Introduction to the International Classification of Functioning, Disability and Health (ICF): Difference between revisions
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== Introduction == | == Introduction == | ||
The model of disability which has been systematically developed by The World Health Organization (WHO) is based on the ongoing interaction between one's health and contextual factors. This model acknowledges that [[Disability, Rehabilitation, Socioeconomics and Health|disability]] is a universal human experience, is etiologically neutral, and it lies on a continuum from no disability to complete disability.<ref name=":0">Cieza A, Sabariego C, Bickenbach J, Chatterji S. [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-1002-6 Rethinking disability]. BMC medicine. 2018 Dec;16(1):1-5.</ref>The contextual factors affecting a person's health include real-life environment, social interactions, and social participation.<ref name=":0" />Every healthcare personnel needs to understand and appreciate that patient perceives his health through the lenses of his daily life impacted by the environment.<ref name=":0" />This course provides an introduction to the International Classification of Functioning, Disability, and Health (ICF) and review the changes and progress in conceptualising and measuring disability. | |||
== International Classification of Impairment, Disability and Handicaps (ICIDH) == | == International Classification of Impairment, Disability and Handicaps (ICIDH) == | ||
International Classification of Impairment, Disability and Handicaps known as ICIDH, was published by the World Health Organization in 1980. It was a manual containing the classification related to the consequences of disease, injuries, and other disorders | International Classification of Impairment, Disability and Handicaps known as ICIDH, was published by the World Health Organization in 1980. It was a manual containing the classification related to the consequences of the disease, injuries, and other disorders and a framework for health-related information.<ref name=":2">Saleeby P. Introduction to Introduction to the International Classification of Functioning, Disability, and Health (ICF) Course. Physioplus 2022. | ||
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According to ICIDH manual, "an '''impairment''' is any loss or abnormality of psychological, physiological, or anatomical structure or function". <ref name=":1" />Classification of ''impairments'' (I code) reflected: | According to the ICIDH manual, "an '''impairment''' is any loss or abnormality of a psychological, physiological, or anatomical structure or function". <ref name=":1" />Classification of ''impairments'' (I code) reflected: | ||
* abnormalities of body structure (temporary or | * abnormalities of body structure (temporary or permanent) | ||
* appearance or disturbances at the level of the organ or system function resulting from any cause | * appearance or disturbances at the level of the organ or system function resulting from any cause | ||
The following categories of impairments were listed in the manual: intellectual , other psychological, language, aural, ocular, visceral, skeletal, disfiguring, general, sensory and other.<ref name=":1" /> | The following categories of impairments were listed in the manual: intellectual, other psychological, language, aural, ocular, visceral, skeletal, disfiguring, general, sensory and other.<ref name=":1" /> | ||
A '''disability''' was considered "any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being".<ref name=":1" />Classification of ''disabilities'' (D code) reflected: | A '''disability''' was considered "any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being".<ref name=":1" />Classification of ''disabilities'' (D code) reflected: | ||
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* individual's functional performance | * individual's functional performance | ||
* activity by the individual | * activity by the individual | ||
Nine categories of disability included: behaviour, communication, personal care, locomotor, body disposition, dexterity, situational, particular skill, and other activity restrictions. | Nine categories of disability included: behaviour, communication, personal care, locomotor, body disposition, dexterity, a situational, particular skill, and other activity restrictions. | ||
'''Handicaps''' (H code) | '''Handicaps''' (H code) were defined as "the disadvantages experienced by the individual as a result of impairments and disabilities that limits or prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual".<ref name=":1">World Health Organization. [https://apps.who.int/iris/bitstream/handle/10665/41003/9241541261_eng.pdf?sequence=1&isAllowed=y International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of the disease, published in accordance with resolution WHA29]. 35 of the Twenty-ninth World Health Assembly, May 1976. World Health Organization; 1980.</ref>There were two dimensions of ''handicap'' listed in the manual: survival role, with six key dimensions, and other. Six major survival roles included: orientation, physical independence, mobility, occupation, social integration, and economic self-sufficiency. | ||
