The Assessment of Disability in Patients With Psychotic Disorders: An Application of the ICIDH-2

2002 ◽  
Vol 36 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Prem Chopra ◽  
Jeremy Couper ◽  
Helen Herrman

Objectives: To describe the application of the International Classification of Functioning and Disability (ICIDH-2) in the assessment of disability in patients with psychotic disorders. Method: The study was conducted at the inpatient unit of St Vincent's Mental Health Service, Melbourne. Twenty inpatients with psychotic disorders were concurrently assessed by two raters. An evaluation of the feasibility of the instrument was made during this process. Inter-rater agreement was determined using raw agreement percentages and weighted kappas. Results: The ICIDH-2 provides a comprehensive framework for the description and measurement of disability, including the dimensions of impairments in body structures and functions, activity limitations, participation restrictions and environmental factors. Certain codes are difficult for clinicians to rate because of the subjective manner in which they are defined. Our inter-rater reliability assessment varied across the dimensions from poor to almost perfect agreement. Conclusions: The ICIDH-2 is potentially useful in the clinical assessment of disability in patients with psychotic disorders although modifications are needed. These could include the use of anchor points defined for each dimension or code to assist the rating process and an alternative rating scale in which categories for rating are more broadly defined. Formal training may also be necessary to enable standardization of the rating process. There is also a need to augment measurements by clinicians with the assessment of the subjective experience of patients using self-rated disability and assessment of quality of life.

2017 ◽  
Vol 17 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Jan-Rickard Norrefalk ◽  
Kristian Borg

AbstractLong standing non-malignant pain leads to a variety of limitations which can be assessed by means of the self-assessment questionnaire Functional Barometer. It is designed to assess the extent and limitations in function, activity and decreased quality-of-life and is adapted to the International Classification of Functioning and Health.AimTo investigate the outcome and differences in age, gender and origin of pain in patients with longstanding non-malignant pain regarding the subjective experience of functional-, activity- and quality-of-life limitations.Method300 patients with a median duration of pain of 49 months referred to a Pain Management Centre filled out the Functional Barometer questionnaire, adapted to the International Classification of Functioning and Health.Results66% patients were women and 34% were men. Seventy-five percent were in working age, 18-64 years. The duration before being referred to a pain specialist was over 4 years and 65% reported pain from more than three origins. Significant differences in functioning, activity and quality-of-life were found in comparing gender, age and origin of pain. Men more often reported physiological limitations while women more often reported psychological limitations of functioning, activity and quality-of-life. The most important were that men more often had difficulties in walking and climbing stairs, while women reported problems with concentration, stress and psychological demands, family relations and contact with friends.ConclusionThe significant differences regarding functioning, activity and quality-of-life between women and men as age and origin of pain must be taken into account when tailoring individual treatment and rehabilitation programmes.


Author(s):  
Ansam Barakat ◽  
Matthijs Blankers ◽  
Jurgen E Cornelis ◽  
Nick M Lommerse ◽  
Aartjan T F Beekman ◽  
...  

Abstract Background This study evaluated whether providing intensive home treatment (IHT) to patients experiencing a psychiatric crisis has more effect on self-efficacy when compared to care as usual (CAU). Self-efficacy is a psychological concept closely related to one of the aims of IHT. Additionally, differential effects on self-efficacy among patients with different mental disorders and associations between self-efficacy and symptomatic recovery or quality of life were examined. Methods Data stem from a Zelen double consent randomised controlled trial (RCT), which assesses the effects of IHT compared to CAU on patients who experienced a psychiatric crisis. Data were collected at baseline, 6 and 26 weeks follow-up. Self-efficacy was measured using the Mental Health Confidence Scale. The 5-dimensional EuroQol instrument and the Brief Psychiatric Rating Scale (BPRS) were used to measure quality of life and symptomatic recovery, respectively. We used linear mixed modelling to estimate the associations with self-efficacy. Results Data of 142 participants were used. Overall, no difference between IHT and CAU was found with respect to self-efficacy (B = − 0.08, SE = 0.15, p = 0.57), and self-efficacy did not change over the period of 26 weeks (B = − 0.01, SE = 0.12, t (103.95) = − 0.06, p = 0.95). However, differential effects on self-efficacy over time were found for patients with different mental disorders (F(8, 219.33) = 3.75, p < 0.001). Additionally, self-efficacy was strongly associated with symptomatic recovery (total BPRS B = − 0.10, SE = 0.02, p < 0.00) and quality of life (B = 0.14, SE = 0.01, p < 0.001). Conclusions Although self-efficacy was associated with symptomatic recovery and quality of life, IHT does not have a supplementary effect on self-efficacy when compared to CAU. This result raises the question whether, and how, crisis care could be adapted to enhance self-efficacy, keeping in mind the development of self-efficacy in depressive, bipolar, personality, and schizophrenia spectrum and other psychotic disorders. The findings should be considered with some caution. This study lacked sufficient power to test small changes in self-efficacy and some mental disorders had a small sample size. Trial registration This trial is registered at Trialregister.nl, number NL6020.


