TY - JOUR A1 - Hopfe, Maren A1 - Stucki, Gerold A1 - Bickenbach, Jerome E. A1 - Prodinger, Birgit T1 - Accounting for what matters to patients in the G-DRG System: A stakeholder’s perspective on integrating functioning information JF - Health Services Insights N2 - Functioning information constitutes a relevant component for determining patients’ service needs and respective resource use. Diagnosis-Related Group (DRG) systems can be optimized by integrating functioning information. First steps toward accounting for functioning information in the German DRG (G-DRG) system have been made; yet, there is no systematic integration of functioning information. The G-DRG system is part of the health system; it is embedded in and as such dependent on various stakeholders and vested interests. This study explores the stakeholder’s perspective on integrating functioning information in the G-DRG system. A qualitative interview study was conducted with national stakeholders in 4 groups of the G-DRG system (health policy, administration, development, and consultations). Interviews were analyzed using inductive thematic analysis. In total, 14 interviews were conducted (4 administration and 10 consultation group). Three main themes were identified: (1) functioning information in the G-DRG system: opportunities and obstacles, (2) general aspects concerning optimizing G-DRG systems by integrating additional information, and (3) ideas and requirements on how to proceed. The study offers insights into the opportunities and obstacles of integrating functioning information in the G-DRG system. The relevance of functioning information was evident. However, the value of functioning information for the G-DRG system was seen critically. Integrating functioning information alone does not seem to be sufficient and a systems approach is needed. KW - G-DRG System KW - Functioning information KW - Stakeholder interviews Y1 - 2018 UR - https://doi.org/10.1177%2F1178632918796776 IS - 11 SP - 1 EP - 10 ER - TY - JOUR A1 - Maritz, Roxanne A1 - Scheel-Sailer, Anke A1 - Schmitt, Klaus A1 - Prodinger, Birgit ED - Oxford Jounals, T1 - Overview of quality management models for inpatient healthcare settings: A scoping review JF - International Journal of Quality in Health Care N2 - This scoping review aimed to generate an overview of existing quality management (QM) models for inpatient healthcare published in peer-reviewed literature. Data sources Peer-reviewed publications published until June 2016 were retrieved from the databases Medline, PubMed, CINAHL and Cochrane Library using search terms related to QM and models. Study selection Publications mentioning a QM model for general application in healthcare or inpatient care in their title or abstract were included. Languages considered were: English, French, German, Italian and Spanish. Data extraction was 3-fold. First, publication characteristics were summarized. Second, the frequency of each identified model was documented and the publications were divided into conceptual and implementation publications. Third, relevant QM models were identified and information regarding the model, including content and relationship with other models, was extracted. Of 925 retrieved publications, 213 were included. The included publications reported on 64 different QM models that were suitable for or used in inpatient care. Seventeen models were identified as being relevant. The 17 models were then categorized into three different levels: conceptual quality improvement models, concrete application models and country specific adaptations. This scoping review provides an overview of 17 existing QM models for inpatient care and their relationships with each other. Various types of models with differing aspects and components exist. In searching for QM models, many different concepts like QM system, accreditation or methodologies appeared. For future investigation, concepts of interest should be clarified. KW - Quality improvement KW - Total quality management KW - Models KW - Inpatient care Y1 - 2019 UR - https://doi.org/10.1093/intqhc/mzy180 VL - 31 IS - 6 SP - 404 EP - 410 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Rastall, Paul A1 - Kalra, Dipak A1 - Wooldridge, Darren A1 - Carpenter, Iain ED - Thieme E-Journals, T1 - Documenting Routinely What Matters to People: Standardized Headings for Health Records of Patients with Chronic Health Conditions JF - Applied Clinical Informatics N2 - Objective Specifying the content in electronic health records (EHRs) through standardized headings based on international reference classifications will facilitate their semantic interoperability. The objective of this study was to specify potential chapter headings for EHRs aligned with the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF) based on the perspectives of people living with chronic health conditions, carers, and professionals. Methods A multistage process was established including (1) a patient workshop, (2) an online survey of both patients and carers, and (3) an online consultation with patient and professional bodies. The ICF served as a starting point. Based on the first stage, a first draft of the headings was developed and further refined based on the feedback at each stage. We examined in a fourth step whether items from existing assessment tools support the operationalization of the identified headings. Therefore, we used the WHO Disability Assessment Schedule 2.0 (WHODAS2.0), a patient-reported instrument, and interRAI, a clinician-administered instrument. Results The first workshop was attended by eight people, the survey was completed by 250 persons, and the online consultation received detailed feedback by 18 professional bodies. This study resulted in 16 potential chapter headings for EHRs which capture aspects related to the body, such as emotions, motivation, sleep, and memory or thoughts, to being involved in social life, such as mobility, social activities, and finances, as well as to the care process, such as understanding of health issues and treatment or care priorities and goals. When using the WHODAS2.0 and interRAI together, they capture all except one of the proposed headings. Conclusion The identified headings provide a high level structure for the standardized recording, use, and sharing of information. Once implemented, these headings have the potential to facilitate the delivery of personalized care planning for patients with long-term health problems. KW - Patient's perspective KW - electronic health records KW - international classification of functioning KW - disability and health Y1 - 2018 UR - https://doi.org/10.1055/s-0038-1649488 VL - 9 IS - 2 SP - 348 EP - 365 ER - TY - JOUR A1 - Gimigliano, Francesca A1 - De Sire, Alessandro A1 - Gestaldo, Marco A1 - Maghini, Irene A1 - Paoletta, Marco A1 - Pasquini, Andrea A1 - Baldrini, Paolo A1 - Selb, Melissa A1 - Prodinger, Birgit A1 - SIMFER Residents Section Group, ED - Minerva Medica, T1 - 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 JF - European Journal of Physical and Rehabilitation Medicine N2 - 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. KW - Disability and health Y1 - 2019 UR - https://doi.org/10.23736/S1973-9087.18.05324-8 VL - 55 IS - 2 SP - 258 EP - 264 ER - TY - JOUR A1 - Adroher, Núria Duran A1 - Prodinger, Birgit A1 - Fellinghauer, Carolina Saskia A1 - Tennant, Alan ED - Public Library of Science, T1 - All metrics are equal, but some metrics are more equal than others: A systematic search and review on the use of the term 'metric' JF - PLoS One N2 - Objective: To examine the use of the term ‘metric’ in health and social sciences’ literature, focusing on the interval scale implication of the term in Modern Test Theory (MTT). Materials and methods: A systematic search and review on MTT studies including ‘metric’ or ‘interval scale’ was performed in the health and social sciences literature. The search was restricted to 2001–2005 and 2011–2015. A Text Mining algorithm was employed to operationalize the eligibility criteria and to explore the uses of ‘metric’. The paradigm of each included article (Rasch Measurement Theory (RMT), Item Response Theory (IRT) or both), as well as its type (Theoretical, Methodological, Teaching, Application, Miscellaneous) were determined. An inductive thematic analysis on the first three types was performed. Results: 70.6% of the 1337 included articles were allocated to RMT, and 68.4% were application papers. Among the number of uses of ‘metric’, it was predominantly a synonym of ‘scale’; as adjective, it referred to measurement or quantification. Three incompatible themes ‘only RMT/all MTT/no MTT models can provide interval measures’ were identified, but ‘interval scale’ was considerably more mentioned in RMT than in IRT. Conclusion: ‘Metric’ is used in many different ways, and there is no consensus on which MTT metric has interval scale properties. Nevertheless, when using the term ‘metric’, the authors should specify the level of the metric being used (ordinal, ordered, interval, ratio), and justify why according to them the metric is at that level. KW - Metrics KW - MTT assay KW - Database Searching KW - Psychometrics Y1 - 2018 UR - https://doi.org/10.1371/journal.pone.0193861 VL - 13 IS - 3 SP - e0193861 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Taylor, Paul T1 - Improving quality of care through patient-reported outcome measures (PROMs): expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples JF - BMC Health Services Research N2 - Background: Patient reported outcome measures (PROMs) have been integrated in national quality registries or specific national monitoring initiatives to inform the improvement of quality of care on a national scale. However there are many unanswered questions, such as: how these systems are set up, whether they lead to improved quality of care, which stakeholders use the information once it is available. The aim of this study was to examine supporting and hindering factors relevant to integrating patient-reported outcome measures (PROMs) in selected health information systems (HIS) tailored toward improving quality of care across the entire health system. Methods: First, a systematic search and review was conducted to outline previously identified factors relevant to the integration of PROMs in the selected HIS. A social network analysis was performed to identify networks of experts in these systems. Second, expert interviews were conducted to discuss and elaborate on the identified factors. Directive content