Coding example based on ICIDH: "Unable to see" could potentially be coded as 9D90.Z (ICD-11), 51 (Impairment code), or 26 (Disability code) as each | Coding example based on ICIDH: "Unable to see" could potentially be coded as 9D90.Z (ICD-11), 51 (Impairment code), or 26 (Disability code) as each classification has different purposes, and it was up to the user to decide which classifications were appropriate.<ref name=":3">Gray DB, Hendershot GE. [https://www.archives-pmr.org/article/S0003-9993(00)99115-9/fulltext The ICIDH-2: developments for a new era of outcomes research]. Arch Phys Med Rehabil. 2000 Dec;81(12 Suppl 2): S10-4.</ref> ICD would be chosen to understand the cause of blindness. Classification of impairment would allow the facilitation of the grouping of low vision impairments. Disability would help to plan a course of rehabilitation because it allows specifying the outcome or prognosis of a vision-related disability.<ref name=":3" /> | ||
=== ICIDH-2 === | === ICIDH-2 === | ||
ICIDH-2 was a new version of ICIDH which was released as alpha version in 1996, followed by beta one and beta two versions tested by WHO in 1997 and in 1999. The biggest changes in ICIDH-2 as compared to the original ICIDH included adding two new dimensions: participation in social activities and a listing of environmental factors which are important for understanding the complexity of disability.<ref name=":3" /> This model allowed to describe the consequences of the diagnosed condition. <ref name=":3" /> | ICIDH-2 was a new version of ICIDH which was released as the alpha version in 1996, followed by beta one and beta two versions tested by WHO in 1997 and in 1999. The biggest changes in ICIDH-2 as compared to the original ICIDH included adding two new dimensions: participation in social activities and a listing of environmental factors which are important for understanding the complexity of disability.<ref name=":3" /> This model allowed to describe the consequences of the diagnosed condition. <ref name=":3" /> | ||
== WHO-FIC == | == WHO-FIC == | ||
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=== International Classification of Disease (ICD-11) === | === International Classification of Disease (ICD-11) === | ||
The International Classification of Diseases (ICD) was first published in 1893. It belongs to WHO family of classifications and is used to classify existing conditions (morbidity) and/or causes of death (mortality). The ICD is currently in its 11th revision and functions under the name of ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS).<ref name=":3" /> <ref name=":4">Harrison JE, Weber S, Jakob R, Chute CG. [https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01534-6 ICD-11: an international classification of diseases for the twenty-first century]. BMC Med Inform Decis Mak. 2021 Nov 9;21(Suppl 6):206.</ref>ICD-11 framework consists of three parts: Foundation ( | The International Classification of Diseases (ICD) was first published in 1893. It belongs to the WHO family of classifications and is used to classify existing conditions (morbidity) and/or causes of death (mortality). The ICD is currently in its 11th revision and functions under the name of ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS).<ref name=":3" /> <ref name=":4">Harrison JE, Weber S, Jakob R, Chute CG. [https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01534-6 ICD-11: an international classification of diseases for the twenty-first century]. BMC Med Inform Decis Mak. 2021 Nov 9;21(Suppl 6):206.</ref>ICD-11 framework consists of three parts: Foundation (database), classifications (attained from Foundation), and biomedical ontology (linked to Foundation), which represents the most relevant knowledge about the disease, that should be incorporated into the coding system. [[Coronavirus Disease (COVID-19)|COVID-19]] example explains the biomedical ontology portion of the ICD-11 when various manifestations of this disease were discovered after the release of ICD-11, and they were able to be incorporated as new dimensions of the ICD-11 model. <ref name=":4" /> | ||
=== International Classification of Functioning, Disability, and Health (ICF) === | === International Classification of Functioning, Disability, and Health (ICF) === | ||
In 2001, the fifty-fourth World Assembly officially approved the International Classification of Functioning, Disability and Health (ICF) as a replacement for the International Classification of Impairments, Disabilities and Handicaps (ICIDH).<ref name=":5">Millet P. The ICF twenty years later.Available from https://web.archive.org/web/20210716185739id_/https://www.idoriums.com/edpanel/media/D05_Edorium%20Journal%20of%20Disability%20and%20Rehabilitation/2021/pdf/100050D05PM2021.pdf [last accessed 19.06.2022].</ref>The ICF is a classification of health and health-related domains.<ref name=":2" />It focuses on human functioning, from healthy to disability, in relation to person’s activities and participation, influenced by environmental factors, health conditions, and personal factors.<ref name=":5" /> | In 2001, the fifty-fourth World Assembly officially approved the International Classification of Functioning, Disability and Health (ICF) as a replacement for the International Classification of Impairments, Disabilities and Handicaps (ICIDH).<ref name=":5">Millet P. The ICF twenty years later.Available from https://web.archive.org/web/20210716185739id_/https://www.idoriums.com/edpanel/media/D05_Edorium%20Journal%20of%20Disability%20and%20Rehabilitation/2021/pdf/100050D05PM2021.pdf [last accessed 19.06.2022].</ref>The ICF is a classification of health and health-related domains.<ref name=":2" />It focuses on human functioning, from healthy to a disability, in relation to a person’s activities and participation, influenced by environmental factors, health conditions, and personal factors.<ref name=":5" /> | ||
