Introduction to the International Classification of Functioning, Disability and Health (ICF)
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]
Model of disability which has been systematically developed by The World Health Organization (WHO) is based on the ongoing interaction between ones 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 person's health include real-life environment, social interactions, and social participations.[1]Every healthcare personel need 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 disease, injuries, and other disorders, as well as a framework for health-related information.[2]
According to ICIDH manual, "an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function". [3]Classification of impairments (I code) reflected:
- abnormalities of body structure (temporary or parmanent)
- 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, situational, particular skill, and other activity restrictions.
Handicaps (H code) was defined as "the disadvantages experienced by the individual as a result of impairments and disabilities that limits or prevents the fulf1lment 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 keys 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 classifications have 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 facilitation of the grouping of low vision impairments. Disability would help to plan a course of rehabilitation, because it allows to specify 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 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 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 (data base), 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 disability, in relation to person’s activities and participation, influenced by environmental factors, health conditions, and personal factors.[6]
The unique features of the ICF :[2]
- includes social and environmental aspects of disability and health
- allows for the identification of factors at both individual and system levels
- provides a framework for mental and physical disorders
- allows for organisation and communication of information on human functioning
- facilitates interdisciplinary and inter-professional practise, by providing specificity and a common language in the world of functioning and disability[7]
ICF and Rehabilitation[edit | edit source]
The role of the ICF in the rehabilitation is evolving. The following are potential implications of the ICF for rehabilitation:
- concept of functioning and disability finding support in the assessment and documentation
- improving 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
- focusing on removing environmental barriers when rehabilitation services are planned.[7]
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 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 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 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 to functioning and disability measurement and statistics. Disability and rehabilitation. 2019 Jun 5;41(12):1450-62.
