Occupational Therapy Department and the Centre for Allied Health Research, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Clin Rheumatol. 2013 Mar;32(3):383-9. doi: 10.1007/s10067-012-2130-1. Epub 2013 Jan 15.
The objective of this study was to determine whether the International Classification of Functioning, Disability and Health (ICF) and an associated core set are adequate to describe multidisciplinary clinical assessments of patients with chronic musculoskeletal conditions. The multidisciplinary assessment (medical, psychiatry, nursing, physiotherapy, occupational therapy and psychology) of a patient with chronic low back pain (LBP) was audio-recorded, transcribed and qualitatively examined. Concepts were extracted by two raters using a meaning condensation procedure and linked to the ICF. Descriptive analyses were used to examine the adequacy of the ICF and selection of categories contained in the comprehensive LBP core set. Overall, 1,228 concepts were extracted from the 5 h of assessment data. This included 1,056 (86.0 %) concepts that could be linked to the ICF, 366 (34.7 %) of which were designated as personal factors. Eighty different second-level ICF categories were represented in the multidisciplinary assessment. This included 48 of the 78 (61.5 %) comprehensive LBP core set categories and 32 non-core set categories. In addition, 32 of the 80 assessed categories were considered by three or more disciplines during their assessment. The ICF was found to adequately cover the concepts extracted from this patient's assessment. This study demonstrates that clinical assessments of chronic musculoskeletal conditions can be mapped to the overall ICF framework by applying the ICF linking rules. However, it also questions the content validity and clinical utility of the current comprehensive LBP core set and highlights the need for further research prior to widespread application of the tool in clinical practice.
本研究旨在确定《国际功能、残疾和健康分类》(ICF)及其相关核心组是否足以描述慢性肌肉骨骼疾病患者的多学科临床评估。对一名慢性下背痛(LBP)患者进行了多学科评估(医学、精神病学、护理、物理治疗、职业治疗和心理学),对其进行了录音、转录和定性检查。两名评估员使用意义浓缩程序提取概念,并将其与 ICF 联系起来。使用描述性分析来检查 ICF 的充分性和综合 LBP 核心组中包含的类别的选择。总体而言,从 5 小时的评估数据中提取了 1228 个概念。这包括 1056 个(86.0%)可以与 ICF 联系起来的概念,其中 366 个(34.7%)被指定为个人因素。在多学科评估中,有 80 个不同的二级 ICF 类别。这包括综合 LBP 核心组的 78 个类别中的 48 个(61.5%)和 32 个非核心组类别。此外,在评估过程中,有 3 个或更多学科评估了 32 个评估类别。发现 ICF 充分涵盖了从该患者评估中提取的概念。这项研究表明,通过应用 ICF 链接规则,可以将慢性肌肉骨骼疾病的临床评估映射到整体 ICF 框架。然而,它也质疑了当前综合 LBP 核心组的内容有效性和临床实用性,并强调了在该工具广泛应用于临床实践之前需要进一步研究。