The unique features of the ICF : | The unique features of the ICF : | ||
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* provides a framework for mental and physical disorders<ref name=":2" /> | * provides a framework for mental and physical disorders<ref name=":2" /> | ||
* allows for organisation and communication of information on human functioning<ref name=":2" /> | * allows for organisation and communication of information on human functioning<ref name=":2" /> | ||
* facilitates interdisciplinary and inter-professional | * facilitates interdisciplinary and inter-professional practice, by providing specificity and a common language in the world of functioning and disability<ref name=":6">Madden RH, Bundy A. The ICF has made a difference in functioning and disability measurement and statistics. Disability and rehabilitation. 2019 Jun 5;41(12):1450-62.</ref> | ||
* allows for interactive relationship between health | * allows for an interactive relationship between health conditions, impairments, functional limitation/activity restrictions and environmental and personal factors.<ref name=":7">Sagahutu JB, Kagwiza J, Cilliers F, Jelsma J. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226247 The impact of a training programme incorporating the conceptual framework of the International Classification of Functioning (ICF) on behaviour regarding interprofessional practice in Rwandan health professionals: A cluster randomized control trial]. PloS one. 2020 Feb 7;15(2):e0226247.</ref>In this model the relationship is not linear, but one component influencing and being influenced by other factors. <ref name=":7" /> | ||
==== ICF and Rehabilitation ==== | ==== ICF and Rehabilitation ==== | ||
The role of the ICF in | The role of the ICF in rehabilitation is evolving. The following are present and potential implications of the ICF for rehabilitation: | ||
* concept of functioning and disability finds support in the assessment and documentation | * concept of functioning and disability finds support in the assessment and documentation | ||
| Line 64: | Line 64: | ||
Limitations of the ICF classification in rehabilitation: | Limitations of the ICF classification in rehabilitation: | ||
* limited applications by the healthcare professionals, especially those | * limited applications by the healthcare professionals, especially those outsides of the rehabilitation team<ref name=":7" /> | ||
* limited training an interprofessional team to adopt ICF in daily practice<ref name=":7" /> | * limited training an interprofessional team to adopt ICF in daily practice<ref name=":7" /> | ||
* limited use of the ICF in the rehabilitation setting by vocational rehabilitation counselors <ref name=":5" /><ref>Southwick JD, Grizzell ST. [https://journals.sagepub.com/doi/abs/10.1177/0034355220910782 Utilizing the ICF to enable evidence-based practice among vocational rehabilitation counselors]. Rehabilitation Counseling Bulletin. 2020 Oct;64(1):17-30.</ref> | * limited use of the ICF in the rehabilitation setting by vocational rehabilitation counselors <ref name=":5" /><ref>Southwick JD, Grizzell ST. [https://journals.sagepub.com/doi/abs/10.1177/0034355220910782 Utilizing the ICF to enable evidence-based practice among vocational rehabilitation counselors]. Rehabilitation Counseling Bulletin. 2020 Oct;64(1):17-30.</ref> | ||
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== Resources == | == Resources == | ||
*[https://apps.who.int/iris/bitstream/handle/10665/41003/9241541261_eng.pdf?sequence=1&isAllowed=y International classification of impairments, disabilities, and handicaps : a manual of classification relating to the consequences of disease, published in accordance with resolution WHA29.35 of the Twenty-ninth World Health Assembly, May 1976] | *[https://apps.who.int/iris/bitstream/handle/10665/41003/9241541261_eng.pdf?sequence=1&isAllowed=y International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of the disease, published in accordance with resolution WHA29.35 of the Twenty-ninth World Health Assembly, May 1976] | ||
* | * | ||
== References == | == References == | ||
Revision as of 19:12, 19 June 2022
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (20/06/2022)
Original Editor - Ewa Jaraczewska based on the course by Patricia Saleeby
Top Contributors - Ewa Jaraczewska, Jess Bell, Kim Jackson, Tarina van der Stockt and Robin Tacchetti
Introduction[edit | edit source]
The model of disability which has been systematically developed by The World Health Organization (WHO) is based on the ongoing interaction between one's health and contextual factors. This model acknowledges that disability is a universal human experience, is etiologically neutral, and it lies on a continuum from no disability to complete disability.[1]The contextual factors affecting a person's health include real-life environment, social interactions, and social participation.[1]Every healthcare personnel needs to understand and appreciate that patient perceives his health through the lenses of his daily life impacted by the environment.[1]This course provides an introduction to the International Classification of Functioning, Disability, and Health (ICF) and review the changes and progress in conceptualising and measuring disability.
