International Classification Of Functioning Research Articles

Proposing an Interprofessional Competency Framework for Person-Centered Care Connecting Interprofessional Education and Collaborative Practice

Introduction: The number of complex healthcare problems is increasing, the workforce is diminishing, and healthcare costs are rising. Interprofessional Education and Collaborative Practice is a promising solution, necessitating the cultivation of skills and competencies among health and social care professionals. The central question guiding this study revolves around the possibility of merging interprofessional collaboration, lifelong learning, the International Classification of Functioning, Disability and Health (ICF), and the Rehabilitation Competency Framework (RCF) into a unified competency framework that can be used in both education and in the work field. Method: In total, five modified Delphi rounds were executed during three phases specifically comprising the design, relevance, and report stages. The first contains a literature search, the second includes 11 pilots with surveys, and the last finalized the INPRO Competency Framework (INPRO CF). Results: The primary result is the INPRO CF that is readable, accurate, applicable, and accepted. It contains five domains, 17 competencies, and 200 learning outcomes or behaviors. It exists in four languages (Dutch, Finnish, English, German). Discussion: The INPRO CF is a relevant interprofessional competency framework designed to alleviate deficiencies between education and practice so it is suitable for a lifelong learning process. It demonstrates adaptability across various contexts. Implications for Practice The INPRO Competency Framework provides a structured overview of the learning journey in becoming an experienced interprofessional collaborator and is applicable in both practice and educational settings. The INPRO Competency Framework provides a comprehensive understanding of goals that an individual in a team can work on and structures those that it would like to achieve. The INPRO Competency Framework has the potential to positively impact person centered care by promoting collaboration among health and social care professionals. It simultaneously can contributes to transforming education by shaping curricula and preparing students for interprofessional teamwork in their future careers.

Development and validation of health-oriented personal evaluation for the community-dwelling older person based on the International Classification of Functioning, Disability and Health.

The International Classification of Functioning, Disability and Health (ICF) offers a standardized international terminology to operationalize function management across multiple domains, but the summary score of the ICF qualifier scale provides limited information on the comparison of personal abilities and functioning difficulties. To enhance the interpretative power of the ICF-based Health-oriented Personal Evaluation for the community-dwelling older person (iHOPE-OP) scale through the implementation of the item response theory (IRT) modelling. This cross-sectional, multi-centre study administrated 161 ICF categories (58 on body functions, 15 on body structures, 60 on activities or participation and 28 on environmental factors) to evaluate the functional level of 338 older citizens (female = 158, male = 180) residing in community or supportive living facilities. The validation process encompassed assessing the IRT model fitness and evaluating the psychometric properties of the IRT-derived iHOPE-OP scale. The age of participants ranged from 60 to 94.57, with the mean age of 70. The analysis of non-parametric and parametric models revealed that the three-parameter logistic IRT model, with a dichotomous scoring principle, exhibited the best fit. The 53-item iHOPE-OP scale demonstrated high reliability (Cronbach's α = 0.9729, Guttman's lambda-2 = 0.9749, Molenaar-Sijtsma Statistic = 0.9803, latent class reliability coefficient = 0.9882). There was a good validity between person abilities and the Barthel Index (p < .001, r = .83), as well as instrumental activities of daily living (p < .001, r = .84). IRT methods generate the reliable and valid iHOPE-OP scale with the most discriminable and minimal items to represent the older person's functional performance at a comprehensive level. The use of the Wright map can aid in presby-functioning management by visualizing item difficulties and person abilities. Considering the intricate and heterogeneous health status of older persons, a single functional assessment tool might not fulfil the need to fully understand the multifaceted health status. For use in conjunction with the IRT and ICF framework, the reliable and valid iHOPE-OP scale was developed and can be applied to capture presby-functioning. The Wright map depicts the distribution of item difficulties and person abilities on the same scale that facilitates person-centred goal setting and tailors intervention.

Applying ICF Framework to Explore the Factors That Influence Quality of Life in Patients After Lung Surgery.

