceived impact of CAS between the caregiver and child. Recommendations include facilitating a dialogue between the child-caregiver dyad and considering treatment goals that address wellbeing.

Factors Associated With Physical Activity and Sedentary Behavior in People With Parkinson Disease: A Systematic Review and Meta-Analysis.

The goal of this review was to investigate factors associated with physical activity and sedentary behavior in people with Parkinson disease (PD). The magnitude of these associations were investigated in line with the International Classification of Functioning, Disability and Health components. A systematic literature review was conducted until February 2023, searching 4 databases (PubMed, EMBASE, Web of Science, and Scopus) for original articles investigating associations with physical activity or sedentary behavior in people with PD. Two independent researchers performed data extraction, and the risk of bias in the included studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses were conducted to determine the magnitude of the associations, and significant regression models from the included studies were described. Forty-two studies were included. Twenty-one factors associated with overall physical activity were identified. Higher levels of physical activity had small association with cognition and body mass index, and fair association with 17 factors related to self-efficacy, physical function, mobility, quality of life, age, PD symptoms, and more. Better manual dexterity and functional gait had moderate to good association with higher levels of physical activity. The regression model with the higher magnitude was composed mostly of contextual factors, except for the body max index. The magnitude of factors associated with physical activity intensity or sedentary behavior could not be identified. Functional gait and manual dexterity were the strongest factors related to physical activity in people with PD. Further investigation is needed to understand the factors associated with physical activity intensity and sedentary behavior. This study emphasizes the significance of considering contextual factors alongside body function and structure, activity and participation, and the health condition to enhance physical activity improvement during the rehabilitation process. By adopting such holistic approach, rehabilitation professionals can optimize the overall health and wellbeing of individuals with Parkinson disease.

The Long-Term Impact of COVID-19 on Disability after Post-Acute Rehabilitation: A Pilot Study.

Background: The long-term effect of the 2019 coronavirus (COVID-19) pandemic is not fully known. Severe cases of COVID-19 have resulted in disability that can be assessed in a biopsychosocial manner with the International Classification of Functioning, Disability and Health with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire. This study aimed to evaluate the long-term effects on disability of COVID-19 three years after post-acute rehabilitation using WHODAS 2.0. Methods: This single-center cohort study included patients with severe COVID-19 who underwent immediate post-discharge post-acute rehabilitation intervention. Three years later, patients were assessed via telephone using the WHODAS 2.0 questionnaire. Results: Of the 69 patients identified in the hospital database, 27 responded. A total of 16 patients refused to respond due to emotional distress. The mean age was 63.4 ± 8.6 years, 81.5% were independent in the community, 55.3% had been previously admitted to the ICU, and the median rehabilitation hospitalization duration was 18 (11.5,24) days. Comorbidities included type 2 diabetes mellitus (DM) (55.5%), grade 2 high blood pressure (62.9%), pressure ulcers (37%), peripheral neurologic deficits (62.9%), and central neurological deficits (14.8%). ICU admission was significantly correlated with advanced rehabilitation needs (measured by the level of the rehabilitation (p < 0.01) and longer hospitalizations (measured by total days in the hospital (p < 0.001). The overall disability score was 35.09%, significantly influenced by DM and central neurological deficits. Conclusions: Central neurological deficits and DM are associated with higher disability scores. Tailored rehabilitation programs, ongoing medical assessment, integrated care models, and patient education are essential for improving long-term outcomes after COVID-19 disease.