analysis was applied using a HIS Evaluation Framework as the frame of reference. This framework is structured into four components: Organization, Human, Technology, and Net benefits. Results: The literature review revealed 37 papers for the NHS PROMs Programme and 26 papers for the SHPR and SKAR: Five networks of researchers were identified for the NHS PROMs Programme and 1 for the SHPR and SKAR. Seven experts related to the NHS PROMs Programme and 3 experts related to the SKAR and SHPR participated in the study. The main themes which revealed in relation to Organization were Governance and Capacity building; to Human: Reporting and Stakeholder Engagement; to Technology: the Selection and Collection of PROMs and Data linkage. In relation to Net benefits, system-specific considerations are presented. Conclusion: Both examples succeeded in integrating PROMs into HIS on a national scale. The lack of an established standard on what change PROMs should be achieved by an intervention limits their usefulness for monitoring quality of care. Whether the PROMs data collected within these systems can be used in routine clinical practice is considered a challenge in both countries. KW - Health information system evaluation KW - Quality registry KW - Oxford hip score KW - Oxford knee score KW - EQ-5D Y1 - 2018 UR - https://doi.org/10.1186/s12913-018-2898-z VL - 18 SP - 87 PB - Springer Nature ER - TY - JOUR A1 - Ehrmann, Cristina A1 - Prodinger, Birgit A1 - Gmünder, Hans Peter A1 - Hug, Kerstin A1 - Bickenbach, Jerome E. A1 - Stucki, Gerold T1 - Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach JF - Archives of Physical Medicine and Rehabilitation N2 - 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. KW - DAG (directed acrylic graph) KW - ICF KW - SCI (Spinal cord injuries) Y1 - 2018 UR - https://doi.org/10.1016/j.apmr.2018.04.015 VL - 99 IS - 10 SP - 1965 EP - 1981 PB - Elsevier ER - TY - JOUR A1 - Fellinghauer, Carolina Saskia A1 - Prodinger, Birgit A1 - Tennant, Alan T1 - The Impact of Missing Values and Single Imputation upon Rasch Analysis Outcomes: A Simulation Study JF - Journal of Applied Measurement N2 - Imputation becomes common practice through availability of easy-to-use algorithms and software. This study aims to determine if different imputation strategies are robust to the extent and type of missingness, local item dependencies (LID), differential item functioning (DIF), and misfit when doing a Rasch analysis. Four samples were simulated and represented a sample with good metric properties, a sample with LID, a sample with DIF, and a sample with LID and DIF. Missing values were generated with increasing proportion and were either missing at random or completely at random. Four imputation techniques were applied before Rasch analysis and deviation of the results and the quality of fit compared. Imputation strategies showed good performance with less than 15% of missingness. The analysis with missing values performed best in recovering statistical estimates. The best strategy, when doing a Rasch analysis, is the analysis with missing values. If for some reason imputation is necessary, we recommend using the expectation-maximization algorithm. KW - Local item dependencies (LID) KW - Differential item functioning (DIF) KW - Imputation techniques KW - Rasch analysis Y1 - 2018 VL - 19 IS - 1 SP - 1 EP - 25 PB - JAM Press ER - TY - JOUR A1 - Lampart, Patricia A1 - Gemperli, Armin A1 - Baumberger, Michael A1 - Bersch, Ines A1 - Prodinger, Birgit A1 - Schmitt, Klaus A1 - Scheel-Sailer, Anke T1 - Administration of assessment instruments during the first rehabilitation of patients with spinal cord injury: a retrospective chart analysis. JF - Spinal Cord N2 - Objectives To examine which professionals administered which assessment instruments in which patient in clinical practice during first rehabilitation after newly acquired spinal cord injury (SCI) and the differences in the frequencies of different assessments between patient groups. Setting Specialized SCI acute care and rehabilitation clinic. Methods Patients after SCI, aged 18 years and above, admitted for first rehabilitation between December 2014 and December 2015 were analyzed. Descriptive statistics of 54 selected assessments. p values based on the χ 2 test were calculated for assessments used in both paraplegic and tetraplegic patients. Results One hundred and nineteen patients were screened. Forty-one assessments were administered, of which 10 on average more than once per patient. The most frequently used assessments were Spinal Cord Independence Measure III (7.7 times per patient), Skin Assessment (3.6 times), and Manual Muscle Test (3.2 times for Lower Extremities; 2.5 times for Upper Extremities). The American Spinal Injury Association Impairment Scale was administered on average 1.9 times per patient. More variation in the number of assessments per patient was observed in patients with complete and incomplete lesions compared to patients with paraplegia and tetraplegia. Conclusion Assessments covering neurological functioning, mobility, and self-care are used in clinical practice during first rehabilitation of patients with SCI, while others covering autonomic functioning, pain, participation, or quality of life are still missing. Based on these observations and national and international requirements, a meaningful standard for an assessment toolkit, applicable in general and in specific subgroups, needs to be defined and implemented. KW - spinal cord injury (SCI) KW - rehabilitation KW - assessment instruments Y1 - 2018 UR - https://doi.org/10.1038/s41393-017-0039-x VL - 56 IS - 4 SP - 322 EP - 331 PB - Springer Nature ER - TY - JOUR A1 - Saal, Susanne A1 - Klingshirn, Hanna A1 - Beutner, Katrin A1 - Strobl, Ralf A1 - Grill, Eva A1 - Müller, Martin A1 - Meyer, Gabriele T1 - Improved participation of older people with joint contractures living in nursing homes: feasibility of study procedures in a cluster-randomised pilot trial JF - Trials N2 - Background: Acquired joint contractures have a significant impact on functioning and quality of life in nursing home residents. There is very limited evidence on measures for prevention and treatment of disability due to joint contractures. We have developed the PECAN intervention (Participation Enabling CAre in Nursing) to improve social participation in nursing home residents. A cluster-randomised pilot trial was conducted to assess the feasibility of study procedures in preparation for a main trial according to the UK Medical Research Council (MRC) framework. Methods: Nursing homes in two regions of Germany were randomly allocated either to the intervention or optimised standard care (control group). All residents with joint contractures aged > 65 years were eligible for the study. The residents’ data were collected through structured face-to-face interviews by blinded assessors at baseline, after 3 and 6 months. The primary outcome was social participation, measured by a subscale of the PaArticular Scales. Secondary outcomes included activities and instrumental activities of daily living, health-related quality of life, falls and fall-related consequences. Data on the trial feasibility were collected via documentation forms. Results: Seven out of 12 nursing homes agreed to participate and remained in the trial. Of 265 residents who fulfilled the inclusion criteria, 129 were randomised either to the intervention (n = 64) or control group (n = 65) and analysed. A total of 109 (85%) completed the trial after 6 months. The mean age was 85.7 years (SD 7.0), 80% were women. The severity of the residents’ disability differed across the clusters. The completion rate was high (> 95%), apart from the Instrumental Activities of Daily Living Scale. Some items of the PaArticular Scales were not easily understood by residents. The frequency of falls did not differ between study groups. Conclusion: Our data confirmed the feasibility of the overall study design. We also revealed the need to improve the procedures for the recruitment of residents and for data collection before implementation into a main trial. The next step will be an adequately powered main trial to assess the effectiveness and cost-effectiveness of the intervention. KW - Joint contractures KW - Nursing homes KW - Participation KW - Complex intervention KW - Cluster-randomised pilot trial KW - Feasibility trial Y1 - 2019 UR - https://doi.org/10.1186/s13063-019-3522-1 VL - 20 SP - 411 ER - TY - JOUR A1 - Nguyen, Natalie A1 - Thalhammer, Regina A1 - Beutner, Katrin A1 - Saal, Susanne A1 - Servaty, Ricarda A1 - Klingshirn, Hanna A1 - Icks, Andrea A1 - Freyberg, Kristina A1 - Vomhof, Markus A1 - Mansmann, Ulrich A1 - Le, Lien A1 - Müller, Martin A1 - Meyer, Gabriele T1 - Effectiveness of a complex intervention to improve participation and activities in nursing home residents with joint contractures (JointConEval): study protocol of a multicentre cluster-randomised controlled trial [DRKS-ID:DRKS00015185] JF - Trials N2 - Background: Nursing home residents are frequently affected by joint contractures, which impacts their participation and daily activities. A complex intervention, the Participation Enabling Care in Nursing (PECAN), was previously developed and pilot tested to address their needs. Its effectiveness and safety will be evaluated in the present study. Methods/design: This multicentre cluster-randomised controlled trial will be conducted in 32 nursing homes spread over two regions of Germany. A total of 578 residents over 65 years old with joint contractures will be included. To compare the effect of the PECAN intervention with optimised standard care (usual care and an information session), randomisation will take place at a cluster level. The individually tailored intervention was designed using the biopsychosocial model in the International Classification of Functioning, Disability and Health (ICF) to reduce activity limitations and participation restrictions resulting from existing joint contractures by addressing barriers and by strengthening supportive factors on an individual level and an organisational level. The implementation strategy comprises a facilitators’ workshop, a peer mentoring approach including a peer mentor visit and telephone peer counselling, an in-house information event, an information session for the nursing team and a training session on collegial consultation for the facilitators. The in-house information event will also take place in the nursing homes of the control group. The primary outcome is the