Slide
1 International
Classification of Functioning, Disability and
Health (ICF)
Teaching Points Exercises
Nenad
Kostanjsek
Department of Measurement and Health Information
Systems
World Health Organization
www.who.int/classification/icf
Slide
2 1. Exercise:
"Disability definitions and ICF Model"
Disability
definition No.1
"Any case of blindness,
deafness and muteness, deafness
(only), loss of arm, leg or both,
deformity of right / left hand /
foot and full paralysis is known
as disability."
Iran, Census 1986 |
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Teaching Points:
- narrow (physical)
impairment based focus
- No info on, health
condition, EF; implicit severity info.
- Not ICF compatible
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Slide
3 1. Exercise:
"Disability definitions and ICF Model"
Disability
definition No.2
"Disability refers to
the physical or organic handicap
of a person due to natural deformity
or deficient functioning of any
limb resulting from accident, disease,
etc. It includes blind, deaf and
dumb, crippled mentally retarded
and insane."
Pakistan, Census
1981 |
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Teaching Points:
- impairment based focus
- info. on cause (underlying
health condition), no info on severity,
time, EF
- Not ICF compatible
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Slide
4 1. Exercise:
"Disability definitions and ICF Model"
Disability
definition No.3
"Totally blind, totally
deaf and /or dumb persons and persons
with a disability in one or more
legs or arms were regarded as physically
disabled."
Sri Lanka, Census
1981 |
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Teaching Points:
- narrow (physical)
impairment based focus
- Explicit & exclusive
severity threshold; no info. on cause,
time, EF
- Not ICF compatible
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Slide
5 1. Exercise:
"Disability definitions and ICF Model"
Disability
definition No. 4
"A restriction or lack
(resulting from an impairment)
of ability to perform an
activity in the manner or
within the range considered normal
for a human being. It describes
a functional limitation or activity
restriction caused by impairment,
Disabilities are description of
disturbances in functioning at the
level of the person. Examples of
disabilities are difficulties
in seeing, speaking, moving, climbing
stairs, grasping, reaching, bathing
eating and toileting."
West Bank & Gaza,
Census 1996 |
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Teaching points:
- Focus on activity
limitations
- Generic statement
on ability combined with some A/P items;
Explicit causality between impairment
and activity limitation; no info. on
health condition cause, time, EF
- Not ICF compatible
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Slide
6 1. Exercise:
"Disability definitions and ICF Model"
Disability
Filter questions, No.1
"Does any of the household
members have a health problem
or a disability that limits
his/her capabilities? If
yes, what kind of disability does
(name) have?
Mental, hearing, vision,
movement, speech, total disability
(all the above), others."
Palestine, Census
1997 |
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Teaching points:
- Impairment focus with
generic capacity notion
- General question
on presence of health condition and
disability combined with impairment
checklist; no info. on time, EF
- Not ICF compatible
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Slide
7 1. Exercise:
"Disability definitions and ICF Model"
Disability
Filter questions No. 2
"Is there any member of
this family who is disabled? If
yes, what is the type of disability?
Physical disability, disabled
in seeing, disabled in hearing,
mental disability, multiple disability,
other disability, chronic disease."
Jordan, Census 1997
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Teaching points:
- Impairment focus
- General question
on presence of disabled person combined
with impairment and chronic disease
items; no info on cause, time, EF
- Not ICF compatible
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Slide
8 1. Exercise: "Disability definitions
and ICF Model"
Disability
Filter questions No. 3
Does anyone in your household
ever have any difficulty in doing
day to day activities because
of a physical, mental or emotional
(or other health) condition?
Has this difficulty lasted,
or is it expected to last 6 months
or more ?
If YES to 1.1 and 1.2, how
would you describe your difficulty?
Does anyone in your household
need assistance to do day
to day activities?
Namibia & Zimbabwe
National Disability Survey, 2003 |
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Teaching points:
- Generic activity limitation
focus with performance notion
- General question
on presence of person in the household
with difficulties in doing day to activities;
causal link underlying health condition,
information on time, severity (implicit)
and environmental factors (EF)
- ICF compatible
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Slide
9
1. Exercise: "Disability definitions and
ICF Model"
Disability
Filter questions, No.4
"Does anyone in your
household have any difficulty
hearing, seeing, communicating,
walking, climbing stairs, bending,
learning or doing any similar activities?
This person could be yourself, or
a child or an adult of any age who
is living in your household.
Does a physical condition
or mental health condition
or health problem reduce the amount
or the kind of activity you, or
anyone in your household, can do:
At home?
At work or at school?
In other activities, for
example transportation or leisure?
Ireland, National
Pilot Survey of PWDs, 2003
Canada Participation and Activity
Limitation Survey (PALS), 2001 |
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Teaching points:
- Specific activity
and participation focus
- Question on presence
of person in the household with difficulties
in specific activities and participation
categories; causal link with underlying
health condition, no information on
time, severity and environmental factors
(EF)
- ICF compatible
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Slide
10 3. Exercise:
"Case Example Mr. Wong" p
Task1:
Mr. Wong: diabetes patient for many years,
underwent surgery where his left limb was
amputated. He is been given a disability certificate
states that as a result of bodily impairments
(loss of limb in left leg (s 750) he
is 40% disabled. The public health insurance
rejected (e 580) his claim for provision
of prosthesis (e 120), instead he is given
crutches (e 120). After weeks at home
Mr Wong is eager to start working again as
shop keeper in his small food store. With
crutches he can walk (d 465) to his workplace
but he has difficulties to carry out
some of his work (d 850) related task.
In particular he has difficulties carrying
(d 430) items and climbing(d 455) the
narrow and small steps within his shop. Thanks
to the financial support from his brother
(e 310) he can afford to buy a prostheses,
which allows him to perform all his work related
task which were difficult for him while using
crutches.
Slide
11 3. Exercise:
"Case Example Mr. Wong"
Teaching Points:
Task2:
- Impairment based decision
with an arbitrary scale
- Focus on scale rather
than need
- Short term utility rather
then long tern utility for person & society
Task 3:
- Need for mobility technology
and return to work is only partially met in
the given work environment.
- Exposure to risk
Task 4:
- Shows different impact
of different EF factors (crutches vs. prosthesis)
and setting
- Comparison of cost-effectiveness
of different EF interventions what input you
get how much output
- Need for comprehensive
coverage of components, appropriate domains
and incl. EF
Slide
12 4. Exercise:
"Disability Survey Gondoland"p
Teaching Points:
Task 1:
- Data not useful because:
- High variation of prevalence
rate
- Lack of common framework
- No standard approach
Task 2:
- Clarify purpose of assistance
programme
- Identify baseline population
before
- Possible categories
- BF: vision
- A/P: mobility,
employment
- EF: technology
& personal assistance
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