2021 ◽  
pp. 6-14
Author(s):  
О. О. Bespalova ◽  
P. F. Rybalko ◽  
A. M. Sitovskyi ◽  
T. Y. Tsjupak ◽  
I. V. Savchuk

Excessive training loads during sports cause chronic functional overload of the joints and their trauma, which reduces the quality of life of athletes, limits activity and participation, termination of sports careers, and in severe cases - disability. In sports practice, one of the most common sites of osteoarthritis is the knee joints (gonarthrosis). Gonarthrosis of the knee joint is a degenerative-dystrophic disease in which the destruction of hyaline cartilage, deformation of bone tissue and the qualitative composition of synovial fluid. A key link in the development of an individual program of rehabilitation intervention is the formulation of a rehabilitation diagnosis. The aim of the research: to determine the rehabilitation diagnosis of patients with gonarthrosis of the knee joints on the basis of the International Classification of Functioning, Restriction of Life and Health (ICF). Materials and methods: theoretical (analysis and generalization of scientific-methodical and clinical literature); clinical (analysis of medical records, communication, palpation, clinical and functional testing; physical examination); scale methods for assessing the condition of patients (Leken index, pain scale, depression scale (CES-D), assessment of quality of life according to the SF-36 questionnaire); instrumental (goniometry, manual-muscular testing). The research involved 7 veteran athletes aged 45 to 49 years with primary gonarthrosis stage II. Inclusion criteria: current athletes - men of different specializations; primary gonarthrosis of the second radiological stage according to Kellgren; duration of pain not less than 4 months; the level of pain when walking on the scale of YOUR 45 and more; age of patients older than 45 years; informational consent of patients to participate in the research. Inclusion criteria: secondary gonarthrosis of the knee joint; the presence of comorbidities; severe condition of the patient; knee surgery; planning of arthroplasty of the knee joint; intra-articular injections; lack of information consent. Rehabilitation diagnosis is the most complete reflection of the patient's current problems, which affect the level of his functioning, activity and participation, and are significant for him. It is established by all members of the multidisciplinary team, and is based on the results of comprehensive rehabilitation diagnostics. The main tool for establishing a rehabilitation diagnosis are the categories and domains of IFF. Rehabilitation diagnosis of patients with gonarthrosis: moderate structural changes in the knee joints (s750.2), episodic moderate pain (b28014.2), short-term morning stiffness (b7800.2), decreased mobility of the knee joint (b710.2), his stability (b7150.2) and support function, decrease in muscle tone (b7350.2) and strength of the quadriceps femoris (b7300.2), which limits domestic activity and prolongs it over time (d450.1); difficulties in changing body position (d410.2), moving up stairs and moving long distances (d460.3), which limits participation in active forms of recreation. Patients report poor mood, depression due to health and forced restriction of participation (b152. 1), and concerns about future careers. Conclusions. Rehabilitation care is provided to patients in several stages, one of which is the formulation of a rehabilitation diagnosis. Rehabilitation diagnosis was established, in which the current problems of patients at the level of structure and function, activity and participation, as well as contextual factors that contribute, limit or prevent the achievement of the desired level of functional independence, allow individualization of rehabilitation intervention to bring this level to the maximum possible.


