Rauch Alexandra, Kirchberger Inge, Stucki Gerold, Cieza Alarcos
Swiss Paraplegic Research (SPF), Nottwil, Switzerland; ICF Research Branch of the WHO CC FIC (DIMDI) at SPF Nottwil, Switzerland.
Physiother Res Int. 2009 Dec;14(4):242-59. doi: 10.1002/pri.448.
The 'Comprehensive ICF Core Set for obstructive pulmonary diseases' (OPD) is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with OPD. To optimize a multidisciplinary and patient-oriented approach in pulmonary rehabilitation, in which physiotherapy plays an important role, the ICF offers a standardized language and understanding of functioning. For it to be a useful tool for physiotherapists in rehabilitation of patients with OPD, the objective of this study was to validate this Comprehensive ICF Core Set for OPD from the perspective of physiotherapists.
A three-round survey based on the Delphi technique of physiotherapists who are experienced in the treatment of OPD asked about the problems, resources and aspects of environment of patients with OPD that physiotherapists treat in clinical practice (physiotherapy intervention categories). Responses were linked to the ICF and compared with the existing Comprehensive ICF Core Set for OPD.
Fifty-one physiotherapists from 18 countries named 904 single terms that were linked to 124 ICF categories, 9 personal factors and 16 'not classified' concepts. The identified ICF categories were mainly third-level categories compared with mainly second-level categories of the Comprehensive ICF Core Set for OPD. Seventy of the ICF categories, all personal factors and 15 'not classified' concepts gained more than 75% agreement among the physiotherapists. Of these ICF categories, 55 (78.5%) were covered by the Comprehensive ICF Core Set for OPD.
The validity of the Comprehensive ICF Core Set for OPD was largely supported by the physiotherapists. Nevertheless, ICF categories that were not covered, personal factors and not classified terms offer opportunities towards the final ICF Core Set for OPD and further research to strengthen physiotherapists' perspective in pulmonary rehabilitation.
“慢性阻塞性肺疾病综合ICF核心组合”（OPD）是《国际功能、残疾和健康分类》（ICF）的一种应用，代表了慢性阻塞性肺疾病患者功能问题的典型范围。为了优化以多学科和患者为导向的肺康复方法（其中物理治疗起着重要作用），ICF提供了一种关于功能的标准化语言和理解。为使其成为物理治疗师在慢性阻塞性肺疾病患者康复中有用的工具，本研究的目的是从物理治疗师的角度验证该慢性阻塞性肺疾病综合ICF核心组合。
基于德尔菲技术，对有慢性阻塞性肺疾病治疗经验的物理治疗师进行三轮调查，询问他们在临床实践中治疗慢性阻塞性肺疾病患者时所涉及的问题、资源和环境方面（物理治疗干预类别）。将回答与ICF相关联，并与现有的慢性阻塞性肺疾病综合ICF核心组合进行比较。
来自18个国家的51名物理治疗师列出了904个单一术语，这些术语与124个ICF类别、9个个人因素和16个“未分类”概念相关。与慢性阻塞性肺疾病综合ICF核心组合主要为二级类别相比，所确定的ICF类别主要为三级类别。70个ICF类别、所有个人因素和15个“未分类”概念在物理治疗师中获得了超过75%的共识。在这些ICF类别中，55个（78.5%）被慢性阻塞性肺疾病综合ICF核心组合所涵盖。
物理治疗师在很大程度上支持慢性阻塞性肺疾病综合ICF核心组合的有效性。然而，未涵盖的ICF类别、个人因素和未分类术语为最终确定慢性阻塞性肺疾病ICF核心组合以及进一步加强物理治疗师在肺康复方面的观点的研究提供了机会。