International Classification of Impairment, Disability and Handicaps (ICIDH)[edit | edit source]
International Classification of Impairment, Disability and Handicaps known as ICIDH, was published by the World Health Organization in 1980. It was a manual containing the classification related to the consequences of the disease, injuries, and other disorders and a framework for health-related information.[2]
According to the ICIDH manual, "an impairment is any loss or abnormality of a psychological, physiological, or anatomical structure or function". [3]Classification of impairments (I code) reflected:
- abnormalities of body structure (temporary or permanent)
- appearance or disturbances at the level of the organ or system function resulting from any cause
The following categories of impairments were listed in the manual: intellectual, other psychological, language, aural, ocular, visceral, skeletal, disfiguring, general, sensory and other.[3]
A disability was considered "any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being".[3]Classification of disabilities (D code) reflected:
- individual's functional performance
- activity by the individual
Nine categories of disability included: behaviour, communication, personal care, locomotor, body disposition, dexterity, a situational, particular skill, and other activity restrictions.
Handicaps (H code) were defined as "the disadvantages experienced by the individual as a result of impairments and disabilities that limits or prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual".[3]There were two dimensions of handicap listed in the manual: survival role, with six key dimensions, and other. Six major survival roles included: orientation, physical independence, mobility, occupation, social integration, and economic self-sufficiency.
Coding example based on ICIDH: "Unable to see" could potentially be coded as 9D90.Z (ICD-11), 51 (Impairment code), or 26 (Disability code) as each classification has different purposes, and it was up to the user to decide which classifications were appropriate.[4] ICD would be chosen to understand the cause of blindness. Classification of impairment would allow the facilitation of the grouping of low vision impairments. Disability would help to plan a course of rehabilitation because it allows specifying the outcome or prognosis of a vision-related disability.[4]
ICIDH-2[edit | edit source]
ICIDH-2 was a new version of ICIDH which was released as the alpha version in 1996, followed by beta one and beta two versions tested by WHO in 1997 and in 1999. The biggest changes in ICIDH-2 as compared to the original ICIDH included adding two new dimensions: participation in social activities and a listing of environmental factors which are important for understanding the complexity of disability.[4] This model allowed to describe the consequences of the diagnosed condition. [4]
WHO-FIC[edit | edit source]
ICD-11 and ICF constitute the core classifications of the WHO family of international classifications, otherwise known as WHO-FIC.[2]
International Classification of Disease (ICD-11)[edit | edit source]
The International Classification of Diseases (ICD) was first published in 1893. It belongs to the WHO family of classifications and is used to classify existing conditions (morbidity) and/or causes of death (mortality). The ICD is currently in its 11th revision and functions under the name of ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS).[4] [5]ICD-11 framework consists of three parts: Foundation (database), classifications (attained from Foundation), and biomedical ontology (linked to Foundation), which represents the most relevant knowledge about the disease, that should be incorporated into the coding system. COVID-19 example explains the biomedical ontology portion of the ICD-11 when various manifestations of this disease were discovered after the release of ICD-11, and they were able to be incorporated as new dimensions of the ICD-11 model. [5]
International Classification of Functioning, Disability, and Health (ICF)[edit | edit source]
In 2001, the fifty-fourth World Assembly officially approved the International Classification of Functioning, Disability and Health (ICF) as a replacement for the International Classification of Impairments, Disabilities and Handicaps (ICIDH).[6]The ICF is a classification of health and health-related domains.[2]It focuses on human functioning, from healthy to a disability, in relation to a person’s activities and participation, influenced by environmental factors, health conditions, and personal factors.[6]
