@article{ProdingerStuckiCoenenetal.2019, author = {Prodinger, Birgit and Stucki, G. and Coenen, M. and Tennant, A.}, title = {The measurement of functioning using the International Classification of Functioning, Disability and Health: comparing qualifier ratings with existing health status instruments}, series = {Disability and Rehabilitation}, volume = {41}, journal = {Disability and Rehabilitation}, number = {5}, pages = {541 -- 548}, year = {2019}, abstract = {Background: The International Classification of Functioning, Disability and Health is the international standard for describing and monitoring functioning. While the categories, the units of the classification, were not designed with measurement in mind, the hierarchical structure of the classification lends itself to the possibility of summating categories into some higher order domain. Focusing on the chapters of d4 Mobility, d5 Self-Care and d6 Domestic Life, this study seeks to ascertain if qualifiers rating of categories (0-No problem to 4-Complete problem) within those chapters can be summated, and whether such derived measurement is consistent with estimates obtained from well-known instruments which purport to measure the same constructs. Methods: The current study applies secondary analysis to data previously collected in the context of validating Core Sets for stroke, rheumatoid arthritis, and osteoarthritis. Data included qualifier-based ratings of the categories in the Core Sets, and the physical functioning sub-scale of the Short-Form 36, and the World Health Organization Disability Assessment Schedule 2.0. To examine qualifier-comparator scale item agreement Kappa statistics were used. To identify whether appropriate gradients of the comparator scales were observed across qualifier levels, an Independent Sample Median Test of the ordinal scores was deployed. To investigate the internal validity of the summated ICF categories, the Rasch model was applied. Results: Data from 2,927 subjects from Europe, Australasia, Middle East and South America were available for analysis; 36.3\% had experienced a stroke, 35.8\% osteoarthritis, and 27.9\% had rheumatoid arthritis. The items from the Short-Form 36 could not match directly the qualifier categories as the former had only 3 response options. The Kappa between World Health Organization Disability Assessment Schedule 2.0 items and categories was low. For all qualifiers, a significant (<0.001) overall gradient was observed across the comparator scales. Only in few of the World Health Organization Disability Assessment Schedule 2.0 items could no discrete level be detected. The aggregation of the qualifiers at the Chapter and higher order levels mostly revealed fit to the Rasch model. Almost all ICF qualifiers showed ordered thresholds suggesting that the current structure and response options of the qualifiers worked as intended. Conclusions: The findings of this study provide supporting evidence for the use of the professionally rated categories and associated qualifiers to measure functioning. Implication for Rehabilitation - This study provides evidence that functioning data can be collected directly with the International Classification of Functioning, Disability and Health (ICF) by using the ICF categories as items and the ICF qualifiers as rating scale. - The findings of this study show the aggregated ratings of ICF categories from the chapters d4 Mobility, d5 Self-care, and d6 Domestic life capture a broader spectrum of the construct than the corresponding summated items from the SF36-Physical Function sub-scale and the corresponding items of the World Health Organization Disability Assessment Schedule 2.0. - This study illustrates the potential of building quantitative measurement by aggregating ICF categories and their qualifier ratings into meaningful domains.}, language = {en} } @article{MukainoProdingerOkouchietal.2020, author = {Mukaino, M. and Prodinger, Birgit and Okouchi, Y. and Mizutani, K. and Senju, Y. and Suzuki, M. and Saitoh, E.}, title = {Development and assessment of a home environment checklist to evaluate mismatch between patients' ability and home environment}, series = {Annals of Physical and Rehabilitation Medicine}, volume = {63}, journal = {Annals of Physical and Rehabilitation Medicine}, number = {4}, pages = {288 -- 295}, year = {2020}, abstract = {Background Modification of the home environment, together with rehabilitative interventions, is important for maximizing the level of functioning after an individual with disability undergoes rehabilitation in the hospital. Objectives We developed a simple screening scale - the home environment checklist (HEC) - to identify any mismatch between an individual's abilities and their home environment to help clinicians monitor the appropriateness