To explore the relationship between pulmonary function, physical activity, and health-related quality of life (QoL) in resected lung cancer patients based on the International Classification of Functioning, Disability, and Health (ICF) framework developed by the World Health Organization to describe health and health-related states. A quantitative study was designed with postoperative lung cancer survivors to assess personal characteristics. We also assessed functional impairment related to the lung using forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1), activity limitations using maximal oxygen consumption (VO2max), anaerobic threshold (AT) and 6-minute walking distance (6MWD), and participation restriction using the 36-item Short Form Health Survey V1 (SF-36). Data analyses were conducted using the multivariate method and Smart- PLS to examine path coefficient among the measures. Forty-one patients were enrolled in this study. FVC and FEV1 were poorly correlated with QoL, and 6MWD, AT, or VO2max were positively associated with QoL. AT or VO2max showed a significant (p<0.01) direct path with SF-36 in the ICF model. Although age and body mass index were not strongly correlated with QoL, these personal factors had a medium to large effect on perceived QoL. Disability is a complex in patients with lung resection, and physical activity plays an important role in enabling participation. Improving VO2max and AT is needed to improve the QoL of resected lung cancer patients. We should also pay more attention to contextual factors that have a significant impact on social participation.

Occupational Therapy Outcome Measures in Preschool Children With Autism Spectrum Disorders: A Scoping Review.

With the rising prevalence of autism spectrum disorder (ASD), early assessment of preschool children is vital for occupational therapists. This scoping review aimed to provide detailed information about outcome measures used in occupational therapy interventions in preschool children with ASD and map the focus of the outcome measures based on the International Classification of Functioning, Disability, and Health (ICF) components. A thorough search from 2000 to 2022 was conducted that employed ICF linking rules to categorize the outcome measures. Seventy-four outcome measures were identified. They predominantly targeted body function and activity/participation, with less emphasis on environmental factors, and none assessed body structure. The most common measures were Vineland Adaptive Behavior Scale (VABS-2), Canadian Occupational Performance Measure (COPM), and Parenting Stress Index-Short Form (PSI-SF). This study offers a diverse array of outcome measures and underscores the potential of the ICF framework in enhancing evaluations, particularly concerning broader environmental components as one of the primary facilitating/hindering factors in the participation of children with ASD.

How to follow up patients with brachial plexus birth palsy in the long term: a survey of expert opinion.

There is no generally accepted diagnostic, treatment and follow-up algorithm for brachial plexus birth palsy in the current literature. This study evaluates the opinion of experts in the field of brachial plexus birth palsy surgery, to provide a follow-up guideline. A total of 35 experts attending an international meeting with a mean of 21.5 years (SD 10.1) of experience in the field filled out a questionnaire to evaluate the following: (1) the surgeons' background; (2) clinical follow-up; (3) radiological follow-up; and (4) International Classification of Functioning, Disability and Health (ICF) domains. A mean of 40 new brachial plexus birth palsy patients were seen per year by each expert, of which 36% needed surgery. In total, 27 experts scheduled a regular follow-up every year and the majority (83%) believed that standardized long-term clinical follow-up is necessary. However, standardized radiological follow-up is not necessary. Only 13 of 34 participants used patient-reported outcome measures to investigate ICF domains.Level of evidence: V.

Ocena skuteczności kompleksowej rehabilitacji osób z niepełnosprawnościami na podstawie ICF

Assessment of the effectiveness of comprehensive rehabilitation of persons with disabilities based on the ICF The pilot comprehensive rehabilitation program for persons with disabilities was implemented by PFRON in partnership with the Central Institute for Labor Protection – National Research Institute (CIOP-PIB) and ZUS in 2018-2023. During it, over 600 participants underwent several months of comprehensive rehabilitation in four centers. In the developed model, the main diagnostic tool that enabled various groups of specialists to cooperate in various areas of impact was the International Classification of Functioning, Disability and Health (ICF). Many participants achieved their intended goal – they undertook professional activity tailored to their capabilities, needs and preferences. A large number of people became active, improved their mental and physical well-being and gained knowledge that they can use in their future work. This article presents selected results of the assessment of the effectiveness of rehabilitation impacts, which is the difference between the final and initial research results in various categories of the ICF classification. Keywords: comprehensive rehabilitation, ICF

Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework.

Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.

The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program.

Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.

