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Introduction to ICF-based Documentation Tools and Rehab-Cycle

The Rehab-Cycle®

To facilitate the use of the ICF in clinical practice, it is essential to have ICF-based tools that could be integrated into the existing processes. In the rehabilitation setting, ICF-based tools can be employed in rehabilitation management - the multidisciplinary team can use them to comprehensively describe the functioning of persons experiencing or likely to experience disability, to guide the planning of functioning-oriented rehabilitation services and evaluate changes in the functioning status over a certain time period.

Rehabilitation management can be characterized with a problem-solving approach. One such approach based on the ICF is the rehabilitation cycle, called Rehab-Cycle®. The Rehab-Cycle® can facilitate the structuring, organization and documentation of the rehabilitation process, as well as help the professionals involved in a patient's rehabilitation with coordinating their actions. This iterative process includes four key elements: 1) assessment, 2) assignment, 3) intervention and 4) evaluation.

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The ICF Assessment Sheet

The ICF Assessment Sheet provides a comprehensive overview of the person’s functioning state by presenting the assessment results in all the components of functioning, environmental and personal factors with input from both the health professional and the person (patient). The ICF Assessment Sheet can help the rehabilitation team to understand the person's functioning and to identify the needs to be addressed in rehabilitation.

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The ICF Categorical Profile

The ICF Categorical Profile is a visual depiction of a person's functioning status at the time of assessment showing the qualifier values for selected ICF categories considered relevant to a individual patient's case. It can facilitate the identification of intervention targets that are related to shared goals, serving as the central source of information for the rehabilitation team for intervention planning.

Completing the ICF Categorical Profile requires the rehabilitation team, with input from the patient, to state long and short-term goals, link these goals with the ICF categories that should be targeted for intervention, and identify for each category the qualifier value that should be achieved after intervention. The ICF Categorical Profile is generally set-up using a suitable ICF Core Set. If no ICF Core Set exists for the respective health condition, the ICF Categorical Profile should include the ICF categories that are essential for comprehensively describing the health status of the person at the time of assessment.

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The ICF Intervention Table

Information from the ICF Categorical Profile can be used to complete the ICF Intervention Table.

The ICF Intervention Table can facilitate the coordination of interventions, roles and resources within a multidisciplinary team. It provides a comprehensive overview of all the intervention targets (as represented by ICF categories), the interventions themselves and the corresponding rehabilitation professional(s) who is (are) assigned to address each intervention target. It also shows the initial ICF qualifier rating of the intervention targets, the goal value i.e. the ICF qualifier expected to be achieved after intervention, and the end or final value i.e. the ICF qualifier rating at a second assessment or evaluation. Logically, the end value is entered in the table after completion of intervention.

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The ICF Evaluation Display

The ICF Evaluation Display is based on the ICF Categorical Profile. In comparison to the ICF Categorical Profile, the ICF Evaluation Display includes only the ICF categories that were defined as intervention targets i.e. those categories that were related to a specific goal (global goal, service-program goal and/or cycle goal). The ICF Evaluation Display is also enlarged to include a visual depiction of the person's functioning status at the time of the second assessment or 'evaluation' and a column indicating goal achievement. It provides a picture of the change between functioning status before and after intervention. It is important to note however that this “before-after” picture of change does not necessarily signify that the change is due to the intervention itself, but only that there was a change.

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