of the home environment to which individuals with disability will be discharged. We also examined the psychometric properties of the HEC. Methods The HEC was developed by a multidisciplinary panel of rehabilitation experts using information routinely collected in rehabilitation clinics before discharge. The reliability of the checklist was assessed in 60 individuals undergoing rehabilitation. The inter-rater agreement and internal consistency of the scale were assessed by weighted kappa statistics and Cronbach's alpha, respectively. Rasch analysis was performed with 244 rehabilitation individuals to evaluate the internal construct validity, and the known-groups validity was confirmed by a comparison of the daily activity levels of 30 individuals with disabilities under rehabilitation to the HEC score. Results The HEC was developed as a simple, 10-item checklist. The weighted kappa statistics ranged from 0.73 to 0.93, indicating excellent inter-rater reliability. Cronbach's alpha was 0.92, indicating high internal consistency. Rasch analysis with a testlet approach on 3 subscales demonstrated a good fit with the Rasch model (χ2 = 13.2, P = 0.153), and the demonstrated unidimensionality and absence of differential item functioning supported the internal construct validity of the HEC. HEC scores were significantly different (P < .01) among individuals with disability and 3 levels of restrictions in their activities (no limitation, home-bound, and bed-bound), which demonstrates the known-groups validity of the HEC. Conclusions The HEC has good reliability and validity, which supports its utility in rehabilitation clinics.}, language = {en} } @article{MukainoProdingerYamadaetal.2020, author = {Mukaino, M. and Prodinger, Birgit and Yamada, S. and Senju, Y. and Izumi, S. I. and Sonoda, S. and Selb, M. and Saitoh, E. and Stucki, G.}, title = {Supporting the clinical use of the ICF in Japan - development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 set, its operationalization through a rating reference guide, and interrater reliability study}, series = {BMC Health Services Research}, volume = {20}, journal = {BMC Health Services Research}, number = {1}, pages = {66}, year = {2020}, abstract = {Background The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) in 2001 and has been in the process of implementing it in clinics since then. Current international efforts to implement ICF in rehabilitation clinics include the implementation of ICF Core Sets and the development of simple, intuitive descriptions for the ICF Generic-30 Set (also called Rehabilitation Set). The present study was designed to operationalize these ICF tools for clinical practice in Japan. This work included 1) the development of the Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set, 2) the development of a rating reference guide for Activity and Participation categories, and 3) the examination of the interrater reliability of rating Activity and Participation categories. Methods The Japanese version of the simple, intuitive descriptions for the ICF Generic-30 Set was developed following the process employed to develop the Chinese and Italian versions. For further operationalization of this ICF Set in practice, a rating reference guide was developed. The development of the rating reference guide involved the following steps: 1) a trial of rating patients by several raters, 2) cognitive interviewing of the raters to analyse the thinking process involved in rating, 3) drafting of the rating reference guide, and 4) review by ICF specialists to confirm consistency with the original ICF concepts. After the rating reference guide was developed, interrater reliability of the rating with the reference guide was determined. Interrater reliability was examined using weighted kappa statistics with linear weight. Results Through the pre-defined process, the Japanese version of the simple, intuitive descriptions for 30 categories of the ICF Generic-30 Set and the rating reference guides for 21 Activity and Participation categories were successfully developed. The weighted kappa statistics ranged from 0.61 to 0.85, showing substantial to excellent agreement of the ratings between raters. Conclusions The present study demonstrates that ICF categories can be translated into clinical practice. Collaboration between clinicians and researchers would further enhance the implementation of the ICF in Japan.