@article{GimiglianoDeSireGestaldoetal.2019, author = {Gimigliano, Francesca and De Sire, Alessandro and Gestaldo, Marco and Maghini, Irene and Paoletta, Marco and Pasquini, Andrea and Baldrini, Paolo and Selb, Melissa and Prodinger, Birgit and SIMFER Residents Section Group,}, title = {Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project}, series = {European Journal of Physical and Rehabilitation Medicine}, volume = {55}, journal = {European Journal of Physical and Rehabilitation Medicine}, number = {2}, editor = {Minerva Medica,}, pages = {258 -- 264}, year = {2019}, abstract = {The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice.1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool.Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM.Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS).Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6\%) and the most common altered ICF categories were b280 (76.3\%) and b710 (72.9\%).This multicenter cross-sectional study shown that the ICF Generic-30 Set is a valuable instrument for reporting and assessing functioning and disability in clinical populations with different health conditions and along the continuum of care and that SID facilitate the understanding of the ICF categories and therefore their use in clinical practice. This National survey, improving the knowledge of ICF among Italian PRM residents, represents an important step towards the system-wide implementation of ICF in the healthcare system.}, 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{ProdingerReinhardSelbetal.2016, author = {Prodinger, Birgit and Reinhard, J.D. and Selb, M. and Stucki, G. and Yan, T. and Zhang, C. and Li, J.}, title = {Towards system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {6}, pages = {508 -- 514}, year = {2016}, abstract = {Objective: A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study. Methods: A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive. Results: The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C. Discussion: This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.}, language = {en} } @article{DorjbalCiezaGmuenderetal.2016, author = {Dorjbal, D. and Cieza, A. and Gm{\"u}nder, H.-P- and Scheel-Sailer, A. and Stucki, G. and {\"U}st{\"u}n, T.B. and Prodinger, Birgit}, title = {Strengthening quality of care through standardized reporting based on the World Health Organization's reference classifications}, series = {International Journal of Quality in Health}, volume = {28}, journal = {International Journal of Quality in Health}, number = {5}, pages = {626 -- 633}, year = {2016}, abstract = {Quality issue Responding to person's health and related needs requires the availability of health information that reflects relevant aspects of a health condition and how this health condition impacts on a person's daily life. Initial assessment Health information is routinely collected at different time points by diverse professionals, in different settings for various purposes with varying methods. Consequently, health information is not always comparable, posing a challenge to the regular monitoring of quality. Choice of solution The World Health Organization's (WHO) International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI; under development) are complementary and serve as meaningful reference classifications for comparing data on persons' health and related interventions across health systems. Implementation We developed a systematic approach of translating routinely collected information into a standardized report based on the three WHO reference classifications and the Rehab-Cycle®. Subsequently, we have demonstrated its application using five random case records of individuals attending a rehabilitation program. Evaluation All identified concepts were able to be linked to WHO's reference classifications. The ICF served as a tool to standardize information on rehabilitation goals and their achievement. The ICHI served as the basis for reporting the interventions that were documented in the case records, including the intervention targets that were derived from the ICF codes. Lessons learned Our experience shows that, it is possible to translate routinely collected information into standardized reports by linking existing narrative records with WHO's reference classifications.}, language = {en} } @article{HinrichsProdingerBrinkofetal.2016, author = {Hinrichs, T. and Prodinger, Birgit and Brinkof, M.W. and Gemperli, A.}, title = {Subgroups in epidemiological studies on spinal cord injury: Evaluation of international recommendations in the Swiss Spinal Cord Injury Cohort Study}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {141 -- 148}, year = {2016}, abstract = {Objective: To test subgroups of a community-based sample of individuals with spinal cord injury, categorized by the application of current recommendations by the International Spinal Cord Society. Design: Community survey. Participants: Individuals with traumatic and non-traumatic spinal cord injury residing in Switzerland. Methods: Recommended subgroups of age, gender, years since injury, severity of injury and aetiology were tested against the following criteria: (i) distribution of participants across categories; (ii) within- and between-group variability with regard to selected outcomes of functioning and quality of life. Results: Data-sets for 1,549 participants (28.5\% women; mean age 52 ± 15 years) were available for analyses. There was a number of participants in every subgroup, yet numbers were relatively small in the group with the shortest time since injury (< 1 year; n = 23) and in the oldest age group (≥76; n = 94). A high variability in some outcomes was detected between categories. All variables were predictive for most of the endpoints investigated. Conclusion: Recommended categorization could well fit the present sample. A minor concern was the low numbers of participants in some subgroups.}, language = {en} } @article{ProdingerCiezaOberhauseretal.2016, author = {Prodinger, Birgit and Cieza, A. and Oberhauser, C. and Bickenbach, J. and {\"U}st{\"u}n, T.B. and Chatterji, S. and Stucki, G.}, title = {Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy}, series = {Archives of Physical Medicine and Rehabilitation}, volume = {97}, journal = {Archives of Physical Medicine and Rehabilitation}, number = {6}, pages = {875 -- 884}, year = {2016}, language = {en} } @article{SaalMeyerBeutneretal.2018, author = {Saal, S. and Meyer, G. and Beutner, K. and Klingshirn, H. and Strobl, R. and Grill, E. and Mann, E. and K{\"o}pke, S. and Bleijlevens, M.H.C. and Bartoszek, G. and Stephan, A.