Content comparison of utility and effectiveness instruments to the Prosthetic Interventions Core Outcome Set: a step to inform the benefits measured in lower-limb prosthetic health economic evaluations

Purpose Health Economic Evaluations (HEEs) calculate a cost-benefit ratio using utility and effectiveness instruments. It is unknown whether existing instruments measure the items of the Prosthetic Interventions Core Outcome Set (PI-COS) that represent the benefits most important to lower-limb prosthesis users and funders. Comparing the content of existing instruments against the PI-COS will support instrument selection for future prosthetic HEEs. Materials and methods Utility and effectiveness instruments used to evaluate prosthetic interventions were identified and their International Classification of Functioning, Disability and Health framework (ICF) linking results were extracted. Content of each instrument was compared to the PI-COS through three metrics: content density, content diversity and bandwidth. Results Of the 130 utility and effectiveness instruments, 24 had previously been linked to the ICF. The instrument with the greatest bandwidth (i.e., broadest content coverage of the PI-COS) was the SF-36 given it linked to 6 of the 14 items of the PI-COS. Combining PROMIS subscales and short-forms allow measurement of a greater range of the PI-COS items. Conclusions There is no perfect fit instrument providing coverage of the PI-COS using the metrics of content density, content diversity and bandwidth. The PROMIS instrument may provide increase coverage of the PI-COS in future HEEs.

Health-related quality of life for children with anterior cruciate ligament deficiency: Ensuring content validity of the new KIDS-KNEES-ACL questionnaire.

The existing knee-specific pediatric patient-reported outcome measures (PROMs) lack content and construct validity for children with anterior cruciate ligament (ACL) injury. This impairs their accuracy which can lead to false interpretations of data and inaccurate clinical guidelines. The purpose of this study was to develop a content-valid PROM for children with an ACL injury. The process adhered to the COnsensus-based Standards for the selection of health Measurement INstruments guidelines for PROM development. Informants were children with ACL deficiency and sampled based on age, sex, and treatment. Semistructured interviews were conducted exploring themes within the International Classification of Functioning, Disability and Health model. Interviews continued beyond data saturation. By thematic analysis and by probing items from the adult PROM 'KNEES-ACL', new themes and items emerged. Content coverage, relevance and understandability were continuously evaluated. All interviews were recorded and transcribed verbatim. The NVivo 12 software was used for data analysis and coding of items. A PROM of 60 items across nine subscales was formed. From cognitive interviews, 19 new items emerged. Forty-one of 55 items from KNEES-ACL were endorsed as relevant; however, all required rewording to ensure understandability. Substantial differences in the psychosocial impact between adults and children were observed. The children experienced a more considerable negative psychosocial impact caused by a loss of participation in sports, lower self-confidence and loss of social networks. This resulted in four new domains. The physical issues were similar to adults, with few exceptions. The 'KIDS-KNEES-ACL' 1.0 (qualitative version) was developed. This version will be subjected to psychometric analysis, resulting in adequate measurement properties of the final KIDS-KNEES-ACL 2.0. As the only adequate pediatric ACL-specific PROM, its use in clinical trials and databases will enhance PROM data quality, and strengthen clinical guidelines and thus the treatment of children with ACL injury. Not applicable.

Development of a self-assessment tool to address the functioning of community-dwelling older adults in general practice: a validation study of the EFA23 questionnaire

BackgroundMultimorbidity is increasingly prevalent among ageing patients, leading to reduced daily functioning. To address the challenges posed by multimorbidity in older adults, a person- and context-centred approach is needed. This study aimed to develop a questionnaire as a self-assessment tool for older adults focusing on functioning in general practice based on the International Classification of Functioning, Disability and Health (ICF).MethodsA mixed-methods approach was employed in the development and validation of the German EFA23 (Erfassung Funktionaler Gesundheit im Alter – 23 Fragen; Assessing Functional Health in Old Age – 23 questions) questionnaire. Based on an ICF subset developed in a preparatory phase and consensus study, questionnaire items were formulated and tested in a qualitative pretest, followed by a validation study. A workshop with general practitioners (GPs) was held to develop a supplementary manual for GPs on how to interpret the questionnaire results and discuss them with the patients.ResultsA total of 69 items were developed and tested in the qualitative pretest with 15 respondents, resulting in 37 items for the validation study. The validation study, involving 237 older adults, showed the presence of one significant principal component. It demonstrated good internal consistency (Cronbach’s alpha = 0.967) and construct validity, showing positive correlations with established assessment tools. Descriptive statistics showed differences between the means of self-assessment by patients and an external GP assessment. The final EFA23 questionnaire consists of 23 items assessing limitations in functioning.ConclusionsThe EFA23 questionnaire can be used as a valid self-assessment instrument to measure functioning in older adults, supporting a person- and context-centred approach in general practice.