2020 ◽  
pp. 174239532094520
Author(s):  
José C Araújo Filho ◽  
Luana P Rocha ◽  
Frederico CB Cavalcanti ◽  
Patrícia EM Marinho

Objective To identify which functioning, personal and environmental factors are more relevant to adults in hemodialysis treatment. Materials and methods Data was collected by semi-structured interview, recorded, transcribed in full, verified and produced by Bardin Thematic content analysis. Two independent researchers identified the relevant themes and named the thematic categories found according to the coding of the International Classification of Functioning, Disability and Health (ICF). Results Six men and three women aged between 32–65 years were interviewed, with per capita family income between 1–2.9 minimum salaries and hemodialysis treatment time between 5 to 26 years. Fifty-seven ICF categories were listed: 17 Body Functions, 9 Body Structures, 21 Activities and Participation, and 10 Environmental Factors. Health, transportation and general social support services, systems and policies; doing housework; recreation and leisure; emotional functions, temperament and personality functions; energy and drive functions; sensation of pain; and structures of the cardiovascular system, lower extremity and musculoskeletal structures related to movement were the most reported aspects by the participants. Conclusion Patients’ need for physical/emotional support from their partners, friends and health professionals, including emotional and social support, with health policies, transportation and job maintenance, in order to increase their survival and quality of life.


2017 ◽  
Vol 35 (4) ◽  
pp. 477-499 ◽  
Author(s):  
Ute Knoch ◽  
Carol A. Chapelle

Argument-based validation requires test developers and researchers to specify what is entailed in test interpretation and use. Doing so has been shown to yield advantages (Chapelle, Enright, & Jamieson, 2010), but it also requires an analysis of how the concerns of language testers can be conceptualized in the terms used to construct a validity argument. This article presents one such analysis by examining how issues associated with the rating of test takers’ linguistic performance can be included in a validity argument. Through a manual search of published language testing research, we gathered examples of research studies investigating the quality of rating processes and products. We then analyzed them in terms of how the research could be framed within a validity argument. Drawing on Kane’s (2001, 2006, 2013) conceptualization of inferences, warrants, and assumptions, we show that the relevance of research about the rating of test performances extends beyond one or two inferences about rater reliability. Such research results, for example, provide backing for assumptions about the correspondence of the rating scale to the test construct (explanation inference) and the context of extrapolation as well as the decisions made based on the ratings and their consequences. Our analysis reveals a picture of the extensive reach of the rating process into many aspects of test score meaning as well as concrete suggestions for integrating rating issues into future argument-based validation studies.


2014 ◽  
Vol 28 (1) ◽  
pp. 2-23 ◽  
Author(s):  
Allison R. Fleming ◽  
Michael J. Leahy

Researchers and policy makers have proposed that quality of life (QOL) is an important and useful way to measure the impact of services, although practical application of QOL in rehabilitation has been limited. In this study, a comprehensive framework (the International Classification of Functioning [ICF]) is used to compare the relationship between QOL and function in key life areas in a sample of adults with disabilities receiving vocational services (n = 224). Results of a multiple regression analysis indicated that level of education, duration of disability, difficulty with social relationships and inclusion, the impact of the disability or health condition on the person or his or her family, and relational support and attitudes of family, friends, and acquaintances showed significant relationships with QOL. This study highlights the role of the social impact of disability on QOL and provides support for the use of the ICF for conceptualizing disability and its impact in a way that is inclusive of personal and environmental factors.


2020 ◽  
Vol 10 (1) ◽  
pp. 5-9
Author(s):  
R. R. Ahunova ◽  
G. R. Ahunova

Ankylosing spondylitis is a chronic, gradually progressive inflammatory disease characterized by lesions of the sacroiliac joints and / or spine, which can occur with simultaneous lesions of the enthesis and peripheral joints, leading to early disability and a decrease in the quality of life of patients, mainly young age. The international society for evaluation of spondylarthritis (ASAS) recommended a combination of nonpharmacological and pharmacological methods in the treatment and rehabilitation of patients with ankylosing spondylitis for the longest possible preservation of the quality of life of patients, which requires a multidisciplinary therapeutic approach.Currently, in many European countries, the international classification of functioning, disability and health (IСF) is used as a universal approach to the assessment of human health. The IСF classifies the different areas of each patient’s life that are health-related and affect health, thus describing changes in their physical functioning and psychological well-being. It helps to introduce multidisciplinary, patient-centered, problem-oriented rehabilitation care into the real work of clinics.The IСF shows a broader and more meaningful picture of the patient’s health, which allows the multidisciplinary team to consider the patient from different perspectives — biological, personal and social. Using the IСF in the process of complex therapy and rehabilitation of patients with ankylosing spondylitis, a multidisciplinary team can achieve a more complete coherence of views in the treatment of patients with ankylosing spondylitis, which is very important in achieving the success of therapy of this category of patients.


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