Centre for Augmentative and Alternative Communication, Faculty of Humanities, University of Pretoria, South Africa.
Am J Audiol. 2022 Dec 5;31(4):1116-1132. doi: 10.1044/2022_AJA-21-00269. Epub 2022 Aug 31.
Falling is a multifactorial condition that can cause severe injury and even death in older adults. Early identification of fall risk factors, as the first step of preventive health care, can assist in reducing the negative and often debilitating effects of falls in older adults. By using the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to develop an ICF code set to identify fall risk factors in older adults, health care practitioners could obtain health information in a multidimensional way.
This study describes the final phase of a comprehensive, three-phase, mixed-methods sequential study. For this third phase, a pre-post group design that focused on the audiologist's perceptions of the clinical utility of a newly developed ICF code set was employed. The questionnaire that was used for this purpose consisted of two distinct sections: clinical application and clinical utility (viz., appropriateness, accessibility, practicability, acceptability, and professional utility). Thirty practicing audiologists participated in the study. Data were analyzed for each of the two sections of the questionnaire.
Results related to clinical application indicated that regardless of the audiologists' experience in routine fall risk assessment or fall risk factor identification, the use of the developed ICF code set increased their ability to correctly identify relevant clinical aspects. Results related to clinical utility showed high scores across all five measure components, with the highest clinical utility component being acceptability, closely followed by appropriateness and professional utility, and the lowest being accessibility.
Several clinical implications have emerged from this study, including the usefulness of the ICF code set to identify and document fall risk factors in older adults, the code set's ability to guide audiologists to determine individualized assessment needs either by themselves or by other health care disciplines, and that the code set could be used by audiologists regardless of their experience in vestibular assessments.
跌倒 是一种多因素导致的状况，可能会导致老年人严重受伤甚至死亡。早期识别跌倒风险因素作为预防保健的第一步，可以帮助减少老年人跌倒的负面影响，降低其致残率。利用世界卫生组织的国际功能、残疾和健康分类（ICF）框架来制定一个识别老年人跌倒风险因素的 ICF 编码集，使医疗保健工作者能够以多维的方式获取健康信息。
本研究描述了一个全面的、三阶段、混合方法顺序研究的最后阶段。在第三阶段，采用了预-后组设计，重点关注听力学家对新开发的 ICF 编码集的临床实用性的看法。为此目的而使用的问卷由两个不同的部分组成：临床应用和临床实用性（即适当性、可及性、可行性、可接受性和专业实用性）。30 名执业听力学家参与了这项研究。对问卷的两个部分都进行了数据分析。
与临床应用相关的结果表明，无论听力学家在常规跌倒风险评估或跌倒风险因素识别方面的经验如何，使用新开发的 ICF 编码集都能提高他们正确识别相关临床方面的能力。与临床实用性相关的结果显示，所有五个衡量指标的得分都很高，其中临床实用性得分最高的是可接受性，其次是适当性和专业实用性，得分最低的是可及性。
从这项研究中得出了几个临床意义，包括 ICF 编码集在识别和记录老年人跌倒风险因素方面的有用性，该编码集能够指导听力学家确定个性化的评估需求，无论是由他们自己还是由其他医疗保健学科来确定，以及听力学家无论其在前庭评估方面的经验如何，都可以使用该编码集。