}, language = {en} } @article{PongpipatpaiboonSelbKovindhaetal.2020, author = {Pongpipatpaiboon, K and Selb, M and Kovindha, A and Prodinger, Birgit}, title = {Toward a framework for developing an ICF-based documentation system in spinal cord injury-specific rehabilitation based on routine clinical practice: a case study approach}, series = {Spinal Cord Series and Cases}, volume = {6}, journal = {Spinal Cord Series and Cases}, number = {33}, year = {2020}, abstract = {Study design Case study. Objective To present a framework for developing an International Classification of Functioning, Disability and Health (ICF)-based documentation system in spinal cord injury (SCI)-specific rehabilitation. Setting Data collection took place at Maharaj Hospital, Thailand. The preparatory studies and analysis were performed at Swiss Paraplegic Research, Switzerland. Methods Data collected from interviews and health records of four SCI cases across the continuum of care (acute, post-acute, early and late long term) were linked to ICF categories using established ICF linking rules. The resulting categories were compared with selected ICF sets (ICF Generic-30, ICF core sets for SCI and multiple sclerosis) to determine the extent of coverage. Furthermore, the context of applicable services was described systematically. Results Less than half of the ICF categories in the defined ICF sets were covered by clinical assessment tools. Low correspondence was found predominantly in acute and late long-term phase. Least well covered were categories of activities and participations and environmental factors. The correspondence of categories increased when considering the additional ICF categories identified from patient interviews. The description of rehabilitation services provided in each case classified according to the dimensions of service provider, funding, and service delivery. Conclusions There is a need to promote the systematic and standardized assessment of functioning among health professionals working in the field of SCI in developing countries. This study describes basic steps toward developing a standardized ICF-based system for assessing and reporting functioning outcomes in SCI rehabilitation and across the continuum of care.}, language = {en} } @article{EhrmannProdingerGmuenderetal.2018, author = {Ehrmann, Cristina and Prodinger, Birgit and Gm{\"u}nder, Hans Peter and Hug, Kerstin and Bickenbach, Jerome E. and Stucki, Gerold}, title = {Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach}, series = {Archives of Physical Medicine and Rehabilitation}, volume = {99}, journal = {Archives of Physical Medicine and Rehabilitation}, number = {10}, publisher = {Elsevier}, pages = {1965 -- 1981}, year = {2018}, abstract = {Objective: To describe functioning in people living with spinal cord injuries (SCI) in Switzerland. Design: Secondary analysis of cross-sectional survey data. Setting Community, Switzerland. Participants: Individuals (N=1549) 16 years of age or older with a history of traumatic or nontraumatic SCI and permanently residing in Switzerland. Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized through 4 domains: (1) impairments in body functions; (2) impairments in mental functions; (3) independence in performing activities; and (4) performance problems in participation. Results: Univariate analysis indicated a high prevalence of problems in 5 areas: (1) housework; (2) climbing stairs; (3) tiredness; (4) spasticity; and (5) chronic pain. Graphical modeling showed a strong association among the four domains of functioning. Moreover, we found that the differences in the dependence structures were significant between the paraplegia SCI population and the tetraplegia SCI population. Conclusions: This study is a first study in the epidemiology of functioning of people living with SCI in Switzerland. Using univariate and graphical modeling approaches, we proposed an empirical foundation for developing hypotheses on functioning in each domain and category that could inform health systems on people's health needs.}, language = {en} } @article{ProdingerWeiseShawetal.2010, author = {Prodinger, Birgit and Weise, A. P. and Shaw, L. and Stamm, T. A.}, title = {A Delphi study on Environmental Factors that impact work and social life participation of individuals with Multiple Sclerosis in Austria and Switzerland}, series = {Disability and Rehabilitation}, volume = {32}, journal = {Disability and Rehabilitation}, number = {3}, pages = {183 -- 195}, year = {2010}, abstract = {Purpose: This study aimed to gain knowledge about environmental factors (EFs) that impact work and social life participation of people with multiple sclerosis (MS) in Austria and Switzerland to extend the knowledge of participation and to identify key areas for measuring participation. Method: A three-round Delphi study was conducted defining patients as experts. In the 1st round, qualitative data was gathered through questionnaires, analyzed with content analysis, and factors were assigned to EFs as classified in the ICF. In the 2nd and 3rd round, experts judged EFs according to its relevance to obtain consensus (cut-off 75\%). Categories were ranked on a scale from mostly important to important. Results: One hundred and twelve Austrian and 109 Swiss experts were recruited. The content analysis revealed 768 EFs. The study resulted in a list of 176 consensus factors for Austria and 177 Switzerland. Five categories revealed to be highly important, 12 moderately important, 6 fairly important, and 10 important. Conclusions: This study indicates that participation in work or social life is influenced by physical, social, attitudinal, and policy factors. Consensus factors afford insights into areas for consideration in the development of participation outcome measurements and support a comprehensive and inclusive rehabilitation approach.