scholarly journals Content Comparison of Long-Term Care Instruments Based On The International Classification of Functioning, Disability And Health (ICF)

Author(s):  
Yan Gao ◽  
Jingpu Zhao ◽  
Xiangxiang Liu ◽  
Xiaohua Xie ◽  
Yulong Wang

Abstract Background: Aging crisis is proposing a huge challenge to the whole Chinese social welfare system, however a national Long-term Care (LTC) Instrument has not established yet. The objective of this study was to analyze and compare the content of six selected LTCs based on the linkage of the International Classification of Functioning, Disability and Health (ICF), so as to provide insights for the development of Chinese national LTC instrument in the future. Methods: Two trained health professionals performed the linkage according to the refined ICF linking rules. The main concepts included in the items of three international LTC instruments, namely Minimum Data Set 3.0 (MDS 3.0), Initial Assessment Instrument(IAI), and New Assessment Tool for Determining Dependency on Nursing Care (NBA), as well as three Chinese instruments, namely Disability Assessment of Long-Term Care (DA-LTC), Specification for Elderly Care Unified Need Assessment in Shanghai Version 2.0 (SEC-UNA 2.0), and pictorial-based Longshi Scale (LS) were selected and linked to the ICF categories. The six selected LTC instruments were analyzed and compared at the levels of ICF components, chapters, and categories. Results: The main concepts of 340 valid items of the six LTC instruments were linked to 112 different ICF categories. Within the ICF framework, the “Activities and Participation” component was most frequently addressed in the LTC instruments followed by the “Body functions” component, and the percentages were 0.52 and 0.38, respectively. At the ICF chapters level, “b1 mental functions,” “d4 mobility,” and “d5 self-care” were the core of the LTC instruments. In addition, the contents of the six selected LTC instruments differed greatly. Conclusions: The ICF provides a useful external reference for the analysis and comparison of different LTC instruments. The findings suggest that key elements to determine eligibility for LTC in China need to be further identified. It is anticipated that this study will provide new insights for the development of Chinese national LTC instruments.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Franziska Zúñiga ◽  
Magdalena Osinska ◽  
Franziska Zuniga

Abstract Quality indicators (QIs) are used internationally to measure, compare and improve quality in residential long-term care. Public reporting of such indicators allows transparency and motivates local quality improvement initiatives. However, little is known about the quality of QIs. In a systematic literature review, we assessed which countries publicly report health-related QIs, whether stakeholders were involved in their development and the evidence concerning their validity and reliability. Most information was found in grey literature, with nine countries (USA, Canada, Australia, New Zealand and five countries in Europe) publicly reporting a total of 66 QIs in areas like mobility, falls, pressure ulcers, continence, pain, weight loss, and physical restraint. While USA, Canada and New Zealand work with QIs from the Resident Assessment Instrument – Minimal Data Set (RAI-MDS), the other countries developed their own QIs. All countries involved stakeholders in some phase of the QI development. However, we only found reports from Canada and Australia on both, the criteria judged (e.g. relevance, influenceability), and the results of structured stakeholder surveys. Interrater reliability was measured for some RAI QIs and for those used in Germany, showing overall good Kappa values (>0.6) except for QIs concerning mobility, falls and urinary tract infection. Validity measures were only found for RAI QIs and were mostly moderate. Although a number of QIs are publicly reported and used for comparison and policy decisions, available evidence is still limited. We need broader and accessible evidence for a responsible use of QIs in public reporting.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Matthias Hoben ◽  
Abigail Heninger ◽  
Jayna Holroyd-Leduc ◽  
Jennifer Knopp-Sihota ◽  
Carole Estabrooks ◽  
...  