residents’ participation and activities after 12 months of follow-up as assessed using the PaArticular Scales. The secondary outcome is the residents’ quality of life. A cost-effectiveness analysis (costs per additional resident who experienced a decrease of ten points in the participation or activities subscale of the PaArticular Scales) and a cost–utility analysis (costs per additional quality adjusted life year) will be conducted. We will investigate barriers and facilitators in a comprehensive process evaluation. Discussion: We expect a clinically relevant improvement of participation and activities in residents with joint contractures. Our findings will provide important insights regarding participation in the situation of the affected individuals. KW - Joint contractures KW - Participation KW - Activities KW - Nursing homes KW - International Classification of Functioning KW - Disability and Health (ICF) KW - Complex intervention KW - Multicentre cluster randomised controlled trial Y1 - 2019 UR - https://doi.org/10.1186/s13063-019-3384-6 VL - 20 SP - 305 ER - TY - JOUR A1 - Shaw, L. A1 - Prodinger, Birgit A1 - Jacobs, K. A1 - Shaw, N. T1 - WORK: A historical evaluation of the impact and evolution of its editorial board JF - Work N2 - Objectives: A historical review of the editorial board and the founding editor of WORK: A Journal of Prevention, Assessment and Rehabilitation was conducted to examine the understanding of the editorship and contributions of this team to the knowledge in WORK. Participants: The team of four authors worked together to identify an approach to evaluate the contributions and impact of WORK's editorial board (EB) on the journal's scholarship. The editor-in-chief (EIC) and editorial board members were participants in this evaluation. Methods: Informative and formative evaluations were used to investigate how knowledge was shaped through the development of an epistemic community of scholars in the field of work. Metrics of the EB composition and participation in the journal as well as surveys and interviews with the board and the editor-in-chief were analyzed. Results: The EB represents an international community of scholars with a common interest in work and who contribute academically both within WORK and beyond. The epistemic community that has evolved through the editorial board represents a pluralistic perspective on work that is needed to inform practice, and knowledge. Conclusion: Future directions to continue to advance knowledge through WORK's editorial board and EIC are elaborated. KW - Knowledge development KW - Epistemic community KW - sociology of knowledge Y1 - 2010 UR - http://dx.doi.org/10.3233/WOR-2010-0988 VL - 35 IS - 3 SP - 247 EP - 255 ER - TY - JOUR A1 - Shaw, L. A1 - Campbell, H. A1 - Jacobs, K. A1 - Prodinger, Birgit T1 - Twenty years of Assessment in WORK: A narrative review JF - Work N2 - Introduction: The aim of this review was to gain an understanding of the first 20 years of contributions to WORK within the assessment domain and to reflect on the perspectives underscoring this knowledge base. Method: A narrative review of assessment articles using the WORK ARTicle database was conducted. Assessment articles were searched using issues from 1990 to 2009. Descriptive data was analyzed to examine historical trends of the specific types and dimensions of articles, the regional location of the contributions, and the methodological accordance. A reflective process was used by an editorial board member of WORK to inductively interpret perspectives and contextual issues that underpinned the evolution of the assessment domain in WORK. Results: Over half of N= 108 of the articles on assessment in WORK focused on establishing or reporting reliability and validity of assessments used in clinical practice or evaluation research. The majority of the assessment articles were predominantly focused on the person. Contributions of articles were from 5 regions: North America, Europe, Australia, Asia and Africa. Conclusions: Assessment articles in WORK have contributed to the development of evidence to support assessment of the worker. These articles represent a knowledge base that emphasizes evidence-based assessments to evaluate what a person can and cannot do to participate in work. Efforts are needed to expand knowledge generation in assessment to include more evaluations on the workplace and occupation dimensions, and that also considers the worker in context. KW - Knowledge base KW - Evaluation KW - Descriptive KW - Evidence base Y1 - 2010 UR - http://dx.doi.org/10.3233/WOR-2010-0989 VL - 35 IS - 3 SP - 257 EP - 267 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Magalhaes, L. T1 - Advancing knowledge in work-related rehabilitation - Review of research published in the journal of WORK JF - Work N2 - Objective: Many studies published in the journal WORK in the recent decades have discussed work and employment trends. However, the dimensions of these contributions over time have not been reviewed. The main objective of this study was to investigate the knowledge development in regard to work-related rehabilitation in WORK over the last two decades. Methods: A scoping review was conducted using the following five stages: (i) identifying research question, (ii) identifying relevant studies, (iii) study selection, (iv) charting, summarizing, and collating the data, and (v) reporting the results. Studies were selected from the WORK Article Database. Results: Seventy-five relevant studies were identified. The findings reflect that WORK has published papers from across the world, with most of the studies from the United States, Sweden, Canada, and Hong Kong. The complexity and multi-factorial nature of work-related rehabilitation was reflected in the application of quantitative, qualitative, and mixed method research approaches, as well as case studies. Study participants were characterized by work, and non-work related injuries, systematic diseases/chronic illness, fulfilled certain socio-demographic characteristic, and represented various stakeholders. Fewer studies drew on secondary resources. In the findings one re-occurring theme has been noted: 'maintaining/obtaining/returning to secure and stable employment/work'. Conclusions: Four key-reflections evolved from this scoping review that provide potential avenues for future research. These key-reflections include (i) the national, transnational and international dimension of the reviewed studies, (ii) the various societal levels informing work-related rehabilitation practices, (iii) the diversity of methodologies applied in current research, and (iv) the variability of terminology used within the reviewed studies. The journal WORK has published a variety of research over the last two decades and contributed significantly to our current understanding of work-related rehabilitation. However, further research in these reflective areas would expand the current knowledge base. KW - Scoping review KW - Return to work KW - Workers with injury KW - Employment Y1 - 2010 UR - http://dx.doi.org/10.3233/WOR-2010-0992 VL - 35 IS - 3 SP - 301 EP - 318 ER - TY - JOUR A1 - Bauernfeind, B. A1 - Aringer, M. A1 - Prodinger, Birgit A1 - Kirchberger, I. A1 - Machold, K. A1 - Smolen, J. A1 - Stamm, T. T1 - Identification of relevant concepts of functioning in daily life in people with systematic Lupus Erythematosus: A patient Delphi exercise JF - Arthritis Care & Research N2 - Objective To identify the most important and relevant concepts of daily functioning from the perspective of patients with systemic lupus erythematosus (SLE). Methods We conducted a consensus‐building, 3‐round, electronic mail survey with SLE patients using the Delphi technique. The Delphi technique is a structured communication process with 4 key characteristics: anonymity, iteration with controlled feedback, statistical group response, and informed input. The concepts contained in the answers of the patients were extracted and linked to the International Classification of Functioning, Disability and Health (ICF). Results Of the total 225 participants, 194 (86.2%) completed the questionnaires from all 3 Delphi rounds. In total, after the third Delphi round, 307 concepts were identified. Ninety concepts (55 in the domain body functions and structures, 16 in activities and participation, and 19 in environmental factors) were considered relevant by at least 50% of the participants in the third round and linked to the ICF. Twelve concepts were considered important by at least 75% of the participants. Conclusion The high number of concepts resulting from this large‐scale patient Delphi approach underlines the great variety of SLE patients' problems in daily functioning. The results of this patient Delphi project supplement the findings of our focus‐group study in establishing a comprehensive overview of the patient perspective in SLE. KW - Systemic lupus erythematosus KW - Patient Delphi exercise KW - Functioning in daily life Y1 - 2009 UR - https://doi.org/10.1002/art.24165 VL - 61 IS - 1 SP - 21 EP - 28 ER - TY - JOUR A1 - Stamm, T. A1 - Van der Giesen, F. A1 - Thorstensson, C. A1 - Steen, E. A1 - Birrell, F. A1 - Bauernfeind, B. A1 - Marshall, N. A1 - Prodinger, Birgit A1 - Machold, K. A1 - Smolen, J. A1 - Kloppenburg, M. T1 - Patient perspective of hand osteoarthritis in relation to concepts covered by instruments measuring functioning: a qualitative European multicentre study JF - Annals of the Rheumatic Diseases N2 - Objective: To explore whether the concepts important to patients with hand osteoarthritis (OA) are covered by the most commonly used instruments measuring functioning. Method: A qualitative multicentre study using a focus group technique was performed in five European countries: Austria, The Netherlands, Norway, Sweden and the United Kingdom. The qualitative data analysis followed a modified form of “meaning condensation” and used the International Classification of Functioning, Disability and Health (ICF) as a theoretical framework. Finally, the concepts from the focus groups were compared with the content of the most commonly used instruments which had been identified in an earlier theoretical analysis. Results: Fifty-six people (51 women, mean (SD) age 62.7 (7.9) years) with hand OA participated in this study in two focus groups per centre. 