Content analysis of the Measure of the Quality of the Environment by linkage with the International Classification of Functioning, Disability and Health.

This study explores the linkage between the Measurement of Environmental Quality (MQE) and the International Classification of Functioning, Disability, and Health (ICF). Stemming from the Human Development Model-Disability Creation Process (HDM-DCP), MQE enhances understanding of how environmental quality impacts disability development across diverse socio-cultural contexts. Integrating MQE with ICF expands the perspective on disability formation beyond HDM-DCP, encompassing ICF's functioning approach. To link the MQE with the concepts and categories of the ICF. Two health professionals with adequate taxonomic knowledge of the ICF performed the initial linkage, which was based on updated standardized rules considering all hierarchical levels of the ICF. Linkage agreement between the first two assessors was measured using the Kappa (k) coefficient and respective 95% confidence intervals. In the absence of a consensus between the two assessors (k>0.60), a third assessor was consulted to make the arbitrary decision of the final categories linked to the MQE. Insufficient agreement between the two assessors was found for the linkage process (k=0.52; p<0.001), requiring the final decision from the third assessor. At the end of the process, 26 ICF categories were linked to the main concepts (MC) measured by the 26 items of the short version of the MQE. Ten ICF categories were linked to the additional concepts (AC) measured by the MQE. Moreover, the MQE addresses the five domains of the ICF component "environmental factors," with a predominance of the "services, systems and policies" domain (MC=45.8% and AC=40%). The linkage of the concepts measured by the MQE to ICF categories enabled mapping the content of the MQE, identifying it as a promising tool for measuring environmental factors in accordance with ICF percepts.

Nutrition and Food Security among Veterans: Operationalizing ‘Nutritional Functioning’

ObjectiveTo assess injured military veterans’ experiences, beliefs and daily physical and psychosocial functioning in relation to food and nutrition. DesignWe used a convergent mixed-methods study design, and the International Classification of Functioning, Disability and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, and food and nutrition. SettingThree Veterans Affairs Polytrauma Rehabilitation Centers. ParticipantsVeterans who served in the United States military on or after September 11th, 2001, and whose medical diagnoses met the criteria for polytrauma; at least one mild traumatic brain injury, and at least one associated comorbidity (e.g., post-traumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances). InterventionNone Main Outcome MeasuresThemes from survey responses and semi-structured interview data were pooled into core constructs, and influencing factors. Results37 veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans’ relation to food and nutrition (i.e., nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relationships, and current beliefs and behaviors. ConclusionsNutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces) among injured veterans is complex, and shaped by multiple physical, psychosocial, economic, and cultural factors.

Physical therapy of patients after cerebral ischemic stroke from the standpoint of a patient-centered approach

Acute cerebrovascular accident remains an important medical and social problem. An important area of intensification of rehabilitation care for patients after cerebral ischemic stroke is the using of a patient-centered approach, which is often associated with increased patient satisfaction and adherence to rehabilitation. The aim of the study was to balance the restoration of physical and functional capabilities of patients after cerebral ischemic stroke in the post-acute rehabilitation period using a patient-centered approach. A program of physical therapy for patients after cerebral ischemic stroke in the post-acute rehabilitation period was implemented from the standpoint of a patient-centered approach in accordance with the defined goals of rehabilitation intervention. The study included 37 patients, 22 men and 15 women with post-stroke muscle spasticity who were under a nine-month follow-up during the second stage of rehabilitation in the post-acute rehabilitation period. The average age of men was 52.1±8 years, the average age of women was 50±13 years. A comparative evaluation of the effectiveness of the physical therapy program was conducted, based on examination methods in accordance with the International Classification of Functioning, Disability and Health. At the end of the experimental study, the following changes in patients after cerebral ischemic stroke were found: decrease in the intensity of pain in the muscles of spastic limbs according to the visual analog pain scale by 12.9±1.02 points (p&lt;0.05); decrease in the severity of motor deficit by an average of 1.7±1.0 points (p&lt;0.05) according to the Motor Deficit Scale (Medical Research Council); the index of muscle tone of the adductor muscles of the shoulder decreased by 0.9±0.4 points (p&lt;0.05), the muscles of the forearm flexors by 0.4±0.2 (p&lt;0.05) points on the Ashworth Scale (Modified Ashworth Scale); assessment of motor function of the affected limb showed an increase in motor activity by 15±0.4 points (p&lt;0.05), before physical therapy the index was 29±0.2 points (p&lt;0.05), and after it – 44.3±0.8 points (p&lt;0.05) on the Action Research Arm Test scale; statistical impro­vement in self-care and functionality in patients by 1.2±0.1 points (p&lt;0.05) on the Modified Rankin Scale; the average walking and mobility score in patients increased by 3.7±0.1 points (p&lt;0.05) on the Rivermead mobility index. The results of the experimental study confirmed that the algorithm and content of the physical therapy program from the standpoint of a patient-centered approach were effective for patients who had suffered a cerebral ischemic stroke; this indicates the possibility and feasibility of their further using for post-stroke patients in the post-acute rehabilitation period.