Abstract Background The main objective is to better understand the prevalence of depressive symptoms, in long-term care (LTC) residents with or without cognitive impairment across Western Canada. Secondary objectives are to examine comorbidities and other factors associated with of depressive symptoms, and treatments used in LTC. Methods 11,445 residents across a random sample of 91 LTC facilities, from 09/2014 to 05/2015, were stratified by owner-operator model (private for-profit, public or voluntary not-for-profit), size (small: < 80 beds, medium: 80–120 beds, large > 120 beds), location (Calgary and Edmonton Health Zones, Alberta; Fraser and Interior Health Regions, British Columbia; Winnipeg Health Region, Manitoba). Random intercept generalized linear mixed models with depressive symptoms as the dependent variable, cognitive impairment as primary independent variable, and resident, care unit and facility characteristics as covariates were used. Resident variables came from the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) 2.0 records (the RAI-MDS version routinely collected in Western Canadian LTC). Care unit and facility variables came from surveys completed with care unit or facility managers. Results Depressive symptoms affects 27.1% of all LTC residents and 23.3% of LTC resident have both, depressive symptoms and cognitive impairment. Hypertension, urinary and fecal incontinence were the most common comorbidities. Cognitive impairment increases the risk for depressive symptoms (adjusted odds ratio 1.65 [95% confidence interval 1.43; 1.90]). Pain, anxiety and pulmonary disorders were also significantly associated with depressive symptoms. Pharmacologic therapies were commonly used in those with depressive symptoms, however there was minimal use of non-pharmacologic management. Conclusions Depressive symptoms are common in LTC residents –particularly in those with cognitive impairment. Depressive symptoms are an important target for clinical intervention and further research to reduce the burden of these illnesses.


2011 ◽  
Vol 8 (1) ◽  
pp. 31-44 ◽  
Author(s):  
Kethakie Sumathipala ◽  
Eloise Radcliffe ◽  
Euan Sadler ◽  
Charles DA Wolfe ◽  
Christopher McKevitt

2017 ◽  
Vol 11 ◽  
pp. 117955651771503 ◽  
Author(s):  
Niels Ove Illum ◽  
Kim Oren Gradel

Aim: To help parents assess disability in their own children using World Health Organization (WHO) International Classification of Functioning, Disability and Health, Child and Youth Version (ICF-CY) code qualifier scoring and to assess the validity and reliability of the data sets obtained. Method: Parents of 162 children with spina bifida, spinal muscular atrophy, muscular disorders, cerebral palsy, visual impairment, hearing impairment, mental disability, or disability following brain tumours performed scoring for 26 body functions qualifiers (b codes) and activities and participation qualifiers (d codes). Scoring was repeated after 6 months. Psychometric and Rasch data analysis was undertaken. Results: The initial and repeated data had Cronbach α of 0.96 and 0.97, respectively. Inter-code correlation was 0.54 (range: 0.23-0.91) and 0.76 (range: 0.20-0.92). The corrected code-total correlations were 0.72 (range: 0.49-0.83) and 0.75 (range: 0.50-0.87). When repeated, the ICF-CY code qualifier scoring showed a correlation R of 0.90. Rasch analysis of the selected ICF-CY code data demonstrated a mean measure of 0.00 and 0.00, respectively. Code qualifier infit mean square (MNSQ) had a mean of 1.01 and 1.00. The mean corresponding outfit MNSQ was 1.05 and 1.01. The ICF-CY code τ thresholds and category measures were continuous when assessed and reassessed by parents. Participating children had a mean of 56 codes scores (range: 26-130) before and a mean of 55.9 scores (range: 25-125) after repeat. Corresponding measures were −1.10 (range: −5.31 to 5.25) and −1.11 (range: −5.42 to 5.36), respectively. Based on measures obtained at the 2 occasions, the correlation coefficient R was 0.84. The child code map showed coherence of ICF-CY codes at each level. There was continuity in covering the range across disabilities. And, first and foremost, the distribution of codes reflexed a true continuity in disability with codes for motor functions activated first, then codes for cognitive functions, and, finally, codes for more complex functions. Conclusions: Parents can assess their own children in a valid and reliable way, and if the WHO ICF-CY second-level code data set is functioning in a clinically sound way, it can be employed as a tool for identifying the severity of disabilities and for monitoring changes in those disabilities over time. The ICF-CY codes selected in this study might be one cornerstone in forming a national or even international generic set of ICF-CY codes for the benefit of children with disabilities, their parents, and caregivers and for the whole community supporting with children with disabilities on a daily and perpetual basis.