63 concepts were extracted from the focus groups. Twenty-one (33%) of the 63 concepts were covered by at least one instrument. Psychological consequences, different qualities of pain, aesthetic changes and leisure activities are important concepts from the focus groups which were not covered by the instruments. The qualitative analysis revealed detailed descriptions of pain-concerning sensations, levels and a certain relation to activity, none of which were fully represented in the instruments routinely used. Conclusion: It was possible to combine the concepts of the focus groups from each centre into a common qualitative analysis. The concepts important to people with hand OA are not fully represented in the most commonly used instruments. KW - Hand osteoarthritis KW - Measuring functioning KW - Qualitative multicentre study Y1 - 2009 UR - http://dx.doi.org/10.1136/ard.2008.096776 VL - 68 IS - 9 SP - 1453 EP - 1460 ER - TY - JOUR A1 - Dür, M. A1 - Steiner, G. A1 - Stoffer, M.A. A1 - Fialka-Moser, V. A1 - Kautky-Willer, A. A1 - Dejaco, C. A1 - Ekmekcioglu, C. A1 - Prodinger, Birgit A1 - Binder, A. A1 - Smolen, J. A1 - Stamm, T. A. T1 - Initial evidence for the link between activities and health: Associations between a balance of activities, functioning and serum levels of cytokines and C-reactive protein JF - Psychoneuroendocrinology N2 - Growing evidence shows interrelations of psychological factors, neurological and immunological processes. Therefore, constructs like a balance of activities, the so called “occupational balance”, could also have biological correlates. The aim of this study was to investigate potential associations between occupational balance, functioning, cytokines and C-reactive protein (CRP) in patients suffering from a chronic inflammatory disease like rheumatoid arthritis (RA) and healthy people. Moreover, we wanted to explore potential differences in gender and employment status. A descriptive study in patients with RA and healthy people was conducted using the Occupational Balance-Questionnaire (OB-Quest) and the Short-Form 36 Health Survey (SF-36). Serum levels of cytokines, such as interleukin 6 (IL-6) and 8 (IL-8), interferon alpha (INFα), tumour necrosis factor alpha (TNFα), rheumatoid factor (RF) and of CRP were measured. Descriptive statistics, as well as Mann-Whitney U tests and Spearmen's rank correlation coefficients (rs) were calculated. One-hundred-thirty-two patients with RA and 76 healthy people participated. Occupational balance was associated with functioning, cytokines and CRP. The strongest associations were identified in the unemployed healthy-people sample with cytokines and CRP being within the normal range. For example, the OB-Quest item challenging activities was associated with IL-8 (rs = − 0.63, p = 0.04) and the SF-36 sub-scale bodily pain was associated with IFNα (rs = − 0.69, p = 0.02). The items rest and sleep (rs = − 0.71, p = 0.01) and variety of different activities (rs = − 0.74, p < 0.01) correlated with the SF-36 sub-scale social functioning. Employed and unemployed people differed in their age and CRP levels. Additionally, gender differences were found in two OB-Quest items in that fewer women were able to adapt their activities to changing living conditions and fewer men were overstressed. In conclusion, we found preliminary biological evidence for the link between occupation and health in that the concepts encompassed in the construct of occupational balance were associated with functioning, cytokines and CRP. KW - Autoimmune disease KW - Psychoneuroendocrinology KW - Inflammatory markers KW - Occupational balance KW - Measure KW - Immunology Y1 - 2016 UR - https://doi.org/10.1016/j.psyneuen.2015.12.015 VL - 65 SP - 138 EP - 148 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Ballert, C. S. A1 - Cieza, A. T1 - Setting up a cohort study of functioning: From classification to measurement JF - Journal of Rehabilitation Medicine N2 - 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. KW - Disability and health KW - Cohort study KW - Epidemiology KW - International classification of functioning KW - Standardized Reporting Y1 - 2016 UR - https://doi.org/10.2340/16501977-2030 VL - 48 IS - 2 SP - 131 EP - 140 ER - TY - JOUR A1 - Hinrichs, T. A1 - Prodinger, Birgit A1 - Brinkof, M.W. A1 - Gemperli, A. T1 - Subgroups in epidemiological studies on spinal cord injury: Evaluation of international recommendations in the Swiss Spinal Cord Injury Cohort Study JF - Journal of Rehabilitation Medicine N2 - 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. KW - Classification KW - Disability and health KW - Health survey KW - International classification of functioning KW - Spinal cord injury Y1 - 2016 UR - https://doi.org/10.2340/16501977-2029 VL - 48 IS - 2 SP - 141 EP - 148 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Ballert, C.S. A1 - Brinkof, M. W. G. A1 - Tennant, A. A1 - Post, M. W. M. T1 - Metric properties of the Spinal Cord Independence Measure - Self Report in a community survey JF - Journal of Rehabilitation Medicine N2 - Objective: The Spinal Cord Independence Measure – Self Report (SCIM-SR) is a self-report instrument for assessing functional independence of persons with spinal cord injury. This study examined the internal construct validity and reliability of the SCIM-SR, when administered in a community survey, using the Rasch measurement model. Methods: Rasch analysis of data from 1,549 individuals with spinal cord injury who completed the SCIM-SR. Results: In the initial analysis no fit to the Rasch model was achieved. Items were grouped into testlets to accommodate the substantial local dependency. Due to the differential item functioning for lesion level and degree, spinal cord injury-specific sub-group analyses were conducted. Fit to the Rasch model was then achieved for individuals with tetraplegia and complete paraplegia, but not for those with incomplete paraplegia. Comparability of ability estimates across sub-groups was attained by anchoring all sub-groups on a testlet. Conclusion: The SCIM-SR violates certain assumptions of the Rasch measurement model, as shown by the local dependency and differential item functioning. However, an intermediate solution to achieve fit in 3 out of 4 spinal cord injury sub-groups was found. For the time being, therefore, it advisable to use this approach to compute Rasch-transformed SCIM-SR scores. KW - Functional status KW - Independence KW - Psychometrics KW - Reliability KW - Spinal cord injury Y1 - 2016 UR - https://doi.org/10.2340/16501977-2059 VL - 48 IS - 2 SP - 149 EP - 164 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Ballert, C. S. A1 - Brach, M. A1 - Brinkhof, M. W. G. A1 - Cieza, A. A1 - Hug, K. A1 - Jordan, X. A1 - Post, M. W. M. A1 - Scheel-Sailer, A. A1 - Schubert, M. A1 - Tennant, A. A1 - Stucki, G. T1 - Toward standardized reporting for a cohort study on functioning: The Swiss Spinal Cord Injury Cohort Study JF - Journal of Rehabilitation Medicine N2 - Objective: Functioning is an important outcome to measure in cohort studies. Clear and operational outcomes are needed to judge the quality of a cohort study. This paper outlines guiding principles for reporting functioning in cohort studies and addresses some outstanding issues. Design: Principles of how to standardize reporting of data from a cohort study on functioning, by deriving scores that are most useful for further statistical analysis and reporting, are outlined. The Swiss Spinal Cord Injury Cohort Study Community Survey serves as a case in point to provide a practical application of these principles. Methods and Results: Development of reporting scores must be conceptually coherent and metrically sound. The International Classification of Functioning, Disability and Health (ICF) can serve as the frame of reference for this, with its categories serving as reference units for reporting. To derive a score for further statistical analysis and reporting, items measuring a single latent trait must be invariant across groups. The Rasch measurement model is well suited to test these assumptions. Conclusion: Our approach is a valuable guide for researchers and clinicians, as it fosters comparability of data, strengthens the comprehensiveness of scope, and provides invariant, interval-scaled data for further statistical analyses of functioning. KW - Comparability KW - Epidemiology KW - Health information systems KW - Informed decision-making KW - Rasch analysis Y1 - 2016 UR - https://doi.org/10.2340/16501977-2026 VL - 48 IS - 2 SP - 189 EP - 196 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Darzins, S. A1 - Magasi, S. A1 - Baptiste, S. T1 - The International Classification of Functioning, Disability and Health (ICF): Opportunities and Challenges to the Use of the ICF for Occupational Therapy JF - World Federation of Occupational Therapists Bulletin N2 - The occupational therapy community has been receptive to the World Health Organisation's International Classification of Functioning, Disability and Health (ICF) published in 2001. Building upon results of a survey (2008–2009) and subsequent workshop (2010) conducted by the World Federation of Occupational Therapists on the use and utility of the ICF for occupational therapists, this paper addresses some of the opportunities and challenges to strengthening the use of the ICF in occupational therapy practice. Attaining further clarity on the relationship of occupational therapy concepts and the ICF and developing crosswalk tables to exemplify linkages between occupational therapy terminology and the ICF will strengthen utility of the ICF for occupational therapy. Enhanced clarity about the concepts within occupational therapy that correspond to the ICF will ultimately assist other professions and disciplines in their understanding about occupational therapy and occupational therapists’ roles in health and related systems. KW - ICF KW - Occupational therapy KW - Standardization KW - Health care terminology KW - Rehabilitation Y1 - 2015 UR - https://doi.org/10.1179/2056607715Y.0000000003 VL - 71 IS - 2 SP - 108 EP - 114 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Ndosi, M. A1 - Nordenskiöld, U. A1 - Stamm, T. A1 - Persson, G. A1 - Andreasson, I. A1 - Lundgren-Nilsson, A. T1 - Rehabilitation provided to patients with rheumatoid arthritis: A comparison of three different Rheumatology clinics in Austria, Sweden and the UK from the perspectives of patients and health professionals JF - Journal of Rehabilitation Medicine N2 - Objective: To explore patients’ and health professionals’ views of outpatient rehabilitation services for patients with rheumatoid arthritis in 3 different rheumatology sites across Europe. Methods: A qualitative multi-method study was