Development of a method for analysing victims of the Great East Japan Earthquake using the International Classification of Functioning, Disability and Health (ICF): part I proposal for the disaster ICF

Development of a method for analysing victims of the Great East Japan Earthquake using the International Classification of Functioning, Disability and Health (ICF): part I proposal for the disaster ICF

Health-related quality of life, needs, and concerns among cancer survivors referred to rehabilitation in primary healthcare setting.

There is a growing need for rehabilitation services beyond hospitals. This study aims to describe challenges faced by cancer survivors (CSs) referred for rehabilitation in primary healthcare, employing standardized scales measuring health-related quality of life (HRQOL) and open-ended questions. Furthermore, the study explores the applicability of patient-reported outcomes (PROs) in comprehensively understanding challenges encountered by CSs. This cross-sectional study involves CSs referred for cancer rehabilitation in a primary healthcare setting, including those participating in PROs as a part of routine practice. HRQOL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G). The International Classification of Functioning, Disability and Health (ICF) framed the analysis of responses to open-ended questions 'what concerns you the most?' and 'what matters to you?' Results: FACT-G showed the lowest scores for functional well-being (14.4) and emotional well-being (16.6), with higher scores for physical well-being (18.9) and social/family well-being (21.1). Responses to open-ended questions unveiled worries about everyday life and how cancer will impact family well-being presently and in the future. Furthermore, CSs reported a need to maintain normality and proactively address the challenges posed by the disease. CSs referred for rehabilitation in primary healthcare experience comprehensive challenges necessitating a holistic rehabilitation approach. This includes interventions supporting CSs in dealing with uncertainty, regaining a sense of control, and addressing family well-being concerns. When using PROs for need assessment, the combination of validated HRQOL scales and open-ended questions is crucial for an in-depth understanding of CSs' challenges.

Use of the Patient Generated Index to Identify Physical Health Challenges among People Living with HIV: A Cross-sectional Study

Many people living with HIV experience physical health challenges including mobility problems, pain, and fatigue. Purpose: To estimate how many people living with HIV identify physical health challenges as important using the patient generated index (PGI). Secondary Objectives: a. Identify factors associated with reporting physical health challenges; b. Identify relationships between reporting physical health challenges and standardized health-related quality of life (HRQOL) items; and c. Estimate the extent to which reporting a physical health challenge explains downstream HRQOL outcomes. Methods: Cross-sectional data came from a large Canadian cohort. We administered the PGI and three standardized HRQOL measures. PGI text threads were coded according to the World Health Organization's International Classification of Functioning, Disability, and Health. Regression, discriminant analysis, and chi-square tests were used. Results: Of 865 participants, 248 [28.7%; 95% CI (25.7%, 31.8%)] reported a physical health challenge on the PGI. Participants with better pain (OR: 0.81, 95% CI: 0.71, 0.90) and vitality (OR: 0.71, 95%CI: 0.63, 0.80) by 20 points had lower odds of reporting a physical health challenge. Those who reported a physical health challenge had significantly lower HRQOL on some standardized items. Conclusion: The PGI is well-suited to identify the physical challenges of people living with HIV.

Health-related quality of life measures provide information on the contributors, components, and consequences of frailty in HIV: a systematic mapping review.