The unique features of the ICF :
- includes social and environmental aspects of disability and health[2]
- allows for the identification of factors at both individual and system levels[2]
- provides a framework for mental and physical disorders[2]
- allows for organisation and communication of information on human functioning[2]
- facilitates interdisciplinary and inter-professional practice, by providing specificity and a common language in the world of functioning and disability[7]
- allows for an interactive relationship between health conditions, impairments, functional limitation/activity restrictions and environmental and personal factors.[8]In this model the relationship is not linear, but one component influencing and being influenced by other factors. [8]
ICF and Rehabilitation[edit | edit source]
The role of the ICF in rehabilitation is evolving. The following are present and potential implications of the ICF for rehabilitation:
- concept of functioning and disability finds support in the assessment and documentation
- improvement in understanding by the rehabilitation professionals all the domains of participation and how the environment influences the participation, and to include them when planning rehabilitation and anticipating the outcomes
- strengthening universality and standardisation of functions, disabilities, and health[6]
- focusing on removing environmental barriers when rehabilitation services are planned[7]
- evolvement of the researchers’ and professionals’ reasoning when working with statistics and information related to functioning, disabilities, and health [6]
- introduction of a holistic approach to the management of patients[8]
Limitations of the ICF classification in rehabilitation:
- limited applications by the healthcare professionals, especially those outsides of the rehabilitation team[8]
- limited training an interprofessional team to adopt ICF in daily practice[8]
- limited use of the ICF in the rehabilitation setting by vocational rehabilitation counselors [6][9]
Components of ICF[edit | edit source]
Categories for Each Component[edit | edit source]
Resources[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 Cieza A, Sabariego C, Bickenbach J, Chatterji S. Rethinking disability. BMC medicine. 2018 Dec;16(1):1-5.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Saleeby P. Introduction to Introduction to the International Classification of Functioning, Disability, and Health (ICF) Course. Physioplus 2022.
- ↑ 3.0 3.1 3.2 3.3 World Health Organization. International classification of impairments, disabilities, and handicaps: a manual of classification relating to the consequences of the disease, published in accordance with resolution WHA29. 35 of the Twenty-ninth World Health Assembly, May 1976. World Health Organization; 1980.
- ↑ 4.0 4.1 4.2 4.3 4.4 Gray DB, Hendershot GE. The ICIDH-2: developments for a new era of outcomes research. Arch Phys Med Rehabil. 2000 Dec;81(12 Suppl 2): S10-4.
- ↑ 5.0 5.1 Harrison JE, Weber S, Jakob R, Chute CG. ICD-11: an international classification of diseases for the twenty-first century. BMC Med Inform Decis Mak. 2021 Nov 9;21(Suppl 6):206.
- ↑ 6.0 6.1 6.2 6.3 6.4 Millet P. The ICF twenty years later.Available from https://web.archive.org/web/20210716185739id_/https://www.idoriums.com/edpanel/media/D05_Edorium%20Journal%20of%20Disability%20and%20Rehabilitation/2021/pdf/100050D05PM2021.pdf [last accessed 19.06.2022].
- ↑ 7.0 7.1 Madden RH, Bundy A. The ICF has made a difference in functioning and disability measurement and statistics. Disability and rehabilitation. 2019 Jun 5;41(12):1450-62.
- ↑ 8.0 8.1 8.2 8.3 8.4 Sagahutu JB, Kagwiza J, Cilliers F, Jelsma J. The impact of a training programme incorporating the conceptual framework of the International Classification of Functioning (ICF) on behaviour regarding interprofessional practice in Rwandan health professionals: A cluster randomized control trial. PloS one. 2020 Feb 7;15(2):e0226247.
- ↑ Southwick JD, Grizzell ST. Utilizing the ICF to enable evidence-based practice among vocational rehabilitation counselors. Rehabilitation Counseling Bulletin. 2020 Oct;64(1):17-30.