-J. and Hirt, J. and M{\"u}ller, Martin}, title = {Development of a complex intervention to improve participation of nursing home residents with joint contractures: a mixed-method study}, series = {BMC Geriatrics}, journal = {BMC Geriatrics}, year = {2018}, abstract = {Background Joint contractures in nursing home residents limit the capacity to perform daily activities and restrict social participation. The purpose of this study was to develop a complex intervention to improve participation in nursing home residents with joint contractures. Methods The development followed the UK Medical Research Council framework using a mixed-methods design with re-analysis of existing interview data using a graphic modelling approach, group discussions with nursing home residents, systematic review of intervention studies, structured 2-day workshop with experts in geriatric, nursing, and rehabilitation, and group discussion with professionals in nursing homes. Results Graphic modelling identified restrictions in the use of transportation, walking within buildings, memory functions, and using the hands and arms as the central target points for the intervention. Seven group discussions with 33 residents revealed various aspects related to functioning and disability according the International Classification of Functioning, Disability and Health domains body functions, body structures, activities and participation, environmental factors, and personal factors. The systematic review included 17 studies with 992 participants: 16 randomised controlled trials and one controlled trial. The findings could not demonstrate any evidence in favour of an intervention. The structured 2-day expert workshop resulted in a variety of potential intervention components and implementation strategies. The group discussion with the professionals in nursing homes verified the feasibility of the components and the overall concept. The resulting intervention, Participation Enabling CAre in Nursing (PECAN), will be implemented during a 1-day workshop for nurses, a mentoring approach, and supportive material. The intervention addresses nurses and other staff, residents, their informal caregivers, therapists, and general practitioners. Conclusions In view of the absence of any robust evidence, the decision to use mixed methods and to closely involve both health professionals and residents proved to be an appropriate means to develop a complex intervention to improve participation of and quality of life in nursing home residents. We will now evaluate the PECAN intervention for its impact and feasibility in a pilot study in preparation for an evaluation of its effectiveness in a definitive trial. Trial registration German clinical trials register, reference number DRKS00010037 (12 February 2016).}, language = {en} } @article{ProdingerBallertCieza2016, author = {Prodinger, Birgit and Ballert, C. S. and Cieza, A.}, title = {Setting up a cohort study of functioning: From classification to measurement}, series = {Journal of Rehabilitation Medicine}, volume = {48}, journal = {Journal of Rehabilitation Medicine}, number = {2}, pages = {131 -- 140}, year = {2016}, abstract = {Objective: Cohort studies are an appropriate method for the collection of population-based longitudinal data to track people's health and functioning over time. However, describing and understanding functioning in its complexity with all its determinants is one of the biggest challenges faced by clinicians and researchers. Design: This paper focuses on the development of a cohort study on functioning, outlining the relevant steps and related methods, and illustrating these with reference to the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Methods and results: In setting up a cohort study the initial step is to specify which variables are to be included, i.e. what to assess. The International Classification of Functioning, Disability and Health (ICF) is valuable in this process. The second step is to identify how to assess the specified ICF categories. Existing instruments and assessments can then be linked to the ICF. Conclusion: The methods outlined here enable the development of a cohort study to be based on a comprehensive perspective of health, operationalized through functioning as conceptualized and classified in the ICF, yet to remain efficient and feasible to administer.}, language = {en} } @article{BallertHopfeKusetal.2019, author = {Ballert, C.S. and Hopfe, M. and Kus, M. and Mader, L. and Prodinger, Birgit}, title = {Using the refined ICF Linking Rules to compare the content of existing instruments and assessments: a systematic review and exemplary analysis of instruments measuring participation.}, series = {Disability and Rehabilitation}, volume = {41}, journal = {Disability and Rehabilitation}, number = {5}, pages = {584 -- 600}, year = {2019}, abstract = {Background: Existing instruments measuring participation may vary with respect to various aspects. This study aimed to examine the comparability of existing instruments measuring participation based on the International Classification of Functioning, Disability and Health (ICF) by considering aspects of content, the perspective adopted and the categorization of response options. Methods: A systematic literature review was conducted to identify instruments that have been commonly used to measure participation. Concepts of identified instruments were then linked to the ICF following the refined ICF Linking Rules. Aspects of content, perspective adopted and categorization of response options were documented. Results: Out of 315 instruments identified in the full-text screening, 41 instruments were included. Concepts of six instruments were linked entirely to the ICF component Activities and Participation; of 10 instruments still 80\% of their concepts. A descriptive perspective was adopted in most items across instruments (75\%), mostly in combination with an intensity rating. An appraisal perspective was found in 18\% and questions from a need or dependency perspective were least frequent (7\%). Conclusion: Accounting for aspects of content, perspective and categorization of responses in the linking of instruments to the ICF provides detailed information for the comparison of instruments and guidance on narrowing down the choices of suitable instruments from a content point of view. Implications for Rehabilitation For clinicians and researchers who need to identify a specific instrument for a given purpose, the findings of this review can serve as a screening tool for instruments measuring participation in terms of the following: • Their content covered based on the ICF. • The perspective adopted in the instrument (e.g., descriptive, need/dependency or appraisal). • The categorization of their response options (e.g., intensity or frequency).}, language = {en} } @article{MaritzAronskyProdinger2017, author = {Maritz, R. and Aronsky, D. and Prodinger, Birgit}, title = {The Implementation of the International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records - A Systematic Review}, series = {Applied Clinical Informatics}, volume = {8}, journal = {Applied Clinical Informatics}, number = {3}, pages = {964 -- 980}, year = {2017}, abstract = {Background: The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. Objectives: To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Methods: Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline®, CINAHL®, Scopus®, and ProQuest® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Results: Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Conclusion: Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.}, language = {en} }