ICF and Rehab-Cycle
In 2001, the International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly. Since then, all member states have been asked to implement the ICF in different fields as a statistical, research, social policy, clinical and educational tool.
To use ICF in clinical practice, ICF-based tools must be developed and integrated into rehabilitation processes. ICF Core Sets were the first approach to providing ICF-based tools in clinical practice and research. An ICF Core Set was developed to guide health professionals through rehabilitation management in clinical practice and scientists in the research of functioning and disability. This approach is an ongoing and worldwide process that will result in more and more ICF Core Sets in the future.
Besides ICF Core Sets, other ICF-based tools such as the assessment sheet, a categorical profile and evaluation display, facilitate the understanding and description of functioning in a multidisciplinary rehabilitation process and hence support ICF-based rehabilitation management. Multidisciplinary rehabilitation management is based on structured processes, of which the Rehab-Cycle, with its four steps of Assessment, Assignment, Intervention and Evaluation, is just one approach.
Spinal Cord Injury (SCI)
One chronic health condition in which patients experience a variety of functional problems is Spinal Cord Injury (SCI). People of all ages and all health levels, from extraordinary fitness to severe illness, can be struck by SCI. Persons suffering from SCI have limitations in many areas of functioning depending on the level and severity of the disease and, most importantly, the impact of environmental and personal factors.
As a result, a comprehensive understanding of functioning in SCI is the basis for comprehensive and multidisciplinary rehabilitation. To provide such an understanding, the development of an ICF Core Set for SCI was started in 2005 and the first version was finished by September 2007.
Case studies
To illustrate the use of ICF-based tools in a chronic condition like SCI, Swiss Paraplegic Research performed a series of case studies with the nearby Swiss Paraplegic Centre, a rehabilitation centre well-known in Europe and beyond. Swiss Paraplegic Research aims to contribute to optimal functioning, social integration, health and quality of life for people with SCI through clinical and community-oriented research.
One approach is the Case Study Project, which began in October 2006. In this project, patients of different age and gender, suffering from SCI for many reasons and at varying levels of severity, are accompanied during their rehabilitation. The rehabilitation process is then described using the ICF tools. All cases will be published on this website to demonstrate the use of the ICF in clinical practice and the structured rehabilitation management based on the Rehab-Cycle.
Since patients with SCI and the involved health professionals are faced with a number of physical, psychological and social challenges, the case studies aim to cover a broad spectrum of these.
Content of the Case studies
Each case study covers a specific theme of rehabilitation in SCI. A general introduction to each specific theme comes at the beginning of each study and provides general information. However, a more important approach of the case studies is to highlight the individual’s experience of functioning following SCI in each specific case. To gather this information, all voluntary participating patients were interviewed at both the beginning and end of each observation period.
In each case study, rehabilitation management is illustrated within the structured process based on the Rehab-Cycle. A specific ICF tool is used in each step of the Rehab-Cycle.
Information given in the Case studies (Text and boxes)
A case study includes the basic text containing a general introduction and the description of the rehabilitation management. To provide additional information, boxes offer the opportunity to find more detailed information about certain themes. Therefore, the reader will find appropriate links in the text.
Educational approach of the Case studies (questions and multiple choice)
To check what was learned after reading each paper, the reader may answer questions at the end of each text. Another option for a self-administered test is the multiple choice exercise in the ‘quiz’ page.
Aims of the Case studies
- To Illustrate the use of ICF tools in structured rehabilitation management based on the Rehab-Cycle
- To demonstrate problems and resources of patients with SCI
- To demonstrate the perspective of individuals suffering from SCI
- To improve the knowledge of the reader, offering learning tools through quizzes and self-administered testing
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