Frailty in HIV is extensively explored in epidemiological and clinical studies; it is infrequently assessed as an outcome in routine care. The focus on health-related quality of life (HRQL) measures in HIV presents a unique opportunity to understand frailty at a larger scale. The objective was to identify the extent to which generic and HIV-related HRQL measures capture information relevant to frailty. A systematic mapping review using directed and summative content analyseswas conducted. An online search in PubMed/Medline identified publications on frailty indices and generic and HIV-related HRQL measures. Directed content analysis involved identifying contributors, components, and consequences of frailty from thefrailty indices based on the International Classification of Functioning, Disability, and Health framework. Summative content analysis summarized the resultsnumerically. Electronic and hand search identified 447 review publications for frailty indices; nine reviews that included a total of 135 unique frailty indices. The search for generic and HIV-related HRQL measures identified 2008 records; five reviews that identified 35 HRQL measures (HIV-specific: 17; generic: 18). Of the 135 frailty indices, 88 cover more than one frailty dimension and 47 cover only physical frailty. Contributors to frailty, like sensory symptoms and nutrition, are extensively covered. Components of frailty such as physical capacity, cognitive ability, and mood are also extensively covered. Consequences of frailty namely self-rated health, falls, hospitalization, and health services utilization are incomprehensively covered. HRQL measures are informative for contributing factors, components of frailty, and a consequence of frailty. HRQL items and measures show a strong potential to operationalize multidimensional frailty and physical frailty. The study suggests that these measures, connected to evidence-based interventions, could be pivotal in directing resources toward vulnerable populations to mitigate the onset of frailty.

Flourishing and Functional Difficulties among Autistic Youth: A Confirmatory Factor Analysis.

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children's Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10-17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker-Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties.

Age related impairments in ingestion from a large population based-sample

ObjectivesEpidemiological data regarding the evolution of problems related to mastication and swallowing with age are lacking. This study aims to (i) describe changes in oral function with age, using data from a large French population, (ii) validate online, self-report uses of an ICF questionnaire in older persons, and (iii) assess whether impairment is related to avoidance of certain foods, xerostomia, body mass index (BMI) and oral health related quality of life (OHRQoL). MethodsVolunteers aged ≥18 years with internet access completed a series of questionnaires on sociodemographic, anthropometric and oral health characteristics (oral function, Xerostomia Index (XI), OHRQoL, reasons for avoidance of certain food). Oral function was assessed using items derived from the International Classification of Functioning (ICF). Five ICF items related to ingestion function and six items related to activities and participation were used. A validation study was undertaken to identify those with poor chewing ability and low salivary flow amongst older participants reporting impairment. Findings39 597 individuals were included. The prevalence of individuals with impairment for ICF items related to ingestion function and oral activity (eating, drinking and speaking), and the percentage of participants with poor OHRQoL increased significantly with age (p < 0.001). Each ICF item was significantly associated with OHRQoL (p < 0.001), XI (p < 0.001), BMI (p < 0.001) and avoidance of certain food due to chewing or swallowing difficulties. ConclusionOverall, 21.5% and 13.5% of the study population had chewing and/or biting impairments respectively, which might affect food selection and consumption. These findings raise individual and population-based issues. Further studies are needed to assess whether impairment in oral function might increase frailty in older individuals, and also to compare data with those from other countries.

Understanding the multidimensional neurodevelopmental outcomes in children after congenital Zika virus exposure.