conducted with patients and health professionals in Vienna (Austria), Gothenburg (Sweden) and Leeds (UK). Data collection was carried out during focus groups with patients and health professionals. Patients’ hospital records were integrated into the analysis. Data were analysed for site and findings were compared across sites. Results: A total of 20 patients and 20 health professionals participated in 12 focus groups. Although the 3 sites were all publicly funded university clinics, there were differences between sites regarding the structure and content of rehabilitation services. The themes that emerged in the focus groups were: referrals; continuity in rehabilitation; information provided to patients; patients’ organizations; documentation and communication amongst health professionals; interface between primary and specialist care; and prescription practices. Most themes were addressed at all 3 sites, but there were variations in the specifics within themes. Conclusion: Integration of patients’ and health professionals’ views on how rehabilitation services are coordinated and how (parts of) processes are set up elsewhere provide valuable information for the further optimization of rehabilitation services. KW - Delivery of Healthcare KW - Interdisciplinary Communication KW - Multi-centre study KW - Patient perspective KW - Rehabilitation Y1 - 2015 UR - https://doi.org/10.2340/16501977-1914 VL - 47 IS - 2 SP - 174 EP - 182 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Rudman, D. L. A1 - Shaw, L. T1 - Institutional ethnography: Studying the situated nature of human occupation JF - Journal of Occupational Science N2 - Institutional ethnographers and occupational scientists share a common interest in studying what people do in their daily lives. Institutional ethnographers start inquiry at the standpoint of people as they are situated in the actualities of everyday life and then turn their gaze from the individual to the social. We aim to outline in this paper some key tenets of institutional ethnography to argue its relevance for studying human occupation. More specifically, we posit that institutional ethnography provides a promising social theory and method to further understandings of the situated nature of human occupation. KW - Standpoint KW - Daily life KW - Power KW - Ruling relations Y1 - 2015 UR - https://doi.org/10.1080/14427591.2013.813429 VL - 22 IS - 1 SP - 71 EP - 81 ER - TY - JOUR A1 - Castrejon, I. A1 - Carmona, L. A1 - Agrinier, N. A1 - Andres, M. A1 - Briot, K. A1 - Caron, M. A1 - Christensen, R. A1 - Consolaro, A. A1 - Curbelo, R. A1 - Ferrer, M. A1 - Foltz, V. A1 - Gonzalez, C. A1 - Guillemin, F. A1 - Machado, P. A1 - Prodinger, Birgit A1 - Ravellil, A. A1 - Scholte-Voshaar, M. A1 - Uhlig, T. A1 - van Tuyl, L. A1 - Zink, A. A1 - Gossec, L. T1 - The EULAR Outcome Measures Library: development and an example from a systematic review for systemic lupus erythematous instruments JF - Clinical and Experimental Rheumatology N2 - Objective: Patient reported outcomes (PROs) are relevant in rheumatology. Variable accessibility and validity of commonly used PROs are obstacles to homogeneity in evidence synthesis. The objective of this project was to provide a comprehensive library of “validated PROs”. Methods: A launch meeting with rheumatologists, PROs methodological experts, and patients, was held to define the library’s aims and scope, and basic requirements. To feed the library we performed systematic reviews on selected diseases and domains. Relevant information on PROs was collected using standardised data collection forms based on the COSMIN checklist. Results: The EULAR Outcomes Measures Library (OML), whose aims are to provide and to advise on PROs on a user-friendly manner albeit based on scientific grounds, has been launched and made accessible to all. PROs currently included cover any domain and, are generic or specifically target to the following diseases: rheumatoid arthritis, osteoarthritis, spondyloarthritis, low back pain, systemic lupus erythematosus, gout, osteoporosis, juvenile idiopathic arthritis, and fibromyalgia. Up to 236 instruments (106 generic and 130 specific) have been identified, evaluated, and included. The systematic review for SLE, which yielded 10 specific instruments, is presented here as an example. The OML website includes, for each PRO, information on the construct being measured and the extent of validation, recommendations for use, and available versions; it also contains a glossary on common validation terms. Conclusion: The OML is an in progress library led by rheumatologists, related professionals and patients, that will help to better understand and apply PROs in rheumatic and musculoskeletal diseases. KW - Rheuma KW - Lupus erythematous KW - Outcome measures KW - Systematic Review Y1 - 2015 VL - 33 IS - 6 SP - 910 EP - 916 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Shaw, L. A1 - Rudman, D. L. A1 - Stamm, T. T1 - Negotiating disability in everyday life: Ethnographical accounts of women with rheumatoid arthritis JF - Disability and Rehabilitation N2 - Purpose: Drawing on data from a larger study, the aim of this paper is to illuminate how the everyday doings of women with disabilities are coordinated to and shaped by organizational processes and social context, particularly as these relate to the potential of being labelled disabled. Methods: An institutional ethnography was conducted with seven Austrian women diagnosed with rheumatoid arthritis (RA). Interviews and participant observations were conducted, and texts about the historical development of disability policies were identified. Data analysis included grouping similar doings of participants together to subsequently explore links between what the women did and how their doings are shaped by disability policies and the social context. Results: The women, who participated in this study, spent time and effort to keep the disease invisible, resist disability and negotiate a disability pass. By drawing upon the historical development of Austrian disability policies, the interpretation reveals how this development infiltrates into participants’ lives and shapes their everyday doing. Conclusion: This study furthers understanding of how broader policies and practices, shaped over historical time, infiltrate into the daily lives of women with disabilities. It illustrates how full participation may not necessarily be a lived reality for people with disabilities at this point in Austria. Implications for Rehabilitation Maximising full participation for people with rheumatoid arthritis is important. This requires focusing not only on the bodily health of people with rheumatoid arthritis but also on their interaction with the social, cultural and political context in their daily lives. This requires also understanding how knowledge about disability is passed on from previous generations. KW - Employment KW - Policies KW - Rheumatoid arthritis KW - Women Y1 - 2014 UR - https://doi.org/10.3109/09638288.2013.800594 VL - 36 IS - 6 SP - 497 EP - 503 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Turner, S. M. T1 - Using institutional ethnography to explore how social policies infiltrate into daily life JF - Journal of Occupational Science N2 - The paper demonstrates how institutional ethnography provides a way forward for occupational scientists to understand how social policies shape and infiltrate people's daily lives and work. Institutional ethnography is a method of inquiry that starts in individual's experiences and from there traces how their experiences are coordinated to and become shaped within particular organizational processes and social relations. In this paper, we are specifically interested in how social policies, as higher order texts, shape the organizational processes and service agents' work at Labor Market Offices, and enter into the organization of people's everyday activities. We want to make visible how particular policies enter into the organization of the daily lives of women with rheumatoid arthritis who apply for unemployment benefits and ‘regulate’ what they can or may have to do, even though higher order policy texts are not immediately visible or actively referred to in the setting. We learn from the experiences of two women, who are of employable age, have been diagnosed with rheumatoid arthritis, and live in a mid-sized city in Austria. KW - Ruling relations KW - Textual analysis KW - Occupational science KW - Employment KW - Labor market office Y1 - 2013 UR - https://doi.org/10.1080/14427591.2013.808728 VL - 20 IS - 4 SP - 357 EP - 369 ER - TY - JOUR A1 - Dür, M. A1 - Steiner, G. A1 - Fialka-Moser, V. A1 - Kautzky-Willer, A. A1 - Dejaco, C. A1 - Prodinger, Birgit A1 - Stoffer, M. A. A1 - Binder, A. A1 - Smolen, J. A1 - Stamm, T.A. T1 - Development of a new occupational balance-questionnaire: incorporating the perspectives of patients and healthy people in the design of a self-reported occupational balance outcome instrument JF - Health and Quality of Life Outcomes N2 - Background Self-reported outcome instruments in health research have become increasingly important over the last decades. Occupational therapy interventions often focus on occupational balance. However, instruments to measure occupational balance are scarce. The aim of the study was therefore to develop a generic self-reported outcome instrument to assess occupational balance based on the experiences of patients and healthy people including an examination of its psychometric properties. Methods We conducted a qualitative analysis of the life stories of 90 people with and without chronic autoimmune diseases to identify components of occupational balance. Based on these components, the Occupational Balance-Questionnaire (OB-Quest) was developed. Construct validity and internal consistency of the OB-Quest were examined in quantitative data. We used Rasch analyses to determine overall fit of the items to the Rasch model, person separation index and potential differential item functioning. Dimensionality testing was conducted by the use of t-tests and Cronbach’s alpha. Results The following components emerged from the qualitative analyses: challenging and relaxing activities, activities with acknowledgement by the individual and by the sociocultural context, impact of health condition on activities, involvement in stressful activities and fewer stressing activities, rest and sleep, variety of activities, adaptation of activities according to changed living conditions and activities intended to care for oneself and for others. Based on these, the seven items of the questionnaire (OB-Quest) were developed. 