}, language = {en} } @article{ProdingerO'ConnorStuckietal.2017, author = {Prodinger, Birgit and O'Connor, R.J. and Stucki, G. and Tennant, A.}, title = {Establishing score equivalence of the Functional Independence Measure (FIM™) motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health (ICF) and Rasch Measurement Theory}, series = {Journal of Rehabilitation Medicine}, volume = {49}, journal = {Journal of Rehabilitation Medicine}, number = {5}, pages = {416 -- 422}, year = {2017}, abstract = {Introduction: Two widely used outcome measures to assess functioning in neurological rehabilitation are the Functional Independence Measure (FIM™) and the Barthel Index. The current study aims to establish the equivalence of the total score of the FIM™ motor scale and the Barthel Index through the application of the International Classification of Functioning, Disability and Health, and Rasch measurement theory. Methods: Secondary analysis of a large sample of patients with stroke, spinal cord injury, and multiple sclerosis, undergoing rehabilitation was conducted. All patients were assessed at the same time on both the FIM™ and the Barthel Index. The International Classification of Functioning, Disability and Health Linking Rules were used to establish conceptual coherency between the 2 scales, and the Rasch measurement model to establish an exchange of the total scores. Results: Using the FIM™ motor scale, items from both scales linked to the International Classification of Functioning, Disability and Health d4 Mobility or d5 Self-care chapters. Their co-calibration satisfied the assumptions of the Rasch model for each of 3 diagnostic groups. A ceiling effect was observed for the Barthel Index when contrasted against the FIM™ motor scale. Conclusion: Having a Rasch interval metric to transform scores between the FIM™ motor scale and Barthel Index is valuable for monitoring functioning, meta-analysis, quality audits and hospital benchmarking.}, language = {en} } @article{LiProdingerReinhardetal.2016, author = {Li, J. and Prodinger, Birgit and Reinhard, J. D. and Stucki, G.}, title = {Toward the system-wide implementation of the International Classification of Functioning, Disability and Health in routine clinical practice: Lessons from a pilot study in China}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {6}, pages = {502 -- 507}, year = {2016}, abstract = {In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out.}, language = {en} } @article{GrillStroblMuelleretal.2011, author = {Grill, E. and Strobl, R. and M{\"u}ller, Martin and Quittan, M. and Kostanjsek, N. and Stucki, G.}, title = {ICF Core Sets for early post-acute rehabilitation facilities}, series = {Journal of rehabilitation medicine}, journal = {Journal of rehabilitation medicine}, number = {43(2)}, editor = {Foundation of Rehabilitation Information,}, year = {2011}, abstract = {Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in early post-acute rehabilitation facilities. Design: Prospective multi-centre cohort study. Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in early post-acute rehabilitation facilities. Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables. Results: A total of 165 patients were included in the study (67 neurological, 37 cardiopulmonary, 61 musculoskeletal), mean age 67.5 years, 46.1\% female. Selection yielded 38 categories for neurological, 32 for cardiopulmonary, and 31 for musculoskeletal. Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the assessment and monitoring of functioning in patients undergoing early post-acute rehabilitation for neurological, cardiopulmonary, and musculoskeletal conditions.}, language = {en} } @article{MuellerGrill2011, author = {M{\"u}ller, Martin and Grill, E.}, title = {Die Internationale Klassifikation der Funktionsf{\"a}higkeit, Behinderung und Gesundheit (ICF). Core Sets im Akutkrankenhaus: Nutzen und Relevanz f{\"u}r Pflegewissenschaft und -praxis.}, series = {Pflegewissenschaft}, journal = {Pflegewissenschaft}, number = {13(5)}, editor = {hps media,}, pages = {280 -- 288}, year = {2011}, language = {de} }