Since 2016, international research groups have focused on assessing outcomes of children with in utero Zika virus (ZIKV) exposure. While the more severe outcomes of congenital Zika syndrome (CZS) occur in up to 10% of children with antenatal exposure, early findings among ZIKV-exposed children without CZS ages 0-5 years suggest that they may also have differences in multiple domains of neurodevelopment. Thus, longitudinal follow-up of all children with antenatal ZIKV exposure has been recommended. This review presents a summary of neurodevelopmental phenotypes of infants and children following antenatal ZIKV exposure. We present a multidimensional framework to understand child neurodevelopment from an interdisciplinary and whole-child perspective (International Classification of Functioning, Disability and Health model) and multi-domain ZIKV Outcome Toolboxes. The toolboxes are for clinicians, researchers, child educators, and others to implement longitudinal multi-domain neurodevelopmental assessments between ages 0-12 years. Recent innovations in telehealth and neuroimaging can help evaluate outcomes in ZIKV exposed children. The objective is to describe the multiple facets of neurodevelopmental focused care that can support the health, function, and well-being of children with antenatal ZIKV exposure. The research and clinical follow-up strategies are applicable to ZIKV and other congenital infectious or environmental exposures that can impact child neurodevelopment. IMPACT: International longitudinal cohort studies have revealed a range of differences in neurodevelopment among children with antenatal Zika virus (ZIKV) exposure. A multidimensional and whole-child framework is necessary to understand the neurodevelopment of children with antenatal ZIKV exposure in relation to family life, community participation, and environment. Multi-domain toolboxes that utilize parent questionnaires and child evaluations are presented. These toolboxes can be used internationally alongside telehealth, brain imaging, and other innovations to improve understanding of child outcomes.

Graph modeling of relational structures among functioning variables with low back pain: an exploratory analysis based on international classification of functioning, disability and health.

Given the complex etiology, multidimensional impact, and widespread prevalence of low back pain (LBP), it is crucial to prioritize intervention targets based on understanding the relationships between functional impairments in patients. This prioritization maximizes the physical and psychological benefits for patients, and graph modeling holds promise in achieving these objectives. The aim of this study was establishing a graphical model of functioning variables for LBP based on the International Classification of Functioning, Disability, and Health (ICF) to identify the most influential items (i.e., functioning variables) on the physical and mental well-being of patients. Exploring feasible intervention measures by understanding the dysfunction correlations among these variables. Cross-sectional survey. Nine hospitals in Jiangsu Province, China. Three hundred and six persons with LBP aged ≥18 years. All patients were assessed using the Comprehensive ICF Core Sets for LBP. The scoring system was converted to dichotomous data, with 1 indicating dysfunction and 0 indicating no dysfunction. In the graphical model, network parameters and the results of Item Response Theory modeling (as detailed in our other article) were used to determine the importance of items, while partial correlations were utilized to estimate the dysfunction correlations between functioning variables. 1) A total of 56 ICF items were located in the backbone structure of LBP, among which d430 (Lifting and carrying objects) occupied the most central position, followed by b126 (Temperament and personality functions). 2) In the main component of backbone structure, d430 has moderate dysfunction correlation with looking after one's health (0.6027), social norms, practices and ideologies (0.597), stability of joint functions (0.5759), and emotional functions (0.4078). b126 has moderate dysfunction correlation with basic interpersonal interactions (0.6595). d430 and b126 significantly impact the physical and mental well-being of LBP patients. To improve d430, maintaining exercise habits, reducing working hours, enhancing lumbar stability, and overcoming fear-related emotions are recommended. Similarly, improving b126 can be achieved through enhancing interpersonal relationships. Through the identification of crucial functioning variables and the associated dysfunctional correlation relationships, graphical model of Comprehensive ICF Core Set for LBP can offer healthcare decision-makers valuable insights into potential treatment targets and pathways aimed at improving the condition of LBP patients.

Participation of adolescents with and without physical disabilities and chronic diseases: A comprehensive conceptualization.

In 2001, the International Classification of Functioning and Disability (ICF) introduced participation as a main goal of rehabilitation processes. However, to date, a comprehensive concept of participation in the rehabilitative context is missing, particularly in German-speaking countries. We thus aimed to refine and extend the existing concepts of participation in this brief communication. In preceding studies, we conducted semi-structured interviews with adolescents who either had chronic diseases and/or physical disabilities or had no impairments and focus groups with parents and experts. Based on these diverse perspectives and findings, we refine the term participation. Participation is a construct that is embedded in a social context and consists of objective (i.e., attendance) and subjective (i.e., satisfaction and involvement) dimensions. These dimensions are reflected in different domains and areas that are relevant to adolescents' lives. In addition, the subjective relevance of respective areas in life needs to be regarded as a weighing component when evaluating participation. Our results reflect international models on participation, refine the existing concept, and underline the multidimensional character of participation. These findings are urgently needed to develop appropriate instruments, for example, for assessing whether rehabilitative processes are effective regarding the goal of participation.