251 people (132 with rheumatoid arthritis, 43 with systematic lupus erythematous and 76 healthy) filled in the OB-Quest. Dimensionality testing indicated multidimensionality of the questionnaire (t = 0.58, and 1.66 after item reduction, non-significant). The item on the component rest and sleep showed differential item functioning (health condition and age). Person separation index was 0.51. Cronbach’s alpha changed from 0.38 to 0.57 after deleting two items. Conclusions This questionnaire includes new items addressing components of occupational balance meaningful to patients and healthy people which have not been measured so far. The reduction of two items of the OB-Quest showed improved internal consistency. The multidimensionality of the questionnaire indicates the need for a summary of several components into subscales. KW - Qualitative research KW - Rasch analysis KW - Occupational science KW - Patient perspective Y1 - 2014 UR - https://doi.org/10.1186/1477-7525-12-45 VL - 12 SP - 45 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - The emergence of Occupational Science in Austria: An insider perspective JF - Journal of Occupational Science N2 - Occupational science has been discussed in terms of its relation to occupational therapy, its philosophical and theoretical foundations, and its international and interdisciplinary character over the past years. The disciplinary identity of occupational science in non-English speaking countries has not yet been debated in the literature. The aim of this article is to discuss occupational science as an emergent discipline in Austria, a German-speaking country. The discussion is divided into two parts. In the first part we engage in critical reflexivity to explicate the current development of occupational science in Austria by reviewing the disciplinary and historical context of occupational science and the related profession of occupational therapy, the educational and institutional influences as well as the influence of language. In the second part, we illustrate that occupational science is an emerging discipline in Austria by drawing on an ongoing research project: the Gender, Occupational Balance, and Immunology Study. By making explicit how occupational science has emerged, from our insider perspective, we aim to contribute to the further development of the disciplinary identity of occupational science nationally and internationally. KW - Critical reflexivity KW - Knowledge generation KW - Occupational balance KW - Occupational science Y1 - 2012 UR - https://doi.org/10.1080/14427591.2011.582833 VL - 19 IS - 2 SP - 127 EP - 137 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Shaw, L. A1 - Rudman, D. L. A1 - Townsend, E. T1 - Arthritis-related occupational therapy: Making invisible ruling relations visible using institutional ethnography JF - British Journal of Occupational Therapy N2 - Introduction: Occupational therapists' intention of enabling women with rheumatoid arthritis to participate in everyday life is fraught with challenges in everyday practice. Method: Inspired by institutional ethnography, this paper aims to make explicit how the work of occupational therapists in an outpatient rheumatology hospital setting is governed within invisible, ruling relations. An analytical description of the first author's clinical experience was a standpoint from which to explicate how occupational therapy is coordinated to the ruling relations of the Austrian health care system. Findings: Occupational therapy practice and research are ruled within a positivist, body-focused, medical apparatus, which renders largely invisible occupational therapists' knowledge of enabling people to engage in occupations that are meaningful to them. Conclusion: Occupational therapists have professional power that can be asserted by strategically using occupational therapy specific knowledge and language in textually mediated practices, from assessments and case files to media images, to give greater visibility and influence to the profession's work of enabling occupation. KW - Institutional ethnography KW - Rheumatology KW - Participation KW - Health care provision KW - Enabling occupation KW - Sociology of the profession Y1 - 2012 UR - https://doi.org/10.4276/030802212X13496921049707 VL - 75 IS - 10 SP - 463 EP - 470 ER - TY - JOUR A1 - Shaw, L. A1 - Jacobs, K. A1 - Rudmann, D. A1 - Magalhaes, L. A1 - Huot, S. A1 - Prodinger, Birgit A1 - Mandich, A. A1 - Hocking, C. A1 - Akande, V. A1 - Backmann, C. A1 - Bossers, A. A1 - Bragg, M. A1 - Bryson, M. A1 - Cowls, J. A1 - Stone, S. D. A1 - Dawe, E. A1 - Dennhardt, S. A1 - Dennis, D. A1 - Foster, J. A1 - Friesen, M. A1 - Galheigo, S. A1 - Gichuri, J. A1 - Hughes, I. A1 - Isaac, A. A1 - Jarus, T. A1 - Kinsella, A. A1 - Klinger, L. A1 - Leyshon, R. A1 - Lysaght, R. A1 - McKay, E. A1 - Orchard, T. A1 - Phelan, S. A1 - Ravenek, M. A1 - Gruhl, K. R. A1 - Robb, L. A1 - Stadnyk, R. A1 - Sumsion, T. A1 - Suto, M. T1 - Directions for advancing the study of work transitions in the 21st century JF - Work N2 - Objectives: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada. Participants: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society. Methods: A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know. Findings: Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions. Conclusions: Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work. KW - Work disparities KW - occupational justice KW - Occupational transitions Y1 - 2012 UR - https://doi.org/10.3233/WOR-2012-1438 VL - 41 IS - 4 SP - 369 EP - 377 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Salzberger, T. A1 - Stucki, G. A1 - Stamm, T. A1 - Cieza, A. T1 - Measuring Functioning in People with Fibromyalgia (FM) Based on the International Classification of Functioning, Disability and Health (ICF)—A Psychometric Analysis JF - Pain Practice N2 - Objectives: Instruments to assess functioning in patients with FM vary considerably in their content and are often symptom‐specific. This study aimed to examine whether it is feasible to construct a psychometric‐sound clinical instrument to measure functioning in FM based on the Brief ICF‐Core‐Set for chronic widespread pain (CWP). Methods: Two hundred and fifty six people with FM completed the Brief ICF‐Core‐Set. The Rasch model was used for analysis. Once ordering of response options of ICF categories was ensured, the following properties were studied: fit of the ICF categories to the Rasch model, the targeting between ICF categories and a person’s abilities, unidimensionality, and reliability. Results: Six ICF categories were rescored due to disordered thresholds. Five ICF categories were removed due to high model‐misfit and differential item functioning (DIF) for gender. Scores from 46 participants were excluded due to extreme scores. The ICF categories included display consistency with an underlying unidimensional construct, are free of DIF for age, disease duration and gender, display excellent overall reliability, and cover a range of functioning difficulties. Conclusions: This study illustrates that it is possible to measure functioning as a unidimensional construct based on selected ICF categories from the components body functions, as well as activities and participation of the Brief ICF‐Core‐Set for CWP in patients with FM. KW - Fibromyalgia KW - ICF KW - Psychometric Analysis Y1 - 2011 UR - https://doi.org/10.1111/j.1533-2500.2011.00488.x VL - 12 IS - 4 SP - 255 EP - 265 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A. T1 - Self-reflection as a means for personal transformation: An analysis of women's life stories living with a chronic disease JF - Forum Qualitative Sozialforschung / Forum: Qualitative Social Research N2 - The aim of this secondary analysis is to explicate taken-for-granted practices in the health care system in which the life stories of six women with rheumatoid arthritis (RA) are embedded. A secondary analysis of life stories of six women with RA, which were assigned to a typology named "rheumatoid arthritis as a source for new challenges" (STAMM et al., 2008) in the primary narrative study, was conducted. The theoretical framework applied for the analysis was informed by feminist standpoint theory and feminist philosophy. In the present analysis, each of the women challenged established health care practices and the cognitive authority of medicine at a certain point in their life story reflections. Becoming more conscious about health care practices enabled the women to acknowledge their own knowledge and to make choices about their health. The findings challenge health care providers to engage in critical reflexivity to become conscious about and to transform taken-for-granted practices as embedded in larger systems and to create health care environments that enable dialogue between clients and health care providers. KW - Secondary analysis KW - Narratives KW - Feminist critiques on health care KW - Standpoint theory KW - Gender KW - Rheumatiod arthritis Y1 - 2010 UR - http://dx.doi.org/10.17169/fqs-11.3.1379 VL - 11 IS - 4 ER - TY - JOUR A1 - Stamm, T. A. A1 - Machold, K. P. A1 - Smolen, J. A1 - Prodinger, Birgit T1 - Life stories of people with rheumatoid arthritis who retired early: how gender and other contextual factors shaped their everyday activities, including paid work JF - Musculoskeletal Care N2 - Objective: The aim of the present study was to explore how contextual factors affect the everyday activities of women and men with rheumatoid arthritis (RA), as evident in their life stories. Methods: Fifteen people with RA, who had retired early due to the disease, were interviewed up to three times, according to a narrative biographic interview style. The life stories of the participants, which were reconstructed from the biographical data and from the transcribed ‘told story’ were analysed from the perspective of contextual factors, including personal and environmental factors. The rigour and accuracy of the analysis were enhanced by reflexivity and peer‐review of the results. Results: The life stories of the participants in this study reflected how contextual factors (such as gender, the healthcare system, the support of families and social and cultural values) shaped their everyday activities. In a society such as in Austria, which is based on traditional patriarchal values, men were presented with difficulties in developing a non‐paid‐work‐related role. For