Pflege ◽  
2007 ◽  
Vol 20 (4) ◽  
pp. 205-210 ◽  
Author(s):  
Elisabeth Rappold

In diesem Artikel wird die im Auftrag des Dachverbands Wiener Sozialeinrichtungen, durchgeführte Analyse von ausgewählten Assessmentinstrumenten für die Hauskrankenpflege beschrieben. Standardisiertes Vorgehen zur Erhebung der Pflegebedürftigkeit gewinnt in der Gesundheits- und Krankenpflege an Bedeutung. Zahlreiche Assessmentinstrumente bieten dafür einen Rahmen. Für den Auftraggeber waren das SMAF (le Système de Mesure de l’Autonomie Fonctionnelle), das RAI HC 2.0 (Resident Assessment Instrument – Home Care) und die ICF (International Classification of Functioning, Disability and Health) von besonderem Interesse und wurden analysiert. Besonderes Augenmerk wurde auf die grundlegenden Bestandteile der Instrumente, die Erfahrungen mit der praktischen Anwendung sowie auf wissenschaftliche Befunde gelegt. Das Resultat dieser Arbeit zeigt, dass die Verbreitung im deutschsprachigen Raum sowie die wissenschaftlichen Untersuchungen unterschiedlich weit fortgeschritten sind und noch ein breites Betätigungsfeld bieten.


2016 ◽  
Vol 32 (3) ◽  
pp. 152-159 ◽  
Author(s):  
Anne B Halk ◽  
Robert J Damstra

Introduction Lipedema is a chronic, progressive condition that can result in considerable disability. In 2011, the Dutch Society of Dermatology and Venereology organized a task force to create guidelines on lipedema, using the International Classification of Functioning, Disability and Health of the World Health Organization. Guideline development Clinical questions on significant issues in lipedema care were proposed, involving (1) making the diagnosis of lipedema; (2) clinimetric measurements for early detection and adequate follow-up; and (3) treatment. A systematic review of literature published up to June 2013 was conducted. Based on available evidence and experience of the task force, answers were formed and recommendations were stated. The guidelines define criteria to make a medical diagnosis of lipedema, a minimum data set of (repeated) clinical measurements that should be used to ensure early detection and an individually outlined follow-up plan, pillars on which conservative treatment should be based and recommendations on surgical treatment options. Conclusions Little consistent information concerning either diagnostics or therapy can be found in the literature. It is likely that lipedema is frequently misdiagnosed or wrongly diagnosed as only an aesthetic problem and therefore under- or mis-treated. Treatment is divided into conservative and chirurgic treatment. The only available technique to correct the abnormal adipose tissue is surgery. Recommendations To ensure early detection and an individually outlined follow-up, the committee advises the use of a minimum data set of (repeated) measurements of waist circumference, circumference of involved limbs, body mass index and scoring of the level of daily practice and psychosocial distress. Promotion of a healthy lifestyle with individually adjusted weight control measures, graded activity training programs, edema reduction, and other supportive measures are pillars of conservative therapy. Tumescent liposuction is the treatment of choice for patients with a suitable health profile and/or inadequate response to conservative and supportive measures.


2016 ◽  
Vol 59 (6) ◽  
pp. 1533-1542 ◽  
Author(s):  
Tammy Hopper ◽  
Susan E. Slaughter ◽  
Bill Hodgetts ◽  
Amberley Ostevik ◽  
Carla Ickert

Purpose The study aims were (a) to explore the relationship between hearing loss and cognitive-communication performance of individuals with dementia, and (b) to determine if hearing loss is accurately identified by long-term care (LTC) staff. The research questions were (a) What is the effect of amplification on cognitive-communication test performance of LTC residents with early- to middle-stage dementia and mild-to-moderate hearing loss? and (b) What is the relationship between measured hearing ability and hearing ability recorded by staff using the Resident Assessment Instrument–Minimum Data Set 2.0 (RAI-MDS; Hirdes et al., 1999)? Method Thirty-one residents from 5 long-term care facilities participated in this quasiexperimental crossover study. Residents participated in cognitive-communication testing with and without amplification. RAI-MDS ratings of participants' hearing were compared to audiological assessment results. Results Participants' speech intelligibility index scores significantly improved with amplification; however, participants did not demonstrate significant improvement in cognitive-communication test scores with amplification. A significant correlation was found between participants' average pure-tone thresholds and RAI-MDS ratings of hearing, yet misclassification of hearing loss occurred for 44% of participants. Conclusions Measuring short-term improvement of performance-based cognitive communication may not be the most effective means of assessing amplification for individuals with dementia. Hearing screenings and staff education remain necessary to promote hearing health for LTC residents.


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