People, places, systems and society:A qualitative exploration of socio-cultural factors in head and neck cancer survivorship

PurposePeople living with head and neck cancer (HNC) often endure permanent and life changing adverse effects of treatment and reduced health-related quality of life. Study of post-traumatic growth (PTG), is gaining traction to understand why some people living with cancer have better psychosocial outcomes than others. Current theoretical models on PTG point to the importance of ‘socio-cultural influences’ but do not provide insight into how such socio-cultural factors influence survivorship outcomes. This research aimed to illuminate pathways to PTG following HNC by exploring socio-cultural factors in experiences of living with, and moving on from, HNC. MethodSemi-structured interviews with people living with HNC (up to 5 years post-treatment) on experiences of diagnosis, treatment and recovery. Qualitative framework analysis using the environmental factors codes from the International Classification of Functioning, Disability and Health (ICF) HNC core set. Results20 people living with HNC were interviewed (11 male, 9 female; aged 46–83 years). Four inter-related themes described socio-cultural factors that influence (positively and/or negatively) the experience of living with HNC: (1) people and places; (2) healthcare systems and support services; (3) societal attitudes to cancer; (4) work and finances. ConclusionSupport from family, friends and healthcare professionals, as well as societal attitudes, financial and work security and personal experiences all appear to contribute to an individuals’ ability to navigate the HNC experience. These findings could inform development of interventions targeting the socio-cultural factors in the lives of people living with HNC, particularly for those at risk for poorer psycho-social outcomes.

SPECIAL CARE DENTISTRY FOR DEVELOPMENTALLY DISABLED CHILD

Special Care Dentistry (SCD) is a discipline focused on enhancing oral health for individuals with diverse impairments, including physical, sensory, intellectual, and medical conditions. It highlights the significant prevalence of disabilities in India and globally, as well as the complex nature of disability according to the WHO International Classification of Functioning. It discusses the extended lifespan of Children with Special Healthcare Needs (CSHCN) due to medical advancements, which necessitates tailored dental care to manage associated oral health challenges. Despite global efforts to improve oral health, disadvantaged and disabled populations continue to face disparities. It concludes by outlining the scope of a forthcoming library dissertation, which aims to review prevalent oral conditions among individuals with special needs and propose general care recommendations to address their unique challenges in accessing dental treatment.

Parent and caregiver report questionnaires for children and adolescents with intellectual disabilities: a systematic review

Objectives Parent and caregiver questionnaires are important outcome measures in education, clinical and research practice with children with intellectual disabilities. Methods Following PRISMA guidelines, this systematic review aimed to provide an overview of freely available caregiver report questionnaires, identified from five databases (Cinahl, Embase, Eric, PsycINFO and PubMed). Questionnaires were categorised following inductive analyses, and subscales were conceptually mapped using constructs and definitions from the International Classification of Functioning, Disability and Health-Children and Youth version (ICF-CY). Results 3406 records were identified leading to the inclusion of 34 caregiver report questionnaires on the impact of having, or caring for a child with, intellectual disabilities. Freely available questionnaires published in English after 2000 were eligible; screening tools, interviews and surveys were excluded. Questionnaire outcome goals were categorised to: ‘behaviour’, ‘impact of the child with intellectual disabilities on others/impact of others on the child with intellectual disabilities’, ‘cognitive and adaptive functioning’ and ‘quality of life’. From the questionnaires, 152 subscales were identified and conceptually mapped using constructs from the ICF-CY. Conclusions Most questionnaires focused on individual child behaviours, with gaps identified in consideration of environmental factors. Future studies should analyse the psychometric properties of available questionnaires to promote evidence-based practices.