women, if paid work had to be given up, they were more likely to engage in alternative challenging activities which enabled them to develop reflective skills, which in turn contributed to a positive and enriching perspective on their life stories. Health professionals may thus use some of the women's strategies to help men. Conclusion: Interventions by health professionals in people with RA may benefit from an approach sensitive to personal and environmental factors. KW - Rheumatoid arthritis KW - Gender KW - Everyday activities Y1 - 2010 UR - https://doi.org/10.1002/msc.168 VL - 8 IS - 2 SP - 78 EP - 86 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Weise, A. P. A1 - Shaw, L. A1 - Stamm, T. A. T1 - A Delphi study on Environmental Factors that impact work and social life participation of individuals with Multiple Sclerosis in Austria and Switzerland JF - Disability and Rehabilitation N2 - 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. KW - Contextual factors KW - Patient perspective KW - Consensus method KW - ICF KW - Disability and health Y1 - 2010 UR - https://doi.org/10.3109/09638280903071883 VL - 32 IS - 3 SP - 183 EP - 195 ER - TY - JOUR A1 - Lustenberger, N. A1 - Prodinger, Birgit A1 - Dorjbal, D. A1 - Rubinelli, S. A1 - Schmitt, K. A1 - Scheel-Sailer, A. T1 - Compiling standardized information from clinical practice: using content analysis and ICF Linking Rules in a goal-oriented youth rehabilitation program JF - Disability and Rehabilitation N2 - Purpose: To illustrate how routinely written narrative admission and discharge reports of a rehabilitation program for eight youths with chronic neurological health conditions can be transformed to the International Classification of Functioning, Disability and Health. Methods: First, a qualitative content analysis was conducted by building meaningful units with text segments assigned of the reports to the five elements of the Rehab-Cycle®: goal; assessment; assignment; intervention; evaluation. Second, the meaningful units were then linked to the ICF using the refined ICF Linking Rules. Results: With the first step of transformation, the emphasis of the narrative reports changed to a process oriented interdisciplinary layout, revealing three thematic blocks of goals: mobility, self-care, mental, and social functions. The linked 95 unique ICF codes could be grouped in clinically meaningful goal-centered ICF codes. Between the two independent linkers, the agreement rate was improved after complementing the rules with additional agreements. Conclusions: The ICF Linking Rules can be used to compile standardized health information from narrative reports if prior structured. The process requires time and expertise. To implement the ICF into common practice, the findings provide the starting point for reporting rehabilitation that builds upon existing practice and adheres to international standards. Implications for Rehabilitation This study provides evidence that routinely collected health information from rehabilitation practice can be transformed to the International Classification of Functioning, Disability and Health by using the “ICF Linking Rules”, however, this requires time and expertise. The Rehab-Cycle®, including assessments, assignments, goal setting, interventions and goal evaluation, serves as feasible framework for structuring this rehabilitation program and ensures that the complexity of local practice is appropriately reflected. The refined “ICF Linking Rules” lead to a standardized transformation process of narrative text and thus a higher quality with increased transparency. As a next step, the resulting format of goal codes supplemented by goal-clarifying codes could be validated to strengthen the implementation of the International Classification of Functioning, Disability and Health into rehabilitation routine by respecting the variety of clinical practice. KW - Rehab-Cycle KW - Spina bifida (myelomeningocele, MMC) KW - Cerebral palsy KW - Spinal curd injury KW - Quality of health care Y1 - 2019 UR - https://doi.org/10.1080/09638288.2017.1380718 VL - 41 IS - 5 SP - 613 EP - 621 ER - TY - JOUR A1 - Maritz, R. A1 - Aronsky, D. A1 - Prodinger, Birgit T1 - The Implementation of the International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records - A Systematic Review JF - Applied Clinical Informatics N2 - 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. KW - International Classification of Functioning KW - Disability and health KW - Electronic health records KW - Reference standards KW - Medical Informatics Y1 - 2017 UR - https://doi.org/10.4338/ACI2017050078 VL - 8 IS - 3 SP - 964 EP - 980 ER - TY - JOUR A1 - Prodinger, Birgit A1 - O'Connor, R.J. A1 - Stucki, G. A1 - Tennant, A. T1 - 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 JF - Journal of Rehabilitation Medicine N2 - 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. KW - International Classification of Functioning KW - Disability and health KW - ICF KW - Outcome measures KW - Patient outcome assessment Y1 - 2017 UR - https://doi.org/10.2340/16501977-2225 VL - 49 IS - 5 SP - 416 EP - 422 ER - TY - JOUR A1 - Selb, M. A1 - Gimigliano, F. A1 - Prodinger, Birgit A1 - Stucki, G. A1 - Pestelli, G. A1 - Iocco, M. A1 - Boldrini, P. T1 - Toward an International Classification of Functioning, Disability and Health clinical data collection tool: The Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories JF - European Journal of Physical and Rehabilitation Medicine N2 - As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy.Consensus process.Expert conference. Multidisciplinary group of rehabilitation professionals.The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China. Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice. Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session. The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous. Participants then voted (final vote) for which of the three proposed descriptions they preferred.Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B. The remaining 7 categories were decided in the final vote.The findings were discussed in light of current efforts toward developing strategies for ICF implementation, specifically for the application of an ICF-based clinical data collection tool, not only for Italy but also for the rest of Europe. Promising as minimal standards for monitoring the impact of interventions and for standardized reporting of functioning as a relevant outcome in rehabilitation. KW - ICF KW - Italian Rehabilitation Community KW - ICF Rehabilitation Set category Y1 - 2017 UR - https://doi.org/10.23736/S1973-9087.16.04250-7 VL - 53 IS - 2 SP - 290 EP - 298 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Scheel-Sailer, A. A1 - Escorpizo, R. A1 - Stucki, G. T1 - UEMS-PRM ICF workshop moderators and rapporteurs. (2017) European initiative for the application of the International Classification of Functioning, Disability and Health: Development of Clinical Assessment Schedules for specified rehabilitation services JF - European Journal of physical and rehabilitation medicine N2 - Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016.PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds.Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet.The groups recognized a need for a systematic effort to identify data collection tools currently used.CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for improving data collection on people's functioning. KW - Outcome assessment KW - Health care KW - Rehabilitation KW - Health information systems Y1 - 2017 UR - https://doi.org/10.23736/S1973-9087.16.04438-5 VL - 53 IS - 2 SP - 319 EP - 332 ER - TY - JOUR A1 - Fekete, C. A1 - Post, M. A1 - Bickenbach, J. A1 - Middleton, J. A1 - Prodinger, Birgit A1 - Selb, M. A1 - Stucki, G. T1 - A structured approach to capture the lived experience of spinal cord injury: Data model and questionnaire of the International Spinal Cord Injury Community Survey (InSCI) JF - American Journal of physical and rehabilitation medicine N2 - The International Spinal Cord Injury (InSCI) community survey has been developed to collect internationally comparable data on the lived experience of persons with spinal cord injury (SCI) in all 6 WHO regions. The InSCI survey provides a crucial first step to generate evidence on functioning, health maintenance, and subjective well-being in persons with SCI globally. A major challenge in setting up the InSCI community survey was to develop a data model and questionnaire that comprehensively captures what matters to people and, at the same time, is feasible and parsimonious in terms of participant’s burden. This paper outlines the components of the InSCI data model and presents the question selection to operationalize the data model along the 4 guiding principles of efficiency, feasibility, comparability, and truth and discrimination. The data model consists of 6 components operationalized with 125 questions including functioning (n = 28 body functions and structures; n = 42 activities and participation), contextual factors (n = 26 environmental; n = 19 personal factors), lesion characteristics (n = 2), and appraisal of health and well-being (n = 8). The InSCI questionnaire presents an efficient and feasible solution with satisfying comparability to other populations; however, its validity and reliability still needs to be confirmed. KW - International Spinal Cord Injury KW - Comparability of spinal cord injury Y1 - 2017 UR - https://doi.org/10.1097/PHM.0000000000000622 VL - 96 IS - 2 SP - S5 EP - S16 ER - TY - JOUR A1 - Dorjbal, D. A1 - Cieza, A. A1 - Gmünder, H.-P- A1 - Scheel-Sailer, A. A1 - Stucki, G. A1 - Üstün, T.B. A1 - Prodinger, Birgit T1 - Strengthening quality of care through standardized reporting based on the World Health Organization's reference classifications JF - International Journal of Quality in Health N2 - 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. KW - International Classification of Diseases KW - International Classification of Functioning KW - Disability and health KW - Quality improvement KW - Rehabilitation Y1 - 2016 UR - https://doi.org/10.1093/intqhc/mzw078 VL - 28 IS - 5 SP - 626 EP - 633 ER - TY - JOUR A1 - Ballert, C.S. A1 - Hopfe, M. A1 - Kus, M. A1 - Mader, L. A1 - Prodinger, Birgit T1 - 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. JF - Disability and Rehabilitation N2 - 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). KW - Comparability KW - International Classification of Functioning KW - Disability and health KW - Outcome measures Y1 - 2019 UR - https://doi.org/10.1080/09638288.2016.1198433 VL - 41 IS - 5 SP - 584 EP - 600 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Tennant, A. A1 - Stucki, G. A1 - Cieza, A. A1 - Üstün, T.B. T1 - Harmonizing routinely collected health information for strengthening quality management in health systems: requirements and practice JF - Journal of Health Services Research & Policy N2 - Objective Our aim was to specify the requirements of an architecture to serve as the foundation for standardized reporting of health information and to provide an exemplary application of this architecture. Methods The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) served as the conceptual framework. Methods to establish content comparability were the ICF Linking Rules. The Rasch measurement model, as a special case of additive conjoint measurement, which satisfies the required criteria for fundamental measurement, allowed for the development of a common metric foundation for measurement unit conversion. Secondary analysis of data from the North Yorkshire Survey was used to illustrate these methods. Patients completed three instruments and the items were linked to the ICF. The Rasch measurement model was applied, first to each scale, and then to items across scales which were linked to a common domain. Results Based on the linking of items to the ICF, the majority of items were grouped into two domains, Mobility and Self-care. Analysis of the individual scales and of items linked to a common domain across scales satisfied the requirements of the Rasch measurement model. The measurement unit conversion between items from the three instruments linked to the Mobility and Self-care domains, respectively, was demonstrated. Conclusions The realization of an ICF-based architecture for information on patients’ functioning enables harmonization of health information while allowing clinicians and researchers to continue using their existing instruments. This architecture will facilitate access to comprehensive and consistently reported health information to serve as the foundation for informed decision-making. KW - Decision making KW - Health classification KW - Health status measurement KW - Information standards KW - Quality management Y1 - 2016 UR - https://doi.org/10.1177/1355819616636411 VL - 21 IS - 4 SP - 223 EP - 228 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Stamm, T. A1 - Petersson, D. A1 - Stucki, G. A1 - Tennant, A. T1 - Toward a standardized reporting of outcomes in hand osteoarthritis: Developing a common metric of outcome measures commonly used to assess functioning. JF - Arthritis Care & Research N2 - Objective Functioning is an important outcome in hand osteoarthritis (OA). The heterogeneity of patient‐reported outcome measures (PROMs) available challenges the direct comparability of information collected by these instruments. This study aimed to examine whether it is possible to achieve metric equivalence of PROMs commonly used to measure functioning in people with hand OA. Methods A secondary analysis of data from 253 persons who participated in the Vienna Hand Osteoarthritis Cohort Study was conducted applying the Rasch measurement model. Participants completed the Health Assessment Questionnaire, the Australian/Canadian Index for Hand Osteoarthritis, the Functional Index for Hand Osteoarthritis (FIHOA), and the Cochin Scale. The assumptions of stochastic ordering, local independence, unidimensionality, and invariance were tested for each scale independently before the scales were co‐calibrated onto a common metric. Results Except for the FIHOA, all measures indicated issues of local dependency in the initial analyses. After accommodating those with testlets, all scales satisfied the assumptions of the Rasch model (χ2 > 0.05). Marginal misfit in 2 items was found in the FIHOA, but this did not disturb person estimates. As the 4 scales form a common metric that satisfies the assumptions of the Rasch model, the scores can be equated. Conclusion The scores of the 4 hand function measures can be transformed to a common 0–100 metric, such that scores can be interchanged. A user‐friendly transformation table enables clinicians and researchers to have access to the common metric by simply adding up the total score for each instrument and identifying the corresponding transformed score on the common metric. KW - Osteoarthritis KW - Outcome measures KW - Cohort study Y1 - 2016 UR - https://doi.org/10.1002/acr.22816 VL - 68 IS - 8 SP - 1115 EP - 1127 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Cieza, A. A1 - Oberhauser, C. A1 - Bickenbach, J. A1 - Üstün, T.B. A1 - Chatterji, S. A1 - Stucki, G. T1 - Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy JF - Archives of Physical Medicine and Rehabilitation KW - Rehabilitation KW - Disability and health KW - ICF Rehabilitation Set Y1 - 2016 UR - https://doi.org/10.1016/j.apmr.2015.12.030 VL - 97 IS - 6 SP - 875 EP - 884 ER - TY - JOUR A1 - Prodinger, Birgit A1 - Reinhard, J.D. A1 - Selb, M. A1 - Stucki, G. A1 - Yan, T. A1 - Zhang, C. A1 - Li, J. T1 - 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 JF - Journal of Rehabilitation Medicine N2 - 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. KW - Disability and health KW - Health information systems KW - International classification of functioning KW - Practicing standards Y1 - 2016 UR - https://doi.org/10.2340/16501977-2066 VL - 48 IS - 6 SP - 508 EP - 514 ER - TY - JOUR A1 - Cieza, A. A1 - Fayed, N. A1 - Bickenbach, J. A1 - Prodinger, Birgit T1 - Refinements to the ICF Linking Rules to strenghten their potential for establishing comparability of health information JF - Disability and Rehabilitation N2 - Purpose The content of and methods for collecting health information often vary across settings and challenge the comparability of health information across time, individuals or populations. The International Classification of Functioning, Disability and Health (ICF) contains an exhaustive set of categories of information which constitutes a unified and consistent language of human functioning suitable as a reference for comparing health information. Methods and results In two earlier papers, we have proposed rules for linking existing health information to the ICF. Further refinements to these existing ICF Linking Rules are presented in this paper to enhance the transparency of the linking process. The refinements involve preparing information for linking, perspectives from which information is collected and the categorization of response options. Issues regarding the linking of information not covered or unspecified within the ICF are also revisited in this paper. Conclusion: The ICF Linking Rules are valuable for enhancing comparability of health information to ensure that information is available in a consistent manner to serve as a foundation for evidence-based decision-making across all levels of health systems. The refinements presented in this paper enhance transparency in, and ultimately reliability of the process of, linking health information to the ICF. Implications for Rehabilitation The International Classification of Functioning, Disability and Health (ICF) constitutes a unified and consistent language of human functioning suitable as a reference for comparing health information. Comparability of information is essential to ensure that the widest range of information is available in a consistent manner for any decision-maker at all levels of the health system. The refined ICF Linking Rules presented in this article outline the method to establish comparability of health information based on the ICF. KW - Comparability KW - Health KW - Information systems KW - International classification of functioning Y1 - 2019 UR - https://doi.org/10.3109/09638288.2016.1145258 VL - 41 IS - 5 SP - 574 EP - 583 ER - TY - JOUR A1 - Li, J. A1 - Prodinger, Birgit A1 - Reinhard, J. D. A1 - Stucki, G. T1 - 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 JF - Journal of Rehabilitation Medicine N2 - 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. KW - Functional status KW - ICF KW - Psychomatrics KW - Rasch analysis KW - Sensitivity to change Y1 - 2016 UR - https://doi.org/10.2340/16501977-2067 VL - 48 IS - 6 SP - 502 EP - 507 ER - TY - JOUR A1 - Reinhardt, J. D. A1 - Zhang, X. A1 - Prodinger, Birgit A1 - Ehrmann-Bostan, C. A1 - Selb, M. A1 - Stucki, G. A1 - Li, J. T1 - Toward the system-wide implementation of the International Classification of Functioning, Disability and Health in routine clinical practice: Empirical findigns of a pilot study from Mainland China JF - Journal of Rehabilitation Medicine N2 - Objective: The aims of this study were to evaluate the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Generic Set in routine clinical practice, and of creating a functioning score based on it, and, subsequently, to examine its sensitivity to change. Methods: In this prospective cohort study, data from 761 adult inpatients from 21 Chinese hospitals were analysed. Each patient was assessed at admission and discharge. Feasibility was evaluated by analysing mean assessment time. The Rasch model was used to create a metric of functioning. Sensitivity to change was analysed with mixed-effects regression and by calculating standardized effect size based on Cohen's f2. Results: Mean duration of assessment was 5.3 min, with a significant decrease between admission and discharge. After removal of the item remunerative employment, the remaining ICF Generic Set categories fitted the Rasch model well. With a mean improvement in functioning of 12.1 (95% confidence interval (95% CI): 11.5–12.6), this metric proved sensitive to change, both in terms of statistical significance (p < 0.001) and standardized effect size (Cohen's f2 = 2.35). Discussion: The ICF Generic Set is feasible for use in routine clinical practice and is promising to serve as the basis for the development of a functioning score that is sensitive to change. KW - Functional status KW - ICF KW - Psychomatrics KW - Rasch analysis Y1 - 2016 UR - https://doi.org/10.2340/16501977-2102 VL - 48 IS - 6 SP - 515 EP - 521 ER - TY - JOUR A1 - Pongpipatpaiboon, K A1 - Selb, M A1 - Kovindha, A A1 - Prodinger, Birgit T1 - 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 JF - Spinal Cord Series and Cases N2 - 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. KW - ICF KW - rehabilitation KW - documentation KW - case study Y1 - 2020 UR - https://doi.org/10.1038/s41394-020-0283-8 